The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum].
- Duncum, Barbara M.
- Date:
- 1947
Licence: In copyright
Credit: The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum]. Source: Wellcome Collection.
354/664 page 334
![Bird's f1]. Millikin's modification of Snow's instrument has been in use since 1856. All changes have been tried within the last three years. For a time, a mixture of ether, chloroform, and rectified spirits in equal parts was tried, but was discontinued on account of its being very slow in taking effect, whilst the after- effects were unsatisfactory. Clover's [chloroform] bag was tried for a few months, but was discontinued on account of the house- surgeons (there being no special chloroformist) preferring the instrument which had been so long in use, and finding the bag cumbrous. . . . Also, on students leaving the hospital, they preferred to be acquainted with an instrument which, when in the country, would be more portable and more easy of application.' 'Chloroform', he added, 'should always be administered, as it is at this hospital, in a small room adjoining the theatre, previously to the patient being brought in for operation, as he does not then become excited, and is more quickly brought under the influence. Great objection should be made to the administration of chloro- form in the wards.' 2 The Resident Medical Officer and chloroformist at Uni- versity College Hospital replied that a nitrous oxide-ether sequence, administered from Clover's apparatus, was in use for all cases except short operations (for which nitrous oxide alone was used), operations on young children, and operations in or about the mouth (for which chloroform was preferred). Ether had been in use only since the beginning of 1875, ' chloroform having been previously employed, given either on lint or by means of Mr. Clover's chloroform apparatus. The change to ether was made in deference to the generally expressed opinion of the profession that ether was much safer than chloroform. Before the introduction of Mr. Clover's [ combined ] apparatus, the inconveniences of ether, especially in unpractised hands, were much felt, and some of the surgeons always preferred chloroform ; but the efficiency of the present method, and the time saved, have produced an universal revolution of opinion in its favour '. At the Westminster Hospital chloroform was preferred for children ; Clover's apparatus was used. In other operations 1 Golding Bird's inhaler was a leather cylinder with an inspiratory valve at one end, the other being open and adapted to fit tightly over mouth and nose. As in Rendle's inhaler (see Fig. 67), a flannel bag and sponge could be inserted. Just behind the nick in the rim, accommodating the inhaler to the bridge of the nose, was an expiratory valve. Bird claimed this valve as an advantage but in fact it prevented the volume of the mask from being used as an addition to the ' physiological ' dead space. (Med. Times, Lond., 1875, ii, 281.)](https://iiif.wellcomecollection.org/image/b20457200_0358.jp2/full/800%2C/0/default.jpg)
