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.
386/664 page 366
![with a mixture containing eight grams of chloroform vaporized in 100 litres of air. ' When the proportion [of chloroform] was reduced to 7, the ■• sleep was less profound Bert stated. ' It seemed to me pointless to try a higher dose [than 8 grams].' 1 Bert's method was adversely criticized by Gosselin and by Richet. Gosselin chiefly condemned Saint-Martin's gasometer as being ' cumbersome, very heavy and difficult, if not impossible, to transport '. He contrasted its use with the method, ' so simple and so safe for those who thoroughly understand how to use it, which almost all of us employ—a compress or a hand- kerchief on to which one pours, little by little, the necessary doses of the anaesthetic agent. ' Moreover, in my opinion ', said Gosselin, ' M. Bert's meas- ured mixture might, on occasions, very well have detrimental effects on certain patients. The danger of chloroform lies in the susceptibility of the individual. Some go to sleep very quickly and may be deeply anaesthetized by doses which in others induce anaesthesia more slowly and gently. To avoid accidents arising from the exceptional cases of idiosyncrasy, chloroform must be given intermittently, in increasing doses, so as to accustom the body to it gradually. . . . ' What, in my eyes, makes the new procedure inferior to the usual practice, is that it delivers from the outset a uniform dose, which I find too strong for the initial inspirations ; with it one cannot (by beginning with a small dose and gradually increasing it) establish that tolerance which should be sought above all and which is found very quickly in sensitive subjects, more slowly in resistant subjects. M. P. Bert may, it is true, have met with surgeons who administer too great a quantity of chloroform, but they are very rare to-day. ' On the other hand, for those who persistently give too much chloroform at a time and for all those who, in the future, will have to familiarise themselves with the subject, M. P.Bert's procedure will have the advantage of demonstrating far better than we have been able to do up to the present, and in a thoroughly scientific way, how small a quantity of chloroform is necessary for anaesthesia. So far, in this respect, we have approximations only. But while we advocate progressive doses and while we think that, according to the patient, either more or less chloroform must be introduced into the circulation to induce and maintain](https://iiif.wellcomecollection.org/image/b20457200_0390.jp2/full/800%2C/0/default.jpg)
