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.
618/664 page 598
![which I gave chloroform, and I administered it on a sponge, held near to the1 tube in the larynx. It was necessary to give the vapour gently at first, just as if it was entering in the usual way. When it was given at all strong, whilst the patient was still conscious, he showed exactly the distress that a patient experiences when he says that the vapour produces a choking feeling ; which confirms my opinion that the feeling referred to the throat, from the action of pungent vapours and gases, is caused by their presence in the lungs. The chloroform was given to keep the child quiet whilst Mr. Partridge searched for the supposed button in the larynx and bronchi. When the child recovered from the chloroform, before the operation was concluded, the explorations in its air-passages embarrassed the breathing much more, and caused more apparent threatening of suffocation, than they did when he was under the influence of the vapour.' 1 Packing off the throat (and hence the necessity for intuba- tion) to prevent the entrance of blood and operative debris into the air-passages was never suggested by Snow. Referring to the removal of tumours of the upper jaw, for instance, Snow wrote : ' Mr. Syme, Mr. Lizars, and some other surgeons, expressed an opinion at one time that chloroform could not be safely used in this operation, as the blood would be liable to flow into the lungs. This is not the case, however, as the glottis retains its sensibility apparently unimpaired, if the influence of the chloro- form is not too deep or long continued. It is only necessary to hold the head forward now and then, when the throat is very full of blood, in order to allow the patient the same opportunity of breathing that he would require if he were awake. A good deal of blood passes into the stomach in great operations about the mouth under the influence of chloroform ; and if a few drops pass into the wind-pipe they are coughed up again, as they would be in the waking state. . . . The glottis appears to retain some sensibility as long as a creature is capable of breathing. . . . ' I have always made the patient insensible in the usual way, with the inhaler, before the operation of removing tumours of the jaw, and have kept up the insensibility during the opera- tion by means of a mixture of chloroform and spirit on a hollow sponge [2]. . . . Owing to the hands of the surgeon and 1 Snow, J. 1858. On chloroform and other anaesthetics. London. 312. 2 Whenever Snow was obliged for any reason to lay aside his regulating chloro- form inhaler (see Fig. 41) he was in the habit of administering chloroform from a hollow sponge, and to prevent the possibility of giving an overdose he diluted the drug with alcohol (cf. p. 194).](https://iiif.wellcomecollection.org/image/b20457200_0630.jp2/full/800%2C/0/default.jpg)
