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.
395/664 page 375
![Chapter XIII ' MIXED ANAESTHESIA ' AND PREMEDICATION Bernard's ' Mixed Anaesthesia '—The Development of Pre-Anaesthetic Medication and of Basal Anaesthesia Bernard's ' Mixed Anaesthesia ' PRE-ANAESTHETIC medication, the administration of a sedative drug or combination of drugs an appreciable time before the administration of the principal anaesthetic in order, by calming the patient mentally and physically, to lower his resistance to anaesthesia and obviate as far as possible post- operative shock, is to-day a generally accepted routine pro- cedure, even for the ambulatory patient. During the first half-century of anaesthetic practice this was by no means the case although before that period, sedation with wine 1 or opiates commonly played an important part in the preparation of the patient for the operative ordeal and sedatives were also given post-operatively. An important early reference to pre-operative sedation occurs in Georg Wolfgang Wedel's monograph on opium, Opiologia (Jena, 1682).2 Wedel stated that 'opium in a moderate draught' might be given ' to the patient on the night preceding the operation [amputation], for thus he bears the burning and cutting of the limb with a readier spirit, and various [unpleasant] symptoms will be averted '.3 1 As late as 1874, J. T. Clover stated : ' I like to give a teaspoonful of brandy, without water, a few minutes beforehand [i.e. before chloroform], but not so much as a tablespoonful. If wine be given or if the patient must have some water in the brandy, then they should be given half-an-hour before inhaling, to allow time for absorption.' {Brit. med. J., 1874, i, 202.) In England, at this particular time, some such procedure as Clover described was the only kind of premedication attempted. 2 Although pre- and post-operative sedation with opium was frequently em- ployed, the giving of opium to procure surgical anaesthesia, although recognized as a possible procedure, was condemned as unsafe by reputable surgeons. Wedel himself stressed this point and quoted various authorities upholding it ; e.g. Fal- lopius : ' If soporifics are weak , he said, they will not help ; if they are strong they are exceedingly dangerous'. (Wedel, G. W, 1682. Opiologia. Jena. 130.) 3 Wedel, G. W. 1682. Opiologia, ad mentem academiae naturae curiosorum. Jena. 129-30.](https://iiif.wellcomecollection.org/image/b20457200_0399.jp2/full/800%2C/0/default.jpg)
