The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum].

Duncum, Barbara M.

Date:: 1947

Credit: The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum]. Source: Wellcome Collection.

361/664 page 341

$Ophthalmic Hospital, stated that ether was extensively used there (cf. p. 335). (iii) It was feared that the newly reunited ends of fractured bones might become deranged during the turbulent recovery period which frequently followed ether anaesthesia. (iv) The custom of maintaining an analgesic rather than an anaesthetic state during normal labour was firmly established (cf. p. 193), and for this chloroform was found to be admirably suited. It was administered in small intermittent doses so that the danger of an overdose causing cardiac syncope (unless through gross carelessness) was held to be negligible. The occurrence of ventricular fibrillations (see pp. 452-4) was not yet envisaged nor was the danger of serious damage to the liver generally appreciated. (v) Very young children were found to take chloroform more readily than ether. Nineteenth century beliefs in this connection were summarized in 1901 by F. W. Hewitt as follows : ' The upper air-passages of infants and very young children are so sensitive that ether often causes some irritation and respiratory difficulty. This has led many to prefer chloroform which is certainly inhaled with comparative ease by children. It is a mistake, however, to suppose that children are not so susceptible as adults to the toxic effects of this agent, and that with them fatalities are practically unknown. It is true that children inhale chloroform freely, and that they are not as prone as adults to certain forms of respiratory embarrassment. It is certain also that children may be rescued from conditions of respiratory and circulatory depression which in adults would be attended by more immediate risk to life.' 1 More than thirty years earlier, in 1867, Giraldes, a member of the Societe de Chirurgie, in Paris, had said during a discussion on chloroform : '. . . I wish to protest against the immunity [from accidents due to chloroform] which people are disposed to attribute to childhood. That immunity does not exist.' 2 (vi) Before it became customary to premedicate patients with atropine before ether anaesthesia the increase in mucous 1 Hewitt, F. W. 1901 (2nd ed.). Anaesthetics and their administration. London, 116. 2 Bull. Soc. Chirurgie Paris, 1867, 6, 314.$