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.
560/664 page 540
![1 The experience of the last twelve years he continued, ' has confirmed me in the success of this doctrine. ... In my hospital cases I have still entrusted the administration of the chloroform ... to a succession of senior students, changing from month to month, whose only qualification for the duty is that they must previously have served the office of dresser, and that they strictly carry out certain simple instructions, among which is that of never touching the pulse, in order that their attention may not be distracted from the respiration.' Lister also discussed chloroform administration with Junker's inhaler (see pp. 265-6), which he thought acted ' admirably in experienced hands ', but was apt to get out of order, and by the open-drop method with Skinner's mask (see pp. 247-8). The latter, Lister thought, was too large, and ' the closely fitting bag ' seemed to him ' liable to the danger of giving the chloroform too strong, especially when the breathing is shallow '. On this account Lister ' made trials with a piece of flannel stretched over . . . [a] small frame, but having an interval of about half an inch between its border and the skin of the face ; and I found that a piece with an area of nine square inches . . . kept constantly moist with chloroform . . . answered the purpose well if a piece of rag was thrown lightly round the interval between the flannel and the skin, so as to check, but not altogether prevent, the flowing away of the heavy vapour of the chloroform. . . . As there was no special virtue in flannel, as compared with a single layer of linen of coarse texture, I substituted for the frame and flannel the corner of a towel, pursed up systematically into a concave mask to cover the mouth and nose by pinching it together f1] at such a distance from the corner that, when the pinched-up part is held over the root of the nose, the corner extends freely to the point of the chin. ' The cap formed in this manner being so arranged upon the face, chloroform is gradually dropped upon it till the greater part of it is soaked, the edges being left dry to avoid irritation of the skin by the liquid ; and the moist condition is maintained by frequent dropping until the requisite physiological effects are produced. . . . When the cap is made as above directed, . . . the part which is moistened during the production of anaesthesia has an area of about nine square inches (that of a circle three and a half inches in diameter) in the case of the adult male. But the apparatus is self-adjusting in so far that the cap varies 1 Soon after this Lister hit upon the more expedient method of drawing the corner of the towel through a large, closed safety-pin.](https://iiif.wellcomecollection.org/image/b20457200_0566.jp2/full/800%2C/0/default.jpg)
