Notes on the inhalation of sulphuric ether in the practice of midwifery / by J.Y. Simpson.

  • Simpson, James Young, 1811-1870.
Date:
1847
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Licence: Public Domain Mark

Credit: Notes on the inhalation of sulphuric ether in the practice of midwifery / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    A more extensive and careful series of investigations than I have yet been able to institute, may perhaps show that in some consti- tutions, and under some circumstances or degrees of intensity, the process of etherization may possibly interfere with the uterine contractility, particularly in the earlier stages of the labour. At the same time, various analogies would lead us to expect that, as I have hitherto found, the action of the uterus would go on uninter- ruptedly, when the psychical influence of the mind and purely cerebral functions was suspended, as in the more complete states of etherization. At all events, if we may judge from the analogous experiments of VoUkmann, Bidder, and Kolliker, upon the simple contractions and rhythmic reflex actions of the heart, intestines, &C., the motory nervous powers of the uterus belong to the gan- glionic and to the spinal systems, and are not in any necessary dependence upon the brain or mind. Indeed, OUivier and Nasse have published cases of perfect paraplegia, notwithstanding which the act of parturition in the human female proceeded regularly in its course, and without conscious pain. In the one case (Olli- vier's), the cord was compressed and destroyed from the first to the fourth dorsal vertebra by a collection of acephalo cysts; ^ and, in the other instance (Nasse's), complete paralysis had followed. a fracture of the third and fourth cervical vertebrae.^ Of course such lesions necessarily prevented the brain exerting any influence upon the uterus, or its contractions. Long ago, in discussing this subject, Haller adduced the authority of Harvey, Smellie, Lamotte, &c., to prove that uterine contractions and labour may go on with the mother, ignara, stupida et sopita, et immobili, et apoplectica, et epileptica, et convulsionibus agitata,^ et ad summum debili.* Deneux mentions a fact still more in point, because in it the analogy with the operation of ether is still stronger, or indeed identical. A woman, says he,^ was brought to the Hotel Dieu at Amiens in a comatose state, in con- sequence of her taking spirituous liquors since the commencement has described a particular apparatus, like some of our modern forms, for the inhalation of sulphuric ether. See also toI. xvii. p. 134.—Vaporizable substances, when introduced into the system in this manner, probably pass undigested and unchanged into the circulation, and seem (observes Wagner) to make their way into the blood through the unbroken vascular membrane [of the bronchial cells] with the same certainty and ease as when they are injected directly into the veins (Elements of Physiology, 1842, p. 443.) Will this not explain both the rapidity and intensity ot their action when thus used ? ' Traite' de la Moelle Epiniere, p. 784. Untersuchungen zur Physiologic, &c. — Dr Cheyne reports a case of fatal hemorrhagic apoplexy and hemiplegia, in which, without any apparent pains, the uterus (observes Dr Kellic) appears, as an involuntary muscle, to have acted in the ?Mj manner in expelling the foetus and secundines, the day before death. Ihe child was bom alive. Cases of Apoplexy and Lethargy, p. 91 and 161. -'^J^^^g ^ne continuance of puerperal convulsions, uterine action is not suspended, although no signs of pain are manifested by the woman, if she remain comatose. l)r a. Kamsbotham's Obstetric Medicine (1844) p. 455. * Elementa Physiologia;, torn. viii. p. 420. * Receuil Periodique de la Societd de Medicine, April 1818.