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.

    49/878 (page 25)
    J)Qe,rCi°^eou®’ and perhaps averse to the practice, the surgeon need y \ttle °n the subject; but in all cases where much and protracted u enng is likely, chloroform should be recommended. It will and> provided the agent be pro- perly administered, it wilPJ^T the surgeon’s duties more easy There are few °Perations in which its use is not omissible and advantageous. In operations for cataract, especially by extraction, it is likely to prove injurious; as there ITmTcertainty as to the movements of the eyeball and lids for some time after. I have used chloroform for removal of tonsils, in young persons, but the oper- ion is difficult, and lftHe^patlent will keep steady otherwise, it had etter not be used. In staphyloraphy, the co-operation of the patient is so essential that I deem cTrforofoFnTihadmissible. It has been supposed that there is danger from blood trickling into the larynx and trachea in operations under chloroform. In one instance, in the early days of cmorotorm, I took some alarm on this score, in a case where blood was trickling from the posterior nares into the trachea and causing cough, out i teel now certain that there was no just cause of apprehension. i have since repeatedly removed both upper and lower jaw, and done many other operations, involving considerable hemorrhage towards the throat, but have never seen anymore inconvenience from such a cause than il chloroform had not been used. It has happened repeatedly in ormer times, that persons have died during the performance of opera- tions. Mental emotion, shock, hemorrhage, have each and all had heir influence; but, notwithstanding the various instances in which death has happened under chloroform, it may be doubted if sudden death, during operation, has occurred so frequently since the introduc- tion ot anaisthesia, as prior to that date. In my own experience I have twice seen patients under chloroform in great jeopardy—one ot these had a protracted operation performed for resection of a joint, .and possibly a similar state of prostration might have resulted without e use of this agent. In the other instance, tracheotomy was required tor disease of the larynx, and under the chloroform, respiration became so slow and difficult that it was feared the patient would die on the instant, before the operation could be executed. When the trachea was opened he immediately breathed more freely and speedily rallied trom his alarming condition. I was certainly more impressed with the danger in this instance than in any other that I had seen ; but Dr. Snow, who administered the chloroform, did not participate in my fears. The immediate effect ot tracheotomy corroborates the view entertained by Ricord and others that this proceeding may be resorted to with advantage when there’ seems danger from chloroform. When death has occurred seemingly trom this agent it has been immediate, and chloroform leaves the svs- Irn so speedily, that if the patient has once becorhe conscIous/Tdoulrt it death codra ever be attributed to this cause. Chloroform has no influence whatever either in retarding or accelerating the healing of a wound. We have no statistical data on this subject, but altogether the