Anaesthetics and their administration : a text-book for medical and dental practitioners and students.

  • Hewitt, Frederic William, 1857-1916.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Anaesthetics and their administration : a text-book for medical and dental practitioners and students. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    xvni au imdesirable quantity of blood. Should this rale become audible the auresthetic must be at once suspended and with- held until coughing takes place, whilst repeated sponging should be practised. The application of ice-cold water to the face will sometimes help to re-establish the coughing reflex. In some cases the breathing comes to a standstill so quietly that the true nature of the arrest may not be recognised. In gradually increasing obstruction, however, a rale is audible, and pro- gressive cyanosis usually occurs. Should the larynx be natur- ally insensitive, the hiemorrhage free, and the anaesthesia deep, blood may' suddenly invade the air-passages and breathing cease with little or no alteration in colour. Should the with- drawal of the aniesthetic, assiduous sponging, and attention to posture prove unsuccessful in removing blood from the larynx, the chest and the abdomen must be forcibly compressed. As a general rule, this will succeed in expelling blood, but should it not do so, the patient must be partially or completely in- verted and systematic artificial respiration performed, care being taken to keep the teeth apart and the tongue pulled forwards. If these measures fail, lai^ngotomy must be per- formed, artificial respiration renewed, and, if necessary, a catheter introduced into the trachea with the object of sucking out the obstructing fluid. Lung inflation through the laryn- gotomy wound may also be tried should artificial respiration fail to effect an entry of air.^ During operations upon lung cavities blood may enter the bronchi, and under certain circumstances obstruct breathing. The following interesting case may be quoted :— Illustrative Case, No. 46.—M., about 45. Has been very ill for several weeks. Thin. Orthopiicea. Dusky. Prominent eyes. Anxious and nervous e.xpression. Quick respiration. Pulse feeble and quick— about 160. Air enters riglit lung fairly freely. Left side dull and immobile, with amphoric breathing at base. Operation, resection of rib and draining lung cavity. Lies more easily on right than on left side ; but sitting posture most comfortable. Placed partly on right side and partly sitting. A.C.E. mixture given slowly, and then a little ether added to Rendle's inhaler. Breathing quick and somewhat more laboured. 1 For illustrative cases see Bril. Med. Jowni., 24th Fell. 1883, p. 352 (two fatal cases recorded). Also Lancet, 7tii Aug. 1881, ]i. 386. Also Brit. Med. Journ., 16th Sept. 18^2, p. 531 ; and Lancet, 30tli Sept. 1882, p. 540.