On the inhalation of chloroform : ita anæsthetic effects and practical uses / by Robert Dunn.

  • Robert Dunn
Date:
[1851?]
Catalogue details

Licence: Public Domain Mark

Credit: On the inhalation of chloroform : ita anæsthetic effects and practical uses / by Robert Dunn. Source: Wellcome Collection.

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    apt illustrations, and admit of no other explanation. Indeed, it is not to be denied that emotional impulses are ex¬ cited through all the special senses by impressions from without ; and in con¬ sequence the inference is irresistible, that the sensory ganglia are the seat of the emotional feelings, or, in other words, of the feelings of pleasure and pain associated with the emotional states. Dr. Carpenter has ably shown that the true emotions, like the moral feelings and the animal propensities, are of a composite nature, involving, with the sensorial feelings of pleasure and pain, an intellectual element, in all of which the feelings are of sensorial, and the ideas of cerebral origin. Now, bearing in mind the distinction which exists between sensation and per¬ ception,—that, in the one case, sensation or feeling is an act of simple consciousness, and has its seat in the sensorium com¬ mune, or sensory ganglia; and that, in the other, perception is a mental act, and one of intellectual consciousness, having its seat in the hemispherical ganglia, —we have next to inquire what are the feelings experienced and the phenomena observed during the slow and gradual inhalation of the vapour of chloroform. And on this subject I cannot adduce a greater authority than the testimony of my friend Dr. Snow. No medical practitioner in London has administered the agent so extensively, and under a greater variety of circumstances, nor witnessed and studied its effects more assiduously and carefully, than Dr. Snow has done. He has kindly furnished me with the results of his experience, which I shall give in his own words:— “ The first degree of the influence of chloroform includes all the effects of that agent which a person may experi¬ ence whilst he still retains a correct consciousness of where he is and what is occurring around him. There are usually numbness and tingling of the surface of the body, singing or other noise in the ears, and dizziness, with not unfre- quently a sensation like that of rapid travelling. The feelings are generally described as having been agreeable in this stage. “ In the second degree the patient is no longer conscious of his situation, hut the mental functions are not neces¬ sarily suspended. He usually appears as if asleep ; but if the eyelids he raised, he will move his eyes in a voluntary manner, and there are occasionally volun¬ tary movements of the limbs. Although generally silent if undisturbed, he may nevertheless laugh, talk, or sing; and it is chiefly, if not solely, in this degree that dreams take place. Violent moto- rial actions in this dreamy state are sometimes manifested; and when the dreams are remembered, as they occa- sionallv are, such actions are found to have been associated with some quarrel or annoyance. In this disease the loss of sensation is sometimes so complete, especially in children, that the surgeon’s knife may be used without pain : com¬ monly, however, its use at this time occasions expressions indicative ctf pain, which are either not remembered, or recollected as having occurred in a dream. “ In the third degree the pupils of the eyes are generally somewhat con¬ tracted and inclined upwards; the small blood-vessels of the conjunctiva are usually enlarged. There is no longer motion of a voluntary character, but occasionally some rigidity of the mus¬ cles, especially in robust persons. Some¬ times there is an unintelligible mutter¬ ing, but never any distinct articulate s]reech. “ It is seldom necessary to carry the effects of chloroform beyond this degree, for during operations there are usually no signs of pain, and never as it would seem the consciousness of any; for although there are sometimes gestures indicative of feeling, there is never any recollection of pain. “ In the fourth degree the muscles are completely relaxed, the pupils are di¬ lated, and the breathing, hitherto natu¬ ral, is often stertorous. There is never pain from a surgical operation, nor any sign of it. “ In the fifth degree, as witnessed in the lower animals, the ribs cease to move in breathing, and respiration is performed only by the diaphragm. Spontaneous recovery from this state will yet take place if the inhalation be discontinued, but if continued the breathing will cease, the heart continu¬ ing to heat, and its action becoming arrested only for want of the respira¬ tion, as in asphyxia. From this state the animal may sometimes be recovered by artificial respiration. This state may he called the sixth degree.