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.
400/664 page 380
![produced is long drawn out as a result of the influence of the morphine, but by giving the morphine first . . . scarcely is the inhalation of chloroform interrupted before sensibility returns. Thus one has a rapid means alternately to suspend and re- establish sensibility and this is important in certain cases. . . . In giving an injection of morphine first and then administering chloroform a much smaller quantity of the latter is needed. In this way one obtains anaesthesia without so pronounced a stage of excitement and above all without running so great a risk of accident as one does with large and repeated doses of chloroform '—advantages which, Bernard suggested, ought to recommend the method to surgeons. These researches on the combined use of morphine and chloroform formed part of a series of lectures on anaesthetics and asphyxia which Bernard delivered to students at the College de France during 1869 and 1870 ; they were published, as two lectures, during 1869 in the Revue des corns scientifiques.1 From 1869 onwards a few French surgeons, most of whom, as students, had witnessed Bernard's demonstrations of what he termed ' mixed anaesthesia ', applied the method ' both in operating and during childbirth '. In 1875 Bernard stated that such practical applications were still infrequent ; nevertheless his recommendation of mixed anaesthesia exerted an increasing influence, although for more than a decade this was noticeable only on the European Continent and especially in France. Guibert, of Saint-Brieuc (who had attended Bernard's lectures at the College de France), about 1870, was among the first to test the combined action of morphine and chloroform clinically. ' I obtained ', he wrote, ' two distinct states . . . 1. analgesia, 2. anaesthesia '. It was with the analgesic state that Guibert chiefly concerned himself. ' 1. Analgesia.—In the patient who has had a hypodermic injection of from 1 to 2 centigrams [1/6-1/2 grain] of hydrochlor- ide of morphine, the initial effect of an ordinary chloroform inhalation is to produce an analgesic state. Consciousness and voluntary movement are retained but this state is sufficient very noticeably to blunt sensibility to pain during parturition and in minor surgery. ' 2. Anaesthesia.—When sufficient chloroform is uninter- ruptedly inhaled a state of anaesthetic sleep is achieved, with the muscular relaxation which is essential for major surgery. . . . 1 Bernard, C. 1875. Lemons sur les anesthesiques et sur Vasphyxie. Paris. 234.](https://iiif.wellcomecollection.org/image/b20457200_0404.jp2/full/800%2C/0/default.jpg)
