On chloroform and other anæsthetics: their action and administrationSnow, John
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On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
In the first degree, I include all the effects of chloroform that exist
while the patient retains a perfect consciousness of where he is, and
what is occurring around him. This degree constitutes all that a person
remembers of the effects of the vapour, except when he happens to dream,
and recollect it afterwards. The sensations caused by inhaling
chloroform are usually agreeable, when it is taken merely for curiosity;
and individuals who have inhaled nitrous oxide at some previous time of
their lives, often describe their feelings as being very much the same
from both agents. Patients who are about to undergo a surgical operation
are, however, not always in a state for receiving agreeable impressions,
and they sometimes complain of palpitation of the heart, and a feeling
of fulness in the head. There is generally a sense of dizziness, with
singing in the ears and tingling in the limbs. Many persons have a
feeling like that of rapid travelling, and as an appearance of darkness
sometimes comes on from the failure of the sight, whilst there is also a
loud noise in the ears, it not unfrequently happens that a person feels
as if he were entering a railway tunnel, just when he is becoming
unconscious.
Those persons whose mental faculties are most cultivated appear usually
to retain their consciousness longest whilst inhaling chloroform; and,
on the other hand, certain navigators and other labourers, whom one
occasionally meets with in the hospital, having the smallest possible
amount of intelligence, often lose their consciousness, and get into a
riotous drunken condition, almost as soon as they have begun to inhale.
There is a widely different class of persons who also yield up their
consciousness very readily, and get very soon into a dreaming condition
when inhaling chloroform. I allude to hysterical females.
There is often a considerable diminution of the common sensibility
during the first degree of narcotism by chloroform, more especially when
it is inhaled very slowly, so that the patient is kept some minutes
partially under its influence. In this way neuralgia can often be
relieved, without removing the consciousness, when it is not extremely
severe, and the suffering of labour may often be removed in the same
manner, when the pains are not very sharp. In a few cases, the
extraction of a tooth and other minor operations have been performed
without pain, whilst consciousness has been retained; but as a general
rule, it is better not to operate under these circumstances, for failure
is more likely than success; and this plan does not succeed in any case
without inhaling longer, and consuming more chloroform, than would be
necessary in the usual way. The complete recovery of the patient from
the effects of the vapour, after a protracted inhalation of this kind,
is also more tardy.
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