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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    appears to me to be explained by the fact that chloroform is primarily a respiratory poison, and that, if given in sufficient quantity, it stops the action of the respiratory centre before it affects the heart. Accordingly, the heart may be beating vigor- ously some time after the respiration has ceased under the con- centrated vapour. On the other hand, the prolonged circulation of the vapour in the blood ultimately affects the cardiac action, and, consequently, under dilute chloroform, the heart may stop with or immediately after the respiration, and hence the difficulty of resuscitation. To show how well the characters of respiratory cessation under concentrated vapour which I have described are retained, even after repeated reanimation, I show tracings of the final stages of four cessations in the same animal, Figs. 5, 6, 7, 8, Plate I. ; where it will be seen that it is only in the last one, when the animal had succumbed four times, and been more or less under the vapour for 4^ hours, that any slowing is observed, and even then it is not great. So also in Fig. 47, Plate V., taken after seven resuscitations, we have a similar correspondence with the mode of death occurring under the earlier administrations. The observations recorded in this communication touch more than once on points of practical interest, but which time will not permit me to allude to. I content myself at present with a reference to one matter only, namely, that of resuscitation after respiratory cessation. It is with diffidence that I venture to offer any suggestion whatever on so grave a matter as the method of re-establishing respiration in such cases, and this all the more, when the suggestion refers to a mode somewhat different from that ordinarily employed and sanctioned by experience. But the fact remains that the ordinary method sometimes fails in its object, which failure may, in certain cases at least, be accounted for by a defect which I have in- dicated. Encouraged, then, by the success of the experiments on animals peculiarly susceptible to the action of chloroform, which has followed the method I have described, and convinced of the physiological soundness of the principles involved in it, I would venture to suggest that in any case of respiratory cessation under chloroform (with the heart beating after the respiration had ceased), and where the removal of the vapour from the face, the drawing forward of the chin, and compression of the chest have failed to restore breathing, that the method of “perflation” should be tried without delay. It might be done in lieu of a better means by a gum elastic tracheal tube as figured, provided with a conical collar to make it fit tightly into the glottis and prevent it slipping too far m. This could be slipped over the tongue and into the glottis, and the collar pressed down into the rima. The mouth is applied to the tube and several deep inspirations made. The mouth is with-