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.
588/664 page 568
![6 At the end of four or five minutes, the patient still felt and spoke. . . . The pulse was regular, and of normal strength. All at once the patient raised his body, and struggled . . . the assistants . . . however . . . seized . . . and replaced the patient in his position. Within a quarter of a minute, one of the assistants stated that the pulse at the wrist had ceased to beat . . . and the sounds over the region of the heart could no longer be heard. Respiration still continued but . . . ceased completely in the space of about half a minute. ' The extreme danger of the patient was manifest, and immediate and energetic means were employed to rouse him. Ammonia was held to the nostrils, and rubbed in large quantity over the surface of the chest and abdomen. It was also applied to the most delicate parts of the skin, e.g. the lips and the extremity of the penis, with a view to excite irritation. Mustard was used ; the head was inclined over the bed ; and, finally, an attempt was made to restore respiration by means of alternate pressure on the abdomen and chest. After two or three minutes, respiration reappeared, and even acquired a certain fulness, but the pulse nowhere returned. Frictions were continued. Respira- tion became again slower, and at length ceased. Artificial inflation was practised, at first through the mouth, and afterwards through the larynx, by passing a tube through the glottis f1], as it was perceived that air had passed from the mouth into the stomach. The precordial, epigastric, and laryngeal regions were energetically cauterised with a hot iron. The pulse did not return. For the space of half an hour every effort was made to resuscitate the patient ; but in vain.' Case 12, according to Snow, was ' the first which occurred in any of the hospitals in this metropolis ' (London). The patient was a burly and alcoholic porter, forty-eight years old and suffering from an ingrowing toe-nail. Chloroform anaesthesia was uneventful until after the removal of the nail at about 2 p.m. Then : ' He continued insensible ; and, his face becoming dark, the pulse small, quick, but regular, respiration laborious, his necker- chief was removed, and the chest exposed to fresh air from a window near to the bed ; cold water was dashed in his face, the chest rubbed, and ammonia applied to the nose. After struggling for about a minute, he became still, the skin cold, pulse scarcely perceptible, and soon ceased to be felt at the wrist; respiration became slow and at intervals, but continued a few seconds after the cessation of the pulse. Immediately on the 1 Lozes recommended this method in 1818. It was a modification of the earlier intubation method of Chaussier (1806) for the new-born.](https://iiif.wellcomecollection.org/image/b20457200_0596.jp2/full/800%2C/0/default.jpg)
