What anaesthetic shall we use? : Read before the Baltimore Academy of Medicine, June 5th, 1877 / by Julian J. Chisolm.

  • Chisolm, Julian John, 1830-1903.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: What anaesthetic shall we use? : Read before the Baltimore Academy of Medicine, June 5th, 1877 / by Julian J. Chisolm. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    Against the fatality ot idiosyncrasies we can hardly guard, and yet something even here might be done. Three or four times in my own experience I have had cases in which I at the time thought that the anaesthetic which I was administering was badly borne. Once while giving chloroform I noticed a sudden and unusual pallor. I stopped the administration, and the patient, by breathing pure, air, soon assumed a natural appearance. I resumed the chloroform with similar results. I then exchanged it for ether, and had no further appearance of these symptons. What might have OCCured had I continued the chloroform, I am unable to say, possibly nothing but the most satisfactory anaes- thesia. It might have been a groundless fright, still 1 am willing to call it an idiosyncrasy. In a second case, a young girl of seventeen, to whom I had given no stimulus, I thought that the pulse was rapidly enfeebled by the chloroform inhalation, and I exchanged the anaesthetic for ether. These cases occured some years ago. More recently, since the sulphuric ether has been urged as the safer anaesthetic, I, with no reason for doing so beyond popular clamor, have used it very freely. In one or two instances I thought it was badly borne, causing intense congestion of the head or excessive irritation of the throat. In these cases I stopped the ether and administered chloroform, with, as I con- ceived, marked relief. My fears here again might have been altogether groundless, as in the chloroform cases before mentioned. I constantly see cases which excite the most anxious solicitude on the part of the timid and inexperienced operators—a marked enfeebling of the pulse, feeble respiration, pallor of the face, and relaxation of the skin with perspiration pouring out upon the surface. Experience has taught me that this relaxed condition, which so many are terribly alarmed about, is only the precursor of vomiting, and is the signal that I must prepare the patient for emesis. This condition, so constantly met with by the every-day administrator of chloroform, has so frightened many an inexperi- enced or timid operator as to make him believe that he had come within an ace of having a fatal case of inhalation on his hands. When one uses chloroform or ether in the way as explained, he might confidently expect no trouble. Should he believe that chloroform always weakens the heart's action, he puts in antici-