Further remarks on the cause and prevention of death from chloroform / by John Snow.

  • John Snow
Date:
[1856]
Catalogue details

Licence: Public Domain Mark

Credit: Further remarks on the cause and prevention of death from chloroform / by John Snow. 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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    The vapour of sulphuric ether is as pungent and irritating as that of chloroform, if not more so, and, therefore, if the acci- dents were occasioned by the pungency of the vapour prevent- ing the access of air to the lungs, they would be quite as liable to occur under the exhibition of ether as that of chloroform. But accidents during the inhalation of ether were extremely rare; only two are known to have occurred, and these, I be- lieve, not from the effects of the vapour. In one of these cases, which occurred at the Hdtel Dieu d’Auxerre, the patient seemed to die by asphyxia, not occasioned, however, by the pungency of the vapour, but, more probably, the narrowness of the tubes of the inhaler. Symptoms of distress commenced when the man had been inhaling three minutes, and continued till the time of his death, at the end of ten minutes, the apparatus being kept applied the whole time. I need hardly say that no case resembling this has occurred during the exhibition of chloroform. In the other case which happened at the H6tel Dieu de Lyons, the patient died of sudden syncope, caused, in my opinion, by loss of blood dining the removal of the superior maxillary bone—an operation which the surgeon had been re- luctant to undertake, on accoimt of the weakness and general bad state of the patient. In a few cases of death from chloroform the countenance has been observed to become turgid and dusky just after the circu- lation ceased. This circumstance has been thought to indicate death by asphyxia, which is an error. Although not of itself proving the kind of death, the turgid and dusky state of the face is what must take place from sudden arrest of the action of the heart in patients who are not deficient of blood. The moment the lieail; ceases to beat, its right cavities become dis- tended, and no more blood can enter them from the veins; but the arteries are emptied by their contractility, aided by the molecular forces connected with the circulation through the capillaries, and consequently the veins become distended, even to their radicles. In several of the fatal cases of exhibition of chloroform there J
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