Artificial anæsthesia and anæsthetics / by Henry M. Lyman.
- Lyman, Henry M. (Henry Munson), 1835-1904.
- Date:
- 1882
Licence: Public Domain Mark
Credit: Artificial anæsthesia and anæsthetics / by Henry M. Lyman. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
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![ineffectual effort. The pulse wiU be found rapid and feeble, demanding an immediate suspension of the process of etherization. That sort of respiratory forgetfulness, of wliich mention has been made in a previous section, in which the respiratory movements are slow and feeble, with considerable intermissions, calls for stimulation of the function. If the pulse is good, the condition need not excite alarm. Compression of the abdomen, exposure of the chest to the air, the various methods of excit- ing reflex action, will suffice to arouse the energy of the respiratory apjiara- tus without suspension of the process of inhalation. But if the respiratory intermissions are the result of laryngeal spasm, the phenomena of asphyxia appear immediately, and the patient is in danger. The ansesthetic should be removed until all convulsive symptoms have disappeared, and the cu'cu- lation and respiration have resumed their noirmal course. It sometimes happens that persons of a nervous temperament—especially if they a]Dpi*oach the operator with apprehension and alarm—will exhibit their mental per- tui'bation by a sobbing respiration. This need not excite anxiety on the part of the operator, if the pulse does not give way. If the circulation becomes enfeebled, or if symptoms of asphyxia are manifested, a brief delay will usually suffice to remove all unpleasant phenomena. The process of inhalation may then be resumed. The state of the circulation should receive constant attention. By many surgeons it has been considered sufficient to watch the respiration, but the condition of the i)ulse is the best guide to an interpretation of the respira- toiy symptoms. It is desu'able that the rate and the quality of the pulse should be frequently observed ; in fact, if the more potent anaesthetics, hke chloroform, are employed, the finger of the observer should scarcely quit the artery of the patient. Every sudden modification of the rate or volume of the pulse should place the surgeon on his guard. It is true that the period of complete anaesthesia is characterized by a diminution of the number of beats ; but this diminution is gradual, and does not occur befoi-e the development of unconsciousness. A small, hard pulse need not cause susjDension of the act of inhalation. The admission of more air will be sufficient. But if the pulse becomes intermittent and thready, the danger of syncope is imme- diate. Etherization should at once be arrested ; the head of the patient should be depressed ; the face and chest may be siDrinkled with cold water; the surface of the body may be rubbed in a manner favorable to the propulsion of the blood through the capillary net-work of the skin. Usually these measures are sufficient; but if syncope should be fully de- clared, it will become necessary without delay to have recourse to the more energetic measm-es to be described in the chapter which treats of the acci- dents of antesthesia. Sometimes these notes of alarm—these precursors of danger—are repeated more than once during the course of an attempt to produce artificial anaesthesia. The operation should, in such cases, be adjourned, if unfavorable symptoms follow the exhibition of sulphuric ether. If chloroform or any one of its congeners has been the cause of the difficulty, it should at once be discarded in favor of the milder anaesthetic. In fact, were sulphuric ether the only anaesthetic agent employed by inhala- tion, the numerous cautions and precautions which are now found needful when speaking in general terms of anaethesia, would be less needful. Epileptiform, or even epileptic convulsions, sometimes occur during the administration of anaesthetics. Such an event need not excite alarm, unless it be the cUmax of previous excitement in a subject who has never experi- enced such symptoms of disease in his normal condition. For all the or-](https://iiif.wellcomecollection.org/image/b21511251_0044.jp2/full/800%2C/0/default.jpg)
