Volume 1

Remarks on the fatal case of inhalation of chloroform; including additional explanations from Dr. Meggison / [John Snow].

  • Snow, John, 1813-1858
Date:
[1848]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the fatal case of inhalation of chloroform; including additional explanations from Dr. Meggison / [John Snow]. Source: Wellcome Collection.

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    REMARKS ON THE FATAL CASE OF INHALATION OF CHLOROFORM ; INCLUDING ADDITIONAL EXPLANATIONS FROM DR. MEGGISON. By Joun Snow, M.D. An instance having occurred in which the application of chloroform has ended fatally, it is highly desirable to arrive this unfortunate result, as well that a repetition of it may if possible be avoided, as for the satisfaction of scien- tific inquiry. And since the opinion | have formed. differs from that of the medical gentlemen who gave their evi- thought it necessary to state my views of the case. Sir John Fife attributes the fatal in the constitution of the young woman, which could not previously have been foreseen. This would necessarily in- vest the inhalation with some degree of danger, however small, and would entail some anxiety on both the opera- tor and the patient. My view of the matter holds vut more hope for tie future. I look on the result as only what was to be apprehended from the over-rapid action of chloroform when administered on a handkerchief, as re- commended by the greatest authority respecting it—Dr. Simpson, the author of its use, and consider that danger may be avoided by adopting another method. I have observed that the effects of the vapour may accumulate for about twenty seconds after the in- halation is discontinued;* and this accumulation will be the more formi- dable in proportion to the quantity of vapour that is being inhaled at the mo- ment, and the velocity with which the symptoms are being induced. The entire effects of the vapour, when car- ried to a fatal issue, might be divided into five pretty equal portions, accord- ‘ing to the degrees of narcotism I sug- gested. Now, in the case under con- sideration, when the girl had inhaled * See MED. Gaz., Jan. 14. Two days after I made the statement respecting the cumulative property-of vapours in the Westminster Medical ‘Society, viz. Jan. 10, M. Sédillot remarked, in the Academy of Sciences, that with chloroform the pallor, smallness of pulse, weakness of re- spiration, and coldness of the skin, sometimes increase after the inhaler has been removed, in an alarming manner. for about half a minute, there was rigidity of the arm; this would mdi- and supposing that the cloth was re- of the same strength during the thirty seconds, its effects might increase at the same pace for twenty seconds longer; and at the end of fifty seconds from the commencement she would be in the fifth degree of narcotism, in more or less paralysed, and become difficult, feeble, or irregular.” tional information to that given in the report of the inquest on one or two points. my inquiries, and also given me leave to make use of his reply. The follow- ing is part of his note :— 3 “With respect to your queries,—Ist, As to the nature of the breathing after the inhalation was stopped? 2d, How long did the patient breathe after the removal of the cloth? 3d, As to the moan spoken of. The Ist I can reply to satisfactorily. The breathing was at first somewhat quicker and stronger ; then, immediately preceding the moan spoken of, it became very rapid, and ended in what the witness Rayne called a moan, which was a prolonged forced expiration, or rather splutter,—breath, saliva, and tongue, being forced out at once, as it were. ‘The sound was simi- lar to the expiration in epilepsy or hysteria. The remaining expirations and inspirations were exceedingly feeble and few; but I could not speak confidently on the subject, being very much agitated at the time. 2d, The breathing after the removal of the cloth continued upwards of half a minute, but how much [| cannot say, having put my watch in my pocket on seeing her move. 3d, The moan, as I have said before, did not appear to me such, but a splutter.”’ The above explanations make it still more evident that the effect of the chioroform greatly increased after the inhalation was discontinued. The quantity employed—about a fluid drachm—was, in my opinion, suf- ficient to account for the result, even supposing that one-half evaporated into the apartment and only the other half was inhaled; for, in using an in- haler by which little or no vapour