Volume 1
The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.
- Date:
- 1884
Licence: Public Domain Mark
Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
53/1220 page 21
![EFFECT OF ANAESTHETICS ON MORTALITY. of the employment of Anaesthetics ? May it not, in some measure at least, be owing to operations being often performed in very doubtful or extreme cases, now that they can be done painlessly, when formerly the suffering inflicted would have deterred the Surgeon from proposing, or the patient from acceding to, their performance ? A surgical operation was formerly, from the pain attending it, looked upon as a more serious affair than it is at the present day, and surgeons were not willing to inflict suffering unless there were a good prospect of a successful issue. Now, however, that the most serious operations can be performed without any consciousness of suffering, the Surgeon, in his anxiety to give his patient a chance of life, may not unfrequently operate for disease or injury that would otherwise necessarily and speedily be fatal, and which formerly would have been left without an attempt at relief. But there is another cause that may account for this increased rate of mortality. During the first thirty years after the introduction of Anaesthetics, the actual number of operations performed in hospitals enormously increased, probably in a great measure owing to their employment. Hence hospital wards became more crowded than formerly with f severe operation-cases, and the causes of septic diseases became much more rife, those diseases more frequent, and the mortality proportionately augmented. At the present time, owing to im- proved treatment of wounds, and better sanitary arrangements, the mortality after operations is lower than it has ever been before. Making, however, all allowance for the extension of operative Surgery to extieme cases that were formerly not thought to come within its range, I cannot but think that chloroform does exercise a noxious influence on the constitution, and does lessen the prospect of recovery in certain states of the sj stem, more especially when the blood is in an unhealthy state. In such circumstances, the depressing influence of chloroform appears to me to act injuiiously ; the patient does not rally well after the operation, and immunity from suffering is purchased by a lessened chance of recovery. Anaesthesia by the Administration of Chloroform is best commenced before the patient leaves his bed. The chloroform should never be given but oy a person accustomed to its use, and on whose capability the Surgeon has full reliance ; as nothing is more embarrassing during an operation, than to have any doubt about the chloroform being properly administered. ' It must not, however be imagined that it can be safely given only by a specialist. -Hvery student before leaving the hospital may easily make himself sufficiently acquainted with the details of its administration to enable him to give it with perfect safety, provided he pays undivided attention to what he is doing and does not allow Ins mind to be diverted by watching the operation or by attempt- to act both as anaesthetist and assistant. Before administering any anesthetic, the patient should be asked if he wears false teeth, and if so, they bn mio.n’em°VecL , artiGle °f Cl0fchin§- about tbe neck, chest, or waist, ■ ci ,, k cause interference with respiration or circulation must be relaxed, forin n Pa1tlenfc1 theU placed’ lf P°ssible> ^ the recumbent position. Chloro- I ] m‘p Hi a mmistered in many different ways, either on lint or on a hand- whb'rii ,OT !'r0UgU aU iubaler of somc ^nd. The following is the way in aniri Vi hi a01 r °!m .may mosfc be given on lint or a handkerchief, without and onimicf0 <Ulr \m< ‘ _()u a piece of folded lint, about three inches square, the lint is th* *1 n'lT d°ublcs’ about a drachm of chloroform is poured ; and en held at a distance of about three inches from the nose of the](https://iiif.wellcomecollection.org/image/b21974081_0001_0053.jp2/full/800%2C/0/default.jpg)
