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.
417/664 page 397
![suggestion, been used with success in clinical practice before the close of 1880, the method was very far from being in general use either in Scotland or England. For this two good reasons can be found : Fraser's fellow Scots, as a body, had such faith in chloroform that they considered it needed neither atropine nor morphine as an adjuvant, while the English, at this particular time, held chloroform to be so dangerous that they preferred to discard it almost entirely in favour of ether. In France, J. A. F. Dastre, in collaboration with another physiologist, Morat, had also been working since about 1878 on the blocking of the vagus nerves by atropine before chloro- form anaesthesia. The steps leading up to the clinical method which he proposed were described by Dastre in 1883 : ' Vulpian ', he wrote, ' has shown f1] . . . that excitation of the vagus nerves arrests the heart more easily in the anaesthetized animal. ... It is also known that atropine diminishes the excitability of the vagi. ' From the first of these facts one may conclude that cardiac syncope—of such frequent occurrence in chloroform anaesthesia —will be averted if one removes the influence of the vagus nerves upon the heart. Experiments confirm this conclusion. We have in fact observed that dogs anaesthetized after section of the vagi do not present these fatal syncopes. . . . The second of these facts shows that the injection of atropine is a procedure equivalent to section of the vagi. Hence the idea of preparing an animal for chloroform anaesthesia by an injection of atropine. We have succeeded by this method in carrying out prolonged operations on dogs without accident and without the constraint of a tiring and often ineffectual vigilance. . . . The primary arrest of respiration is not an accident in the true sense of the word ; because it occurs only when the anaesthetic has been suddenly pushed or unduly prolonged. It is in fact a toxic effect. . . . ' After the preliminary experiments we proposed our present method to other investigators. The method consists in preparing the subject to be anaesthetized with an injection of 6 to 10 centi- grams of morphine combined with 3 to 5 milligrams of atropine. The morphine, we reasoned, will prevent the period of excitement and prolong anaesthesia (advantages pointed out by Claude Bernard). The atropine, in addition to its safeguarding effect, will remove the drawbacks of morphine—particularly that of nausea. It is up to the surgeons, we added, to test this method and judge the results. What seems to us to be established, in physiological experiments, is that the method removes the 1 C.R. Acad. Sci., Paris, 1878, 86, 1303.](https://iiif.wellcomecollection.org/image/b20457200_0421.jp2/full/800%2C/0/default.jpg)
