On chloroform and other anæsthetics: their action and administrationSnow, John
History
On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
Although the respiration may be suspended by an amount of chloroform
that has very little direct effect in the motion of the heart, it is
quite possible to stop the heart’s action by the immediate effect of
this agent. When frogs are exposed to the action of the vapour, they go
on absorbing it by the skin, after the respiratory movements have
ceased; and in this way the pulsations of the heart are arrested, when a
certain amount of chloroform has been absorbed into the blood. And when
animals of warm blood are made to breathe air containing as much as
eight or ten per cent. of the vapour of chloroform, the blood which is
passing through the lungs becomes so charged with it as to stop the
action of the heart, when it reaches that organ through the coronary
arteries. It is in this way that accidents from chloroform have
happened. The power of this agent to arrest the pulsations of the heart
can also be shewn, by blowing a stream of the vapour on its surface,
when the chest is opened immediately after the breathing has ceased, and
whilst it is still beating.
The ultimate and greatest effect that chloroform is capable of producing
on the animal body is to destroy the irritability of the muscles, and
produce the post-mortem rigidity. Either the whole body or a single limb
can be rendered instantly rigid by injecting the arteries with a little
chloroform shaken up with water. The rigidity remains for weeks in the
dead body, and would probably be permanent if the chloroform were
prevented from evaporating. Whilst it lasts, putrefaction is of course
prevented.
_Effect of Chloroform on the Pulse._ I have not mentioned the state of
the pulse in the above description of the effects of chloroform, for it
affords no criterion of the amount of narcotism, and it was better
therefore to reserve it for a separate notice. It is nearly always
increased both in force and frequency, more especially at the early part
of the inhalation. After the patient has become quite insensible, the
pulse indeed generally settles down nearly to the natural standard, and
in the middle of the most formidable operations, it is often beating
with natural volume and force, not more than sixty or seventy times a
minute. The pulse rarely becomes weaker or slower than natural under the
influence of chloroform, except from considerable loss of blood, or
where the patient is about to be sick. I have twice found the pulse as
slow as 44 in the minute at the conclusion of an operation attended with
great loss of blood. One of the cases was the removal of a large tumour
of the labium pudendi, in a woman, aged forty-five, on the 28th of
April, 1849, at King’s College Hospital, by Mr. Fergusson. The pulse
was, however, not small or weak, and there was no faintness. In a few
minutes, the patient vomited, and the pulse immediately resumed its
natural frequency.[50]
Public-domain text, read in full here on John Shaqi.
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