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.
378/664 page 358
![typical example [of the new method] I will describe M. Labbe's first operation : ' The operation was the removal of an ingrowing nail and nail-bed, the patient an extremely nervous girl of twenty. We entered the large sheet iron chamber of Dr. Daupley's [aero- therapeutic] establishment and the atmospheric pressure was, in the course of a few minutes, gradually increased by 17 cm. (total pressure 92 cm.). The patient lay down on a mattress and M. Preterre applied the valved facepiece, which he was in the habit of using for the inhalation of pure nitrous oxide, the bag of the apparatus being filled with a mixture containing 85 per cent, nitrous oxide and 15 per cent, oxygen. I was holding the patient's wrist, the pulse being rapid, when suddenly, without any warning change in the pulse rate, in the respiration or the colour of the skin or the expression of the face and without any stiffening, struggling or excitement, about ten to fifteen seconds after the first inspiration of the anaesthetic gas, I felt the arm become com- pletely limp. Both insensibility and muscular relaxation were established and the cornea itself could be freely touched. The operation began and the bandaging followed without a single movement on the part of the patient, who slept calmly. The pulse rate had returned to normal. At the end of four minutes, just as M. Labbe finished the bandaging, a slight contracture occurred in one arm, then in one leg. Everything being over, the facepiece was removed, whereupon the contractures ceased. For thirty seconds the girl continued to sleep ; then, someone having tapped her on the shoulder, she woke and looked at us with a surprised air. . . . ' On the way back to hospital Bert added, ' she complained so bitterly of being hungry that we had to stop and get her something to eat.' Bert also referred to sixteen operations performed by Pean, at Dr. Fontaine's therapeutic establishment. These included three excisions of the breast, four operations on the bones, six extirpations of tumours, a nerve resection, and two reductions of three- and four-day-old dislocations of the shoulder. The duration of anaesthesia varied from four to twenty-six minutes. In Bert's opinion the most frequent complication—and one which might appear quite serious—arising during this type of anaesthesia was contracture of the limbs. This, he thought, was due to insufficient tension of the gas and in order to remedy it, all that was necessary was to increase the pressure by two or three centimetres. As a general rule the total increase in pressure varied between 15 and 22 centimetres.](https://iiif.wellcomecollection.org/image/b20457200_0382.jp2/full/800%2C/0/default.jpg)
