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

  • Snow, John, 1813-1858.
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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    has not much exceeded five per cent., the action of the heart is not arrested by its direct influence, but when it reaches to about ten per cent., the action of the heart is at once arrested. I might explain the reason of this by arithmetical calculation, but shall content myself at present by stating the simple fact. In a few experiments, the action of the heart ceased a little before the breathing, and I shall allude to them afterwards. In the paper which I read in 1852,1 expressed my conviction that no accident, of which the particulars had been related, had arisen from the medical man mistaking the symptoms, and continuing to exhibit too long the vapour of chloroform suffi- ciently diluted with an-; but that in all the recorded cases the action of the heart, as well as the respii-ation, had been suddenly arrested by vapour not sufficiently diluted with air. An exa- mination of the accidents from chloroform which have since been recorded, has satisfied me that they have also been occa- sioned in a similar manner. Dr. Black, of St. Bartholomew’s Hospital, who has had great experience in the administration of chloroform, has lately ad- vanced the opinion, that in the accidents from chloroform the patients did not die from the pathological effects of this agent, but died simply of asphyxia before they were brought under the influence of the chloroform, owing to the respiratory move- ments having been arrested, or impeded, by the pungency of the vapour, which has been administered in too concentrated a form, at the beginning of the inhalation. This view is, in my opinion, altogether untenable, as an ex- planation of the accidents from chloroform, for various reasons. I find that when the access of air to the lungs is entirely cut off, death does not take place in less than three minutes and a half in guineapigs, and four minutes in cats. In dogs, the process of asphyxia is still slower. Mr. Erichsen states, that on taking the average of nearly twenty experiments, the con- tractions of the ventricles continued for nine minutes and a quarter after the trachea had been closed, and that the pulsa- tions of the femoral artery also were perceptible for an average