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.
513/664 page 493
![having been turned on to it, and choosing the end of an inspira- tion, the face-piece is removed, the nasal tube is rapidly passed (this can be done during a single expiration), the face-piece is reapplied, and the stopcock is turned so that the gas now flows through the nasal tube ; at this stage the inhalation is continued by both nasal tube and face-piece up to full anaesthesia ; the face-piece is now finally removed, the operation is begun, and narcosis is maintained by the nasal tube alone. To prevent the return of consciousness the netted bag must be kept fully distended, the gas being supplied at considerable pressure.' 1 On May 5, 1899, Paterson, who had been developing Coleman's method and apparatus for nasal nitrous oxide along independent lines, demonstrated, at a meeting of the West London Medico-Chirurgical Society, a new type of nasal cap and his own technique for administering nitrous oxide nasally, which is, essentially, that commonly used at the present time. ' The apparatus . . . [see Fig. 134] ', he said, ' consists of a small metal cover made to fit the nose accurately, with the aid of a rubber pad. The pad is detachable, so that the cover can be readily sterilised by boiling. Two small metal tubes are let into the nose-piece, and to these are attached two rubber tubes which lead to an ordinary gas bag, a twoway stop-cock intervening. In using the apparatus, the nose-piece is placed in situ, the bag being filled with gas, and the stop-cock turned on. After the patient has taken a few breaths of gas a celluloid cover is placed over the mouth. At the top of the mouth cover is an expiratory valve. The patient is now breathing gas through the nose only and expiring through the mouth. I may say that the use of the mouth cover is not absolutely necessary. Its function is twofold. It diminishes the period of inhalation necessary for the production of anaesthesia, and consequently economises gas. In about thirty seconds the mouth cover is removed and the operation proceeded with. The patient is now taking in gas through the nose, and a limited amount of air through the mouth, and there is no difficulty in maintaining anaesthesia, indeed, the stop-cock has often to be turned off occasionally in order to allow the patient to obtain more air than is admitted by the mouth. . . . ' So far as I know ', said Paterson, in conclusion, ' there is only one disadvantage with this method, and that is, that owing to the anaesthetist being engaged in giving gas all through the operation, he is not so able to assist the operator as in giving gas in the ordinary way. It is, however, quite possible, although somewhat inconvenient to manipulate the gag when required. . . . I venture to maintain ', added Paterson, ' that the ordinary](https://iiif.wellcomecollection.org/image/b20457200_0517.jp2/full/800%2C/0/default.jpg)
