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
In the few cases in which epileptic convulsions are occasioned by
chloroform, they do not appear till the third degree of narcotism is
induced, in this respect differing from hysteria, which comes on in the
second degree, or even earlier, as was stated above. The course to
pursue, when epileptic convulsions appear, is to continue the chloroform
steadily and gently, till they subside. I have never seen the chloroform
fail to subdue the convulsions in a very few minutes, and I have never
seen them recur after the operation, as the effects of the vapour
subsided. In medical and obstetric practice, and for slight operations,
it is not requisite to carry the effects of chloroform so far as that
stage in which an epileptic fit would occur, so that under these
circumstances the fact of a patient being subject to epilepsy hardly
requires to be taken into account.
_Pregnancy._ I have repeatedly given chloroform at all periods of
pregnancy, both for tooth-drawing and more important operations, and I
have not met with any ill effects from it in any of the cases.
_The Menstrual Period._ It is customary to avoid the menstrual period in
fixing the time for a surgical operation, when it can be so arranged.
There are, however, often reasons for not waiting over this period, and
under such circumstances, I do not know any objection to the inhalation
of chloroform. I have administered it frequently during the menstrual
period, and have seen no ill effects from it. I have observed that there
is a little more tendency to slight hysterical symptoms, during its
inhalation at this period, than when the same patients inhale it at
other times, which is what we might expect.
_Diseases of the Lungs._ Affections of the lungs sometimes cause a
little difficulty and delay in the administration of chloroform, as the
vapour is liable to excite coughing when the mucous membrane of the
air-passages is irritable. The inconvenience is, however, confined to
the time of inhalation, for the cough is generally relieved afterwards.
I have given chloroform for surgical operations in many cases where
phthisis was present, and in several patients who had suffered from
hæmoptysis, and have not seen any ill effects from its use in these
cases. Chloroform has indeed often been inhaled with advantage to
relieve the cough in consumption. The cases of chronic bronchitis in
which chloroform is administered for surgical operations are still more
numerous. The effects I have observed have been coughing at the time of
inhalation, and very often a relief of the cough afterwards. Some of the
patients had emphysema of the lungs. It is scarcely necessary to allude,
in this place, to acute diseases of the lungs, as surgical operations
are not performed during their continuance, but from the fact of
chloroform being inhaled occasionally in the treatment of these
affections, it is evident that they would cause no obstacle to its
employment.
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