The practice of artificial anaesthesia, local and general : with especial reference to the modes of production, and their physiological significance : introduction to a discussion in the Section of Pharmacology and Therapeutics, at the Annual Meeting of the British Medical Association in Cardiff / by Dudley W. Buxton.

  • Buxton, Dudley Wilmot, 1855-1931.
Date:
1885
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Licence: Public Domain Mark

Credit: The practice of artificial anaesthesia, local and general : with especial reference to the modes of production, and their physiological significance : introduction to a discussion in the Section of Pharmacology and Therapeutics, at the Annual Meeting of the British Medical Association in Cardiff / by Dudley W. Buxton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted for the Author from the British Medical Journal, Sept. 19th, 1885.] THE PRACTICE OF ARTIFICIAL ANAESTHESIA, LOCAL AND GENERAL, WITH ESPECIAL REFERENCE TO THE MODES OF PRODUCTION, AND THEIR PHYSIOLOGICAL SIGNIFICANCE. Introduction to a Discussion in the Section of Pharmc/jcology and Therapeutics, at the Annual Meeting of the British Medical Association in Cardiff. By DUDLEY W. BUXTON, M.D., B.S., M.RC.P., Administrator of Anaesthetics at University College Hospital. Mr. President and Gentlemen.—In attempting to carry out in the best way the honourable and onerous task imposed upon me, that, namely, of opening a discussion upon the practice and theory of antesthesia, I think I shall best subserve the end in view by briefly sketching the plan upon which my subject will be treated, before plunging into such details and by-issues ns are incident to so wide- reaching a theme as that we have assembled to discuss. I may remind this Section, that twenty years ago, artificial ana?s- thesia was discussed under the regis of our great Association, but in the Section devoted to physiology. Then pharmacology and thera- peutics were not what they are now, and hence the relegation of the purely practical subject of amc3thesia to physiology. But now, let us remember that in the Section in which we sit we have to know the physiological side of our therapeutic agents, and to apply this knowledge to the practice of grappling with disease and assuaging pain. And can ive carry out such a scheme for anaesthetics, can we, with hope of profit or success, seek to disentangle the thread and unfold a rational explanation of the physiology of anaisthesia, to be followed by the wholly practical considerations involved in the skilled and beneficial application of anaesthesia for surgical or medical practice ? It seems to me, that such a course is the only one likely to advance the knowledge of our subject, and to prevent undue prominence from being bestowed upon mere details of practice, details important enough in themselves, but surely subservient to the consideration of those great laws of life and death which underlie our practice in the induction of anaesthesia. Y.e may start with a proposition that the end and aim of anaes- thesia, however applied, is comprised in the rendering a given area insensitive to pain. The more perfect the agent in use, the more truly localised must be its action; and conversely, the more widely distnbuted be its action, the less safe is the anajsthetic in question. JSou, to illustrate this proposition, let us briefly sum up the physio- logical bases of life. We may, perhaps, be permitted to regard them as a duality, a conscious voluntary portion wherein we meet with re- ceptive end-organs whose function must be to convey impressions for oui purpose, we will say painful impressions, from the periphery bv nervous strands to the central receptive and perceptive centres, the ceiebio-spmal axis ; and the second member of this duality is the nervous mechanism whereby the wholly involuntary and unconscious lunctums of life are carried out. To these wTe must add the blood- stream, and its physiological behaviour towards the cells, whereby their due regeneration, growth, and function, are performed.