A text-book on surgery : general, operative, and mechanical / by John A. Wyeth.
- Wyeth, John A. (John Allan), 1845-1922.
- Date:
- 1888
Licence: Public Domain Mark
Credit: A text-book on surgery : general, operative, and mechanical / by John A. Wyeth. Source: Wellcome Collection.
38/794 (page 24)
![any other conditions ; and when to this is added the almost perfect free- dom from danger in properly conducted general ansesthesia, how much more should the profession strive to educate the public out of the un- founded dread of taking an ansesthetic. It is this fear which induces many patients to conceal or silently bear a malady which, if operated upon early, would prove insignificant, but which, when left until pain, exhaustion, or impending death drives them to seek relief at the hands of the surgeon, is too often formidable. One cause, and the chief one, for this unfortunate condition of affairs, is the reckless employment of these agents, the lack of precaution in preparing a patient for narcosis, as well as in the method of administration. Of the various anaesthetics Avhich have ])een introduced for surgical use, only two deserve to be con- sidered, and in order of preference they are ether and chloroform. In general, there is no comparison between these agents. Ether is so much safer than chloroform that the latter is fast disappearing in prac- tice. In the present rapid progress of science it can not but be a short while until chloroform will only be employed in a very limited number of cases. The estimated death-rate after ether is 1 in 20,000, in chloro- form 1 in 3,000. All of the objections to ether by the advocates of chloroform narcosis—namely, its slowness of action, irritation of the respiratory tract, nausea and vomiting, inflammability, extra quantity required, etc.—fade into insignificance when brought face to face with the fact that about seven lives are sacrificed by chloroform to one by ether. In my opinion, chloroform narcosis is only Justified under the follow- ing conditions: 1. In children under six years of age, where it is less apt to cause an accumulation of mucus in the trachea and bronchi than ether. Its more rapid and less irritating action renders it preferable in this class of patients. 2. In women in childbirth where the recumbent posture is impera- tive. 3. In an emergency where ether can not be obtained. 4. In a patient who has previously been in ether narcosis, in which dangerous symptoms were caused by the ether. 5. In an emergency where it becomes necessary to perform an opera- tion within two or three hours after the ingestion of a quantity of solid food. 6. In some exceptional cases of laryngeal or tracheal stenosis. In all other conditions ether should be given. The slowness of its action is an objection unfounded in fact, for, if desired, ether narcosis can be effected within ten minutes. Irritation of the respiratory tract is only objectionable in younger children, at which age the windpipe is always narrow and easily occluded, and the frame-work of the glottis soft and readily compressible. Nausea and vomiting are objections with- out value when the proper j:»recautions are taken to prevent the ingestion of solid food or milk for eight hours before the administration begins. The inflammability of ether requires ordinary precaution in not allowing](https://iiif.wellcomecollection.org/image/b20398335_0038.jp2/full/800%2C/0/default.jpg)
