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
The face-piece, to include both the mouth and nostrils, of which that
shown in the engraving is one of the modifications, is one of the
greatest mechanical aids to the process of inhalation which has been
contrived in modern times. Dr. Francis Sibson is its inventor. Dr.
Hawkesley did indeed contrive a very similar one about the same time as
Dr. Sibson,—early in 1847,—but he did not make it known. Dr. Ingen Housz
made patients inhale oxygen through the nostrils by means of a bottle of
India rubber with the bottom cut off; and Mr. Waugh, of Regent Street,
had more recently contrived a mouth-piece to be adapted outside the
lips, but the usual practice of inhalation previous to 1847, was for the
patient to draw in the medicated air by means of a tube placed in the
mouth. This led generally to great awkwardness at first, as the patient
usually began to puff as if he were smoking a pipe; and it had the
further inconvenience, in the administration of ether, that the tube
dropped from the mouth, and the patient began to breathe by the
nostrils, just as he was getting unconscious. The sides of the
face-piece delineated in the engraving are made of thin sheet lead,
which is pliable, and enables it to be adapted exactly to the
inequalities of the face, and the patient can breathe either by the
nostrils or mouth, just as his will, or instinct, or other nervous
functions, determine.
I have introduced two valves into this face-piece, one which rises on
inspiration, to admit the air and vapour from the inhaler, and closes
again on expiration, and the other which rises to allow the expired air
to escape. I contrived the latter valve to turn more or less to one
side, as indicated by the additional line in the engraving, and thus
admit more or less of the external air to dilute still further that
which has passed through the inhaler, and become charged with vapour. By
this means the patient can begin by breathing air containing very little
vapour, and more and more of the air which has passed over the moistened
bibulous paper can be admitted, as the air-passages become blunted to
the pungency of the vapour.
The object of the water-bath is to supply the caloric which is rendered
latent, and carried off, as the chloroform is converted into vapour, and
thus to render the process of inhalation steady and uniform. Without the
water-bath, the evaporation of the chloroform would soon reduce the
temperature of the inhaler below the freezing point of water, and limit
very much the amount of vapour the patient would inhale; and if the
apparatus were warmed by the hand, the temperature would be too high,
and the amount of vapour too great. A medical author of great reputation
in Paris sent to inquire at what temperature I used the water-bath, and
being informed, at the ordinary temperature, published his opinion that
it had no effect, and might as well be left off. He appeared not to have
considered the relations of heat, either to liquids or vapours.
Public-domain text, read in full here on John Shaqi.
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