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.
509/664 page 489
![and the Charybdis of excitement on the other. He will find, after a time, that he is able to detect even slight deviations from the proper course, almost before such deviations have taken place. ' Generally speaking . . . the best results will be obtained by starting the inhalation . . . with from 2 to 4 per cent, of oxygen, and then progressively increasing this proportion to 8 or 9 per cent. It seems to me ', he added, ' that it is a mistake to adopt the plan which is customary in Germany f1], and to begin with as much as 10 per cent, of oxygen. . . . If a 10 per cent, mixture be used from the commencement, excitement is liable to ensue from the undue proportion of oxygen. Witzel, for example, who follows this course in his administrations, finds it necessary to employ arm-rings, foot-straps, and other appliances to restrain the patient's movements, and to have at hand, on all occasions, strong and trained assistants. Such precautions are unnecessary when the method here advocated is followed.' 2 In 1898, in a paper read at a meeting of the Society of Anaesthetists, Alfred Coleman revived an idea which both he and J. T. Clover had put into practice thirty years earlier, namely, the administration of nitrous oxide through the nose (cf. p. 285, footnote) ' with the object of prolonging unconscious- ness during operations on the mouth '. Without referring to the earlier experiments with nitrous oxide given nasally Coleman said : ' I had long found that by forcing air mixed with ether into the nostrils after the removal of the face-piece [he did not explain how he did this, but cf. p. 604] when gas had been administered, some prolongation of the anaesthesia was obtained, but the slight delay in changing the apparatus, combined also with interference with the operator, were drawbacks to its employment. To avoid these I have constructed the apparatus now before you [see Fig- I33]- ^ consists of a nose-piece made to loosely cover the nose and fit accurately to its base, and which is connected with a very flat tube also adapted to fit accurately over the forehead. To the latter is attached a piece of stout rubber tubing having at its further extremity a very lightly constructed two-way stopcock which is connected with the ordinary gas-bag, but between the two is placed a valve which opens towards the nose. The gas- bag is connected by a long tube to the gas-bottle. When using the apparatus it is well, as Dr. Hewitt, who has very kindly 1 The plan was originally introduced in Germany by Adolph Witzel, of Essen, who was a disciple of Hillischer's. 2 Hewitt, F. W. 1897. The administration of nitrous oxide and oxygen for dental operations. London. 48-50. 16*](https://iiif.wellcomecollection.org/image/b20457200_0513.jp2/full/800%2C/0/default.jpg)
