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.
435/664 page 415
![tightly to the face and again very soon (within two minutes) a further 30 c.c. of ether was shaken into the mask. The rim of the mask was then overlaid with a towel to prevent, as far as possible, the dilution of the vapour with air. For the events which followed, Grossmann quoted Garre's own words, taken from his book Die Aethernarkose (Tubingen, 1893) : ' With the first inspirations of ether the respiratory rhythm becomes accelerated and shallow. This is apparently a reflex action caused by the irritant effect of the vapour on the nose. Only a few patients are able to tolerate the vapour without opposition and breathe regularly and deeply. Often the inhal- ation of ether vapour provokes coughing but this is soon over. In the excitement stage the breathing is very much disturbed, now quick and regular, then suddenly interrupted through powerful spasm of the respiratory muscles. The patient becomes cyanotic and struggles violently and there is tonic spasm in the muscles of the extremities. This state of affairs can seem very alarming, but it will pass without our interference. ... In other cases respiratory movements are so shallow that they can only be followed with difficulty. With the onset of muscular relaxation breathing becomes deep and, often, stertorous. If, as is frequently the case in protracted anaesthesia, there is now a large quantity of mucus collected in the pharynx, this may be churned up by the inspired mixture itself, into fine snow-white froth. When this happens the breathing takes on an extremely unpleasant rattling tone. This indicates no danger to the patient, however. But were this chloroform narcosis such wheezing and apparently distressed breathing would create the most painful impression. ' ' The painful , distressing and indeed alarming impressions which the first case of ether anaesthesia with Julliard's mask that I saw at Tubingen, made upon me Grossmann admitted, ' were so strong that I allowed the idea of trying ether myself, in a few cases, to drop. The impression was still fresh when, in March of this year [1893] I visited Dr. L. Landau's Clinic, in Berlin, and had the pleasure of learning how to administer ether by another method. ' What worlds apart the two methods are. Here was no trace of the state of affairs described above—the cyanosis, the froth on the lips, the stertorous breathing, the tracheal rattle (or if there was the least suspicion of them it was an indication that technique was faulty). . . . ' During June and July, through the kindness of Dr. Landau, to whom I offer my sincere thanks, I, acting as a house surgeon,](https://iiif.wellcomecollection.org/image/b20457200_0439.jp2/full/800%2C/0/default.jpg)
