Volume 1

A text-book of surgery / by Hermann Tillmanns ; translated from the 3rd [and 4th] German edition by John Rogers and Benjamin T. Tilton.

  • Tillmanns, Hermann, 1844-1927. Lehrbuch der allgemeinen Chirurgie. English
Date:
1895-1898
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of surgery / by Hermann Tillmanns ; translated from the 3rd [and 4th] German edition by John Rogers and Benjamin T. Tilton. Source: Wellcome Collection.

    49/840 page 37
    ^14.] ETHER NARCOSIS. 3Y and only seems to be less liable to cause vomiting. Its disadvantages are its inflammability and expensiveness. Furthermore, its use is not free from danger—in fact it is probably more dangerous than chloroform. Kappeler mentions nine fatal cases. Methylen bichloride is best administered by Junker's apparatus, which is illustrated on page 21. § 14. Ether Narcosis.—Ether is another mucli-nsed anaesthetic which is coming to be employed more and more in the place of chlo- roform or its compounds. In America, ether narcosis is used almost exclusively, and in England, France, Switzerland, and even Germany, this drag is coming into constantly growing favour. Ether—sulphuric ether, naphtha, ethylether, C4H10O—is a colourless, easily difPusible liquid, possessing a pleasant odour and burning taste. Ether is very volatile and inflammable, and boils at a temperature of 38° C. Its specific gravity at 15° 0. is 0-720. The physiological action of ether is essentially the same as that of chloroform, except that ether less often produces disturb- ances in the circulatory system, and consequently seldom causes death from syncope, but almost always from paralysis of the respiratory centre. P. Bruns and Holz showed that the inhalation of ether produced an increase in the strength of the pulse, while chloroform, on the other hand, weakens it. Kappeler has collected thirteen cases of death from ether, but the number has increased lately, owing to its more general use. In diseases of the air- passages and lungs and in teething children ether should not be employed. The manifestations of ether narcosis resemble those of chloroform narcosis, but the action of the drug is not so lasting. During ether narcosis the great amount of saliva secreted is troublesome, stertorous breathing often occurs, and not infrequently a thick white foam issues from the mouth and nose. There occurs, as a result of the dilatation of the cutaneous vessels, an increased warmth, redness, and cyanosis. Finally, mention should be made of the great inflammability of this drug—a circumstance which increases the difficulty of giving it at night or in operations where the galvano- or thermocautery is to be used. Kappeler relates the case of an eighteen-year-old girl, in Lyons, who was etherised in order to apply the cautery. Suddenly, as the surgeon was about to use the cautery on his patient, the ether vapour ignited, setting fire to the cone filled with ether which was being held over her moutli and nose, and the face of the patient became enveloped in flames. Terrible burns, involving the tissues down to the bone, were the result of this accident, and the surgeon, in his efforts to ex- tinguish the flames, sustained no inconsiderable injuries. Etlier nephritis, though not of frequent occurrence, is a disagree- ah]c after-effect (Goltz). The other consequences of ether narcosis—
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