On the admission of air into the veins ... Read ... February 28, 1850 / [George Frederick Lane].

  • Lane, George F. (George Frederick), 1828?-1856.
Date:
[1850]
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Licence: Public Domain Mark

Credit: On the admission of air into the veins ... Read ... February 28, 1850 / [George Frederick Lane]. Source: Wellcome Collection.

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    The earliest experiments of injecting air into veins were performed by Wsepfer, upwards of two centuries ago, and after him by Redi, Heyde, Brunner, Morgagni, and others, with the same results. Besides certain symptoms com¬ mon to each of them, to he presently mentioned, it was ascertained that death occurred most suddenly when the air was injected with rapidity and force; and finding much air mixed with blood in the cavities of the heart, its con¬ tractions were supposed by these ex¬ periments to he hindered by the dis¬ tension of its walls, much in the same way as urine prevents the contraction I of the bladder in certain cases when accumulated in large quantities within its walls. The first experiments made in this country were by Dr. L an grist),* * * § in 174G : he injected air into the jugular vein—it speedily proved fatal, and after death, finding the right cavities of the heart distended with air and a little I frothy blood, and the left collapsed, he I believed that death was caused by | the resistance which the air afforded to ; the return of blood through the vena3 I eavse. From this period the subject appears to have excited no attention till Bichat | published his “ Recherches Physiolo- 1 giques,’’ in 1811, in which he made some I statements as to the quantity of air re¬ quired to prove fatal, and advanced an | opinion that death was caused by the I irritation of air in the vessels of the brain. Immediately afterwards, Nystenf I published his experiments, showed I from them the error into which Bichat I had fallen, and was led to the same conclusion to which Morgagni had arrived—viz. that the effects of a large quantity of air injected suddenly into I the veins proved fatal, by distending ffl the right cavities of the heart, and pre- 1 venting their contraction so as to I propel the blood through the capillaries I of the lungs. Though the experiments I of killing animals by injecting air into I the circulation bear an ancient date, A yet before the commencement of the I present century no case is recorded of I the entrance of air into a vein during a I surgical operation. It was observed on I the continent in 1806, by Verrier, whilst ■ bleeding a horse, and in 1818 by M. I Bcaucliene, in a human subj ect, at the j * Physical Experiments on Brutes, 8vo. 17-16. t Recherches de Physiologie et de Chimie Pa¬ ll thologique, 1811. Hospital St. Antoine, whilst operating on the base of the neck. After the paper of Magendie’s, in the Journal de Physio- logie, in 1821, the question was consi¬ dered at greater length, and several cases are related as having occurred in different parts, some of which were doubtless unfounded.* In 1839 a sharp discussion was held at the Royal Aca¬ demy of Medicine, Paris, upon a case related by M. Amussat, in which alarm¬ ing symptoms of dissolution came on in the course of an operation on the neck, and attributed by him to the entrance of air into a vein. Amongst others, Velpeau was most sceptical of the al¬ leged cause of the symptoms that su¬ pervened, grounding his objections on the difference which was manifested in the symptoms produced in experiments upon animals, and similar cases in the human subject. Till 1839, if we except four cases, in which air entered acci¬ dentally, its introduction in the various experiments had always been accom plished by injection, but Amussat now firs demonstrated its entrance under favourable circumstances during inspi¬ ratory efforts. Since the time of Dr. Langrish, the authors who have written upon the subject in this country are Dr. Cormack,} Sir C. Bell,} Mr. Erich- sen,§ and Dr. John Reid.|| We propose to examine some of the results to which the experiments alluded to have led; and first, it is a matter of interest to know by what agency air enters certain veins when opened in the living sub¬ ject, in the region termed by Amussat “ espace dangereuse. In expansion of the thorax during inspiration, the blood in the venae cavae and their tributary branches is accele¬ rated in its course to the right auricle by a species of suction, which admits of simple explanation. The atmospheric pressure on the parietes of the thorax being relieved somewhat by the action of the inspiratory muscles, the ordinary pressure on the vessels without, com¬ bined with a tendency to a vacuum around those within, favours the return of blood along the veins immediately emptying into the chest: we should infer that these movements influence the venous current more than the ar- * See Case, Lemons Orales de Clinique Chirur- gicale, par M. Velpeau, tome iii. t Prize Thesis, Edinburgh, August 1837 t Practical Essays, 1841. § Edinburgh Med. & Surg. Jour. vol. lxi. 1844. || Physiological Researches, 1848.
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