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.
534/664 page 514
![the recovery from anaesthesia much hastened ; nausea and vomiting are practically obliterated, and the elements of shock have been greatly reduced. Moreover, we have had no experts, but simply an operative surgeon—the author [Tuttle]—and the ordinary house surgeon to administer it. There is no com- plicated, cumbrous, and costly apparatus necessary for its administration, and it does not require a Saratoga trunk to carry it around. If such experiences with Kelene shall be verified, it seems to me its use will probably supersede that of nitrous oxide, and much of the dread shock and disagreeable experiences of general anaesthesia be done away with.' 1 The man who appears to have done most to popularize the use of ethyl chloride as a general anaesthetic in the United States, during the early years of the twentieth century, was Martin W. Ware, surgeon to the Good Samaritan Dispensary, New York. Ware's inhaler (see Fig. 146) consisted of a dome-shaped facepiece having a three- to five-inch, open-ended tube fitted into it. Over the end of the tube, where it entered the facepiece, a few layers of gauze were laid ; on to this gauze a stream of ethyl chloride was intermittently directed down the tube itself. The main disadvantages of this inhaler were said to be that if the layers of gauze were not sufficiently thick ethyl chloride fell on to the patient's face, whereas if they were too thick hoar frost formed on them and occluded the opening of the tube.2 Referring to this ' layer of hoar frost resulting from the combination of the vapor of the breath with the ethyl chlorid, which forms on the gauze ', Ware himself said: ' I have now learned to regard this rather as a favorable than a deterrent factor, provided the frost be not allowed to form in too thick a layer so as to intercept all access of air. This hoar frost constitutes a storage depot for much of the ethyl chlorid and thereby facilitates narcosis. . . . No untoward experience has resulted from the inspiration of air chilled in its passage over the frost, since the vapor of ethyl chlorid is dis- pelled, expanded and warmed in the pharynx before being taken up in the lungs.' When muscular relaxation was necessary, and to overcome the resistance of chronic alcoholic patients to ethyl chloride 1 Quoted in Kelene, a brochure published by R. W. Greeff & Co., London, n.d. [1901]. 2 Med. News, JV.T., 1904, 84, 1026.](https://iiif.wellcomecollection.org/image/b20457200_0538.jp2/full/800%2C/0/default.jpg)
