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.
592/664 page 572
![k Such measures as dashing cold water on the patient, and applying ammonia to the nostrils, can hardly be expected to have any effect on a patient who is suffering from an overdose of chloroform ; for they would have no effect whatever on one who has inhaled in the usual manner, and is merely ready for a surgical operation, but in no danger. I have applied the strongest ammonia to the nostrils of animals that were narcotized by chloro- form to the third or fourth degree [see p. 163] and it did not affect the breathing in the least. It is difficult to suppose a case in which the breathing should be arrested by the effects of chloro- form whilst the skin remained sensible, yet it is only in such a case that the dashing of cold water on the patient could be of use. There is, however, no harm in the application of this and such like means, provided they do not usurp the time which ought to be occupied in artificial respiration ; for this measure should be resorted to the moment the natural breathing has entirely ceased. . . . ' Whether the artificial breathing is successful or not must depend chiefly on the extent to which the heart has been paralyzed by the chloroform. . . . The fact of the breathing continuing after the action of the heart has ceased, in some of the fatal cases, shows that the heart may be so paralyzed as not to be readily restored by the breathing. It is probable that in all cases in which artificial respiration can restore the patient, its action would be very prompt ; still it is desirable to persevere with the measure for a good while.' Snow drew attention to the fact that ' when the breathing has ceased, the tongue is indeed liable to fall backwards, if the person in a state of suspended animation is lying on the back, and this circumstance requires to be attended to in performing artificial respiration i.1 He did not think it likely, however, that ' the falling back of the tongue into the throat, under the deep influence of chloroform, might be the cause of death by suffocation . . . for the muscles of the larynx and neighbour- ing parts preserve their action as long as the diaphragm, and contract consentaneously with it '. With reference to the fairly common practice of opening one of the jugular veins Snow 2 expressed the opinion that : ' there is every reason to conclude that the right cavities of the heart are distended with blood, in all cases of suspended anima- tion by chloroform, and therefore it would be desirable to open one of the jugular veins if the artificial respiration does not 1 Snow, J. 1858. On chloroform and other anaesthetics. London. 245. 2 Ibid. 261.](https://iiif.wellcomecollection.org/image/b20457200_0600.jp2/full/800%2C/0/default.jpg)
