The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum].

Duncum, Barbara M.

Date:: 1947

Credit: The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum]. Source: Wellcome Collection.

554/664 page 534

$knowledge is almost entirely theoretical, however great may be his aptitude and powers of observation. The rest of the house- staff are expected to devote their attention entirely to the opera- tion, and it must be admitted that the junior's mind is too often absorbed in its details. . . . ' We are far from asserting that the young gentlemen . . . do not in many instances become expert anaesthetizers, but this requires time, so that as a rule, they have only become really proficient when they are replaced by green men. If this criticism applies to the giving of ether, how much more forcibly does it apply to the administration of chloroform ! Doubtless this valuable anaesthetic would be employed much more frequently than it is at present f1] if surgeons had sufficient confidence in the skill and experience of the anaesthetizer. . . . ' Now this state of things ought not to be allowed to continue. We believe that the time will come when every large hospital will have a regular salaried anaesthetizer who will always be available and who will enjoy the same confidence in his depart- ment as the pathologist does in his own. Operations will certainly proceed more smoothly and safely ; we shall hear of fewer deaths from heart failure ; and cases of ether pneumonia and of acute uraemia from ether will be almost unknown. The advantage to the operator will be immense. Instead of having his mind distracted by the struggles of a half-anaesthetized patient ... he will be able to give his entire attention to the operation, relying on the anaesthetizer to note the danger signals, to administer stimulants when they are needed, and to keep him informed as to when he must hasten or when he can proceed deliberately. . . .' 2 In the closing paragraph of the same article the Medical Record severely censured also the practice common in some American hospitals of allowing a nurse to induce anaesthesia. Three years elapsed before the Medical Record (in 1897) followed up this first article with a second entitled ' The pro- fessional anaesthetizer \ ' So far as we are informed in the matter, there exists in this city [New York] no physician who makes a specialty of adminis- tering anaesthetics. There would seem, however, to exist a demand in this direction. Surgeons are constantly at a loss to find at short notice men of experience in ether and chloroform administration, no less than in other forms of general and local ' Some American surgeons held that ether was contra-indicated in patients with pulmonary or renal disturbance and instead used chloroform. (Cf. Med. Rec, N.T., 1895, 47, 720 ; see also p. 419.) 2 Med. Rec, N.T., 1894, 46, 239.$