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.
420/664 page 400
![keep the patient in a state of anaesthesia in prolonged operations. There is nothing to show that atropine does any good in con- nexion with the administration of chloroform, and it may do a very great deal of harm '. Nevertheless in 1891 G. Cockburn Smith was ' surprised to find that no one made any remarks at the Bournemouth meeting of the B.M.A. about the use of atropine, with a view to annul the dangers attending upon the administration of chloroform -v1 In a letter to the Lancet he wrote : ' For a long time, especially in France, atropine has been employed more particularly as an adjunct to morphia, when the latter is needed to relieve pain, etc., and Dr. Brown-Sequard [see pp. 391-2] pointed out that the nausea and vomiting that sometimes attend the hypodermic use of morphia may be done away with by the addition of atropine to the solution. So we have for years had a fair indication of the applicability of atropine and morphia as a means of lessening risk attending upon the administration of chloroform. Wishing to satisfy myself of the action of hyoscine on the pneumogastric, I came to the Continent to avoid the anti-vivisection laws and since being here the extreme kindness of the surgeons has enabled me to satisfy myself that the dangers of ether and chloroform can be greatly, if not entirely, removed by the injection of one centigramme of hydrochlorate of morphia and one milligramme of sulphate of atropia some twenty- five minutes previously to their administration in adults. Much less of the anaesthetic is needed to produce anaesthesia, and the danger from its toxic effects is avoided. There is often no stage of excitement perceptible, salivary secretion is checked [2], an important point in ether inhalation, as swallowing and vomiting do not occur, but above all, the temporary suppression of the inhibitory action of the vagus over the heart removes the risk of its reflex arrest. Dr. Aubert, to whom is greatly due the credit of having practically introduced the mixed method of inducing anaesthesia, says that the atropine as it is given beneath the skin, does not affect the pupil. In several of my cases, however, I have noticed a marked dilatation. . . . For my part, I have found that by administering nitrous oxide gas immediately before the ether, either after Clover's method or that of Brain, the patient having been previously prepared as above described (the atropine and morphia injection), the most rapid surgical anaesthesia can 1 Lancet, 1891, ii, 843. 2 Ebstein, of Berlin, used atropine clinically in 1873 to arrest salivation in a case of hemiplegia. Subsequently he carried out experiments on the subcutaneous injection of atropine to check salivation (Practitioner, 1873, 11,461). In the following year, 1874, Rossbach, of Wiirzburg, wrote a paper on the subject. (Verh. phys.-med. Ges. Wiirzburg, 1874, 7, 20 ; cf. p. 392, footnote.)](https://iiif.wellcomecollection.org/image/b20457200_0424.jp2/full/800%2C/0/default.jpg)
