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 using the inhaler described above, the patient should commence to
inhale with the expiratory valve of the face-piece turned on one side,
and it should be gradually advanced to the required extent, over the
opening it is intended to cover, as the sensibility of the lungs becomes
diminished. Not only patients with phthisis or bronchitis, but many
sensitive and irritable persons with sound lungs, have a great
intolerance of the vapour of chloroform at first, on account of its
pungency; and it is necessary to occupy two or three minutes in
gradually commencing the inhalation, before the patient makes any
appreciable progress towards insensibility. In administering chloroform
to children also, it is desirable to begin very gently; by this means,
and with a little persuasion, one generally succeeds in getting them to
inhale voluntarily; although, occasionally, it is necessary to use a
little force to accomplish one’s purpose.
In certain cases of the medicinal application of chloroform, and also in
obstetric cases, where the pains are not severe, it is unnecessary to
render the patient unconscious, but for surgical operations this is
nearly always requisite. No force should ever be employed so long as the
patient is conscious, unless it be to children or lunatics; but some
patients become excited as soon as they are unconscious, and attempt to
leave the couch, or push away the chloroform; under such circumstances,
if they cannot be calmed by what is said to them, they should be held,
and the vapour should be steadily and gently continued, for a minute or
two, till a state of quietude is produced. By far the greater number of
patients remain quiet as they become unconscious, but there is no
difficulty in ascertaining whether a patient is unconscious or not. If
the eyelids remain open, the countenance shows whether the patient is
conscious or not; and, if they are closed, it is only necessary to touch
them gently, to ascertain this circumstance. If he is still conscious,
he will look at his medical man, and probably speak, or, at all events,
show intelligence in his countenance.
Public-domain text, read in full here on John Shaqi.
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