A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    48/878 (page 24)
    the two ethers above named is still preferred. In my own practice I have rarely used any other than chloroform, and I can most unhesita- tingly bear testimony to its vast utility in operative surgery. While the custom of rendering patients insensible to pain, during the performance of surgical operations, has rapidly gained an undoubted and sure position, there have been various questions and drawbacks regarding it, many of which are, even at the present day, of great prac- tical importance. Several deaths have occurred, to all appearance, directly from the ansesthetic agents, or the mode of their administration, and there has been much discussion on both these points. In the early application of ether, a complicated apparatus was used, but soon it was found that by holding over the patient’s nostrils and mouth, a hand- kerchief, napkin, or piece of sponge, moistened with a few drops of the ansesthetic, the desired effect was speedily produced, and, to this day, perhaps the majority of those who use the agent are content with this mode of administering it. From the commencement it has been the custom of most surgeons in large operating practice, to have the agent administered by some one whose sole attention might be given to its physiological effects on the patient during the performance of the operation ; and among those who have performed this most im- portant duty, there are few so extensively experienced as Dr. Snow. This gentleman, who is justly deemed our highest authority on the subject of anaesthesia in surgical operations, is in the habit of using an apparatus, as he is of opinion that there is less danger and more certainty thereby than with a napkin. There are different views on this subject, however, which need not be discussed here, and it may be sufficient to say that in whatever way the agent is called into use, its powers are fraught with subtle and imminent danger, unless the greatest caution be taken. For my own part, I think it of little con- sequence by what means the agent is administered, provided there be a fair proportion of atmospheric air admitted to the lungs at the same time, or that there be the facility of admitting it, when the influence of the chloroform, or whatever agent is employed, seems too powerful. At one time it was supposed that certain states of the constitution, certain conditions of the disease, or affections of certain organs, must preclude anaesthesia in surgical operations, but experience has shown that these fears have all been groundless. The age of a patient forms no ; objection to its use, for it may be given during the first few weeks of ( life, or at the latest imaginable date. Nor does it appear that positive disease of any organ forms an insuperable objection to its use. There are certain circumstances in the state of the constitution which will deter the surgeon from performing any important surgical operation, and in such instances the propriety of anaesthesia need- never be dis- cussed; but as a general answer to all questions on this score, I am disposed to say, that in whatever case a surgeon may consider an operation justifiable, the use of chloroform (this is named as the agent in most common use) is equally justifiable. If the operation be of minor importance, and of momentary duration, especially if the patient