Scientific American Supplement, No. 1157, March 5, 1898Various
Science
Scientific American Supplement, No. 1157, March 5, 1898
Various
Science -- Periodicals
On December 17, 1897, a fatality occurred during the administration of
ether. The patient, a woman aged forty-four years, who suffered from
"internal cancer," was admitted for operation into the new hospital
for women, Euston Road. It was considered that an operation would
afford a chance of the prolongation of her life. At the time of
admission the patient was in a very exhausted condition. Mrs. Keith,
the anaesthetist to the hospital, administered nitrous oxide gas,
followed by ether, which combination of anaesthetics the patient took
well. After the expiration of thirty minutes and while the operation
was in progress the patient became so collapsed that the surgeon was
requested by the anaesthetist to desist from further surgical procedure
and she at once complied. Resuscitative measures were at once applied,
but the patient died after about ten minutes from circulatory failure
arising from surgical shock and collapse. We have not received any
particulars as to the means adopted to restore the woman or whether
hemorrhage was severe. In all such cases posture, warmth and guarding
the patient from the effects of hemorrhage are undoubtedly the most
important points for attention both before and during the operation.
The fact is established that both chloroform and ether cause a fall
of body temperature, and so increase shock unless the trunk and limbs
are kept wrapped in flannel or cotton-wool. The fall of temperature
under severe abdominal and vaginal operations again is considerable. A
profound anaesthesia allows of a considerable drop in arterial tension,
which has been shown to be least when the limbs and pelvis are placed
at a higher level than the head. Again, saline transfusion of Ringer's
fluid certainly lessens the collapse in such cases when the bleeding,
always severe, has been excessive. We do not doubt that such a severe
operation undertaken when the patient was in a dangerous state of
exhaustion was as far as possible safeguarded by every precaution, and
we regret we have not been favored with the particulars of the methods
employed. A death following the administration of ether is reported
from the Corbett Hospital, Stourbridge.[1] The patient, aged
thirty-nine years, was admitted on September 21, 1897, suffering from
fracture of the right femur. A prolonged application of splints led to
a stiffness with adhesions about the knee joint which were to be dealt
with under an anaesthetic on December 8. Ether was given from a
Clover's inhaler; one ounce was used. The induction was slightly
longer than usual but was marked by no unusual phenomena. No sickness
occurred during or after anaesthesia and no respiratory spasm was seen.
There was a short struggling stage followed by true anaesthesia when
the operation, a very brief one, was rapidly performed. The patient
was then taken back to the ward and the corneal reflex was noticed as
being present. Voluntary movements were also said to have been seen.
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