A practical guide to the administration of anaesthetics / by R.J. Probyn-Williams.

  • Probyn-Williams, R. J.
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: A practical guide to the administration of anaesthetics / by R.J. Probyn-Williams. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    62/228 (page 50)
    considered as a factor in many cases, for it has been already pointed out that death occurs from syncope in many cases :Tvhen the patient is a robust young adult fresh from his work, who is given chloroform for the performance of some shght operation, as the extraction of a tooth. <. The/ causation of death in the gradual or late type is different from that of syncope. In this instance it is probably due to the effect of the drug on the medulla which has already been rendered anaemic by the gradual lowering of the arterial tension which is inseparable from an overdose of chloroform. Signs of Cardiac Syncope. In the severe forms of syncope the signs are unmistakable, and most startling in their onset. With no warning, the patient suddenly becomes blanched, the circulation and respiration fail, if not together, with no appreciable interval between them, the eyelids are separated, the pupils widely dilated, and corneal reflex absent,—in fact, the patient is, to all appearances at least, dead. This is the form which generally happens in the early stages of the administration of chloroform, and from which it is so hard to recover the patient. In the milder forms of syncope there is more often some warning. The patient becomes pale, the pulse gradually fails, and the pupils slowly dilate. The respiration is hardly affected at first, but gradually fails with the circulation. This form is generally met with in cases of syncope arising during light anaesthesia, which may be described as reflex; and also when vomiting is accompanied by syncope. From this form there is fortunately much more hope of recovering the patient. Treatment of Cardiac Syncope. The most important treatment of cardiac syncope is preven- tive; in fact, in the severe cases, no remedial treatment is usually of any avail.