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.
385/664 page 365
![the action depends upon the tension [of the drug] in the inspired air, which regulates the proportion existing in the blood and tissues' (cf Snow's conclusions, pp. 188-91, 217). In order to put this principle into practice and so bring ' to the use of every anaesthetic the same security as nitrous oxide under pressure gives ', Bert advised abandoning the use of compresses and ' all the complicated apparatuses, based on the erroneous principle of quantitative administration, upon which surgeons and instrument makers have exercised their imagina- tion '. He suggested instead, the use ' simply of a tube, a small facepiece and a suitably proportioned mixture of air and anaesthetic agent. There is no need ', he added, ' to bother about the pulse or the respiration, and the temperature scarcely varies. The only things which are not thus avoided are the intrinsic inconveniences of the agent itself, the excitement of the induction period and subsequent nausea and vomiting. ' Measured mixtures have already been used, a few years ago, in my laboratory by two of my pupils ', Bert said, ' and M. Grehant, indeed, preceded them in this course. Snow in England and Lallemand, Perrin and Duroy [x] in France, have also made some reference to this subject. I think that the new researches on the zone maniable ought to determine surgeons to try the application of this method to man.' 2 When in 1883 Bert returned to the subject of measured anaesthetic mixtures he read a paper (before the section of physiology of the Academie des Sciences) dealing with the reactions of dogs to variously proportioned mixtures of chloro- form and air. These mixtures were delivered from a double gasometer, designed by Saint-Martin in the previous year, to which an inhaling mask was attached. At the close of the paper Bert strongly recommended the clinical use of such mixtures ' which would have the advantage of regulating administration—the success of which now depends entirely upon the skill of the surgeon—according to precise rules '.3 Early in 1884 Bert read a second paper on the subject of measured mixtures and was able to refer to twenty-two cases, from Pean's department at the Hopital Saint-Louis, in which patients had been successfully anaesthetized from Saint-Martin's apparatus 1 Lallemand, L., Perrin, M., and Duroy, J. L. P. i860. Du role de Valcool et des anesthe'siques dans Vorganisme. Paris. 354-8. 2 C.R. Acad. Sci.,'Paris, 1881, 93, 768-71. 3 Ibid. 1883, 9^, 1831-3.](https://iiif.wellcomecollection.org/image/b20457200_0389.jp2/full/800%2C/0/default.jpg)
