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.

396/664 page 376

$Cheselden, about 1731, recommended that a 'quieting draught ' should be given where violent pain was present after lithotomy.1 In 1820, John Hennen, Deputy Inspector of Military Hospitals, wrote : ' About his person each medical man, of course, carries a pocket case of instruments ; and I would strenuously recommend that he never omits a canteen of good wine, or spirits diluted. Many men sink beyond recovery for want of a timely cordial before, during, and after operations ; and many of the primary operations would be rendered much more favourable in their results, by the administration of a single glass of wine.' 2 On page 116 of the same treatise Hennen wrote : ' The after management of compound fractures is a most serious duty, requiring industry, judgment, and humanity, as well as great discrimination in both the medical and surgical treatment. . . . Anodynes [i.e. opium in some form or other, cf. ibid. p. 199] are urgently called for in these cases, and are best combined with antimonials, to obviate their heating and constipating effects.' When the use of ether anaesthesia was generally adopted,, late in 1846, the idea that it might be desirable or even necessary to put the patient to some degree under the influence of a sedative drug (itself capable of producing full anaesthesia if given in sufficient quantity) as a preparation for inhalation anaesthesia, did not occur to medical men. Had it done so it would undoubtedly have been rejected as being dangerous. Among anaesthetic concepts that of premedication was extremely slow in growth and slower still in becoming widely accepted, even after a few anaesthetists had stressed its advantages. By 1846 post-operative medication had fallen into disuse. It was again mentioned early in 1863, in the Lancet, as a new pro- cedure in amputation used by Paget, of St. Bartholomew's Hospital. The annotation was headed ' Subcutaneous injection of morphia[3] 1 Douglas, J. 1731- Cheselden''s method of performing the lateral operation for stone. London. 35. 2 Hennen, J. 1820. Principles of military surgery. Edinburgh. 27. 3 Morphine, isolated by Serturner about 1806 (Journal der Pharmacie fiir Aerzte und Apotheker (und Chimisten). Leipzig. 1806, 14, 47), was substituted for opium as an anodyne, by Magendie about 1820. Magendie prescribed it by mouth, but the ' inoculation of morphine ' by dipping the point of a lancet in an aqueous solution and inserting it for a few seconds ' horizontally about one line in depth beneath the epidermis 'was proposed by Lafargue, of Saint-fimilion, in 1836. (Bull. Acad. Med., Paris, 1836, I, 13.) The prototype of the modern hypodermic syringe seems to have been an instru-$