On recent researches upon nitrous oxide narcosis : and their bearing upon the practical question, when and how should laughing gas be administered? : read at the Annual General Meeting of the British Dental Association at Brighton, August, 1889 / by Dudley Wilmot Buxton.

  • Buxton, Dudley Wilmot, 1855-1931.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: On recent researches upon nitrous oxide narcosis : and their bearing upon the practical question, when and how should laughing gas be administered? : read at the Annual General Meeting of the British Dental Association at Brighton, August, 1889 / by Dudley Wilmot Buxton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of the thorax, which the tonic spasm of the muscles may bring about, if that agent is pushed far, would be contra-indicated, and it would be wise, while commencing with nitrous oxide, to continue with ether. The slight influence which nitrous oxide exerts upon the respiratory system renders detailed notice unnecessary. I have never, in my experience, found nitrous oxide, when pure, act as an irritant, and as this bland gas, as I have endea- voured to show, does not impede the pulmonary circulation, there is no ordinary intra-pleural or intra-pulmonary condition which should, in my experience, contra-indicate its use. How far do conditions due to disease of the central nervous system contra-indicate nitrous oxide? I can find no record, either in the experience of others or of myself, to show that any organic or functional lesion of the cerebral hemispheres or spinal cord, interfere with administra- tion of nitrous oxide. One would expect from the very marked changes in the vaso-motor areas of the brain and cord which occur under that anaesthetic that whatever condition were brought about by vaso-motor perturbations would be initi- ated by nitrous oxide, and I believe that this is so in some degree. Epileptics and hysterical persons are often deeply im- pressed by it, and I have many times been struck by the curious condition which supervenes upon its administration to persons afflicted with mania. You are also aware that Dr. Savage who, during his control of Bethlehem Hospital en- joyed an almost unique opportunity of studying the effect of anaesthetics upon the insane, found that in persons who had once been mad, nitrous oxide, ether, or chloroform, would, in a small percentage of cases, give rise to an outbreak—usually transitory. In the following case, for the notes of which I am indebted to the kindness of Dr. Colman, Registrar of the Queen Square Hospital for Paralysis, there is a record of an instance in which a temporary attack of insanity followed frequent dosage with nitrous oxide. Lydia Askew, twenty-six. Married. No neurotic heredity could be traced. No previous illnesses. Admitted under Dr. Bastian suffering from diphtheritic paralysis. When conval- escent, nitrous oxide was administered to facilitate the ex- traction of some carious teeth. The extraction proved very