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.
413/664 page 393
![in the failure of the heart's action from chloroform or other cardiac paralysers—the subcutaneous use of sulphate of atropia, in doses varying from the hundredth to the fortieth of a grain, is the appropriate and most hopeful means of resuscitation.' Harley also stated that after a dose of atropine ' no difference will be observed in the state of the respiration . . . the breathing will be as tranquil as before the injection '. In his third lecture Harley dealt with the combined effects of opium and belladonna : ' There are ', he said, ' a number of persons who accept the general statement . . . that belladonna is antagonistic to opium and vice versa, and they would not hesitate in a case of poisoning by either of these drugs to give at once an equally poisonous dose of the other as an antidote. . . . Feeling that the whole question required more patient and careful examination I have devoted much time during the past year to its elucidation. My observa- tions have been made upon the horse and dog, and upon man. ' In turning to the consideration of the combined operation of opium and belladonna in man, I must first concede that bella- donna possesses an antagonistic influence to some of the earlier effects of the operation of opium. The first effect of opium, in many animals as well [as] in many of humankind, is a derange- ment of the vagus nerve, resulting in nausea and retching, faint- ness, and depression of the heart's action. ... In my own practice, I have had four or five patients in whom the subcutan- eous use of seven drops of laudanum or of one-twelfth of a grain of acetate of morphia, has produced faintness, nausea, ending in vomiting and retching, with intervals of delirious somnolency for eight or nine hours. By repeated experiments upon these individuals I have found that the previous or simultaneous use of a small dose (one-ninety-sixth of a grain) of sulphate of atropia entirely prevents these distressing and often alarming symptoms. . . . It is by virtue of its powerful stimulant effect upon the sympathetic nervous system, that the derangement of the vagus nerve, causing the above mentioned symptoms, is overpowered. This is a most important fact ; for by the help of atropia, we may, I believe, bring all individuals alike under the beneficial influence of opium. The only question of antagonism that now remains, is that which might be supposed to result from this same stimulant effect of belladonna upon the heart ; and it may be asked, would not this action alone be sufficient to arouse a patient in whom the pulse and respiration were well nigh obliterated by the effect of opium ? ' I answer, inasmuch as belladonna has no stimulant action upon the vagus nerve, and therefore no influence upon respiration, 13*](https://iiif.wellcomecollection.org/image/b20457200_0417.jp2/full/800%2C/0/default.jpg)
