The cessation of respiration under chloroform, and its restoration by a new method / by R. Milne Murray.

  • Murray, R. Milne (Robert Milne), 1855-1904.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The cessation of respiration under chloroform, and its restoration by a new method / by R. Milne Murray. 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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    movements of the abdominal and thoracic walls is usually explained in the human subject by the tongue falling back and the glottis becoming closed. But in these animals the air enters by the cannula below the glottis, and this explanation cannot hold good here. I can only explain the cessation of the air current just described by attributing it to a failure in the co-ordination of the muscles of expiration and inspiration, and that, in fact, a respiratory stammer is induced. Thus it might come about, through the action of the anaesthetic on the centre of respiration, that the action of the muscles of inspiration might be antagonised by the action of the muscles of expiration, and vice versa. Further, this inco-ordination might equally apply to the muscles of forced respiration were these called into play. Thus rhythmic movement of the chest might continue to the eye, and, even though a tendency to dyspnoea was induced, it would find no expression in the disordered mechanism. It seems to me no great straining of our experience to suppose that a powerful drug like chloroform, circulating in the blood for a lengthened time, might be quite capable of disturbing the rhythmic action of the centres of expiration and inspiration. We are familiar with the action of alcohol on an associated centre, that of speech, and I see no reason to doubt that a comparable effect may be produced by chloroform on the respiratory centre. If this is so, it bears on an important practical point, and seems to accentuate the importance of disregarding abdominal and costal movements as an indication of the continuation of respira- tory currents during anaesthesia, and of the administrator making certain, by actually feeling it, that air is actually passing in and out of the lungs. Another observation in connexion with this is worthy of note. In an experiment, in which the animal had been under chloroform for several hours, the paper web ran out, and, while it was being readjusted, the tambour ceased working while the movements of the chest continued. On pinching the eyelid with a pair of pointed forceps the movements of the tambour at once recommenced. Some time afterwards, the tambour again stopped, and again began to move when the eyelid was pinched. It seemed natural to suppose that the shock of the afferent impulse in some way or other served to harmonize the disturbed action of the centre of respiration, and it might be worth considering in this connexion how far the resumption of natural respiration, after the dragging for- ward of the tongue in certain cases, may not be the result of a similar reflex, and not merely a removal of an obstruction to the entrance of the air. At the same time, I do not press the theory I have advanced. I have as yet had no satisfactory opportunity of determining all the elements of the condition. I have brought the point under the notice of the Society for the purpose of drawing attention to it, and, if possible, inducing any one who may have the opportunity to o-ive it some consideration. I feel certain that the phenomena are not due to a plug, and it seems essential to assume the occurrence