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
The practice I have always followed has been to try to calm the patient,
by the assurance that there was nothing to apprehend from the
chloroform, and that it would be sure to prevent all pain; but where it
has been impossible to remove the fears of the patient in this way, I
have always proceeded to remove them by causing a state of
unconsciousness. It would of course be wrong to choose a moment for
beginning the inhalation, when fear was producing a very marked
depression of the circulation. On feeling the pulse of a gentleman,
about twenty-one years of age, in March 1855, who had just seated
himself in the chair to take chloroform, previous to having some teeth
extracted, by Mr. Thos. A. Rogers, I found it to be small, weak, and
intermitting, and it became more feeble as I was feeling it. I told the
patient that he would feel no pain, and that he had nothing whatever to
apprehend. His pulse immediately improved. He inhaled the chloroform,
had his teeth extracted, woke up, and recovered without any feeling of
depression. Now if the inhalation had been commenced in this case,
without inquiry or explanation, the syncope which seemed approaching
would probably have taken place, and it would have had the appearance of
being caused by the chloroform, although not so in reality.
MODE OF ADMINISTERING CHLOROFORM.
The experiments previously related show that air containing rather less
than two grains of chloroform, in one hundred cubic inches, is capable
of causing a state of insensibility, sufficiently deep for surgical
operations; but in a creature the size of the human being, an
inconvenient length of time would be occupied in causing insensibility
with vapour so much diluted. About four cubic inches of vapour, or
rather more than five grains of chloroform to each hundred cubic inches
of air, is the proportion which I have found most suitable in practice
for causing insensibility to surgical operations. In medical and
obstetric cases, it should be inhaled in a more diluted form.
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