Anaesthesia, or the employment of chloroform and ether in surgery, midwifery, etc. / by J.Y. Simpson.

  • Simpson, James Young, 1811-1870.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Anaesthesia, or the employment of chloroform and ether in surgery, midwifery, etc. / by J.Y. Simpson. 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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    there is no evidence whatever of pain being felt, far less re- membered. And he adds, In full four-fifths of the cases in which he had administered the ether, there was not the least flinch or groan during the cutting of the surgeon's knife. He considered cases of this kind the only truly successful ones, and believed that with proper care every case might be of this nature. When the patient exhibited signs of pain, although he might have no knowledge or recollection of it afterwards, the ether was only partially successful.* As a proof that such deep states of etherization are not accompanied with danger, I may mention here, though in the way of anticipation, that out of 39 surgical operations, nearly all serious ones, in which Dr. Snow has exhibited ether at St. George's hospital, 2 only of the patients died, namely, 2 on whom amputation of the thigh was performed, after they had been previously reduced to an extremely weak and emaciated''^ state. Now, 2 deaths in 39 hospital operations, or I in 18, would certainly be regarded as a very satisfactory and favourable result under almost any circumstances, and either with or without ether. Dr. Peacock, in his official reports of the Edinburgh Infirmary for 1842 and 1843, has publishedj two tables showing the results of the principal operations in that Institution, from amputation and lithotomy down to the operation for harelip. The tables include 150 cases in all; and 32 of the 150 patients operated upon died, or about 1 in every 5. Excluding 57 cases of extirpation of tumours in various parts, 32 in the 93 individuals on whom other operations were performed, or nearly 1 in every 3, died. To produce the complete ansesthetic and soporific effects of the chloroform some conditions are necessary to be attended to. Without attending to these conditions, you will have failures. 1. The chloroform vapour must always be exhi- bited as rapidly and in as full strength as possible, if you desire to have its first or exhilarating stage practically done away with, and excluded ; and you efl^ect this by giving the vapour so powerfully and speedily as to apathize the patient at , once. If you act otherwise, and give it in small or slow doses, you excite and rouse the patient in the same way as if nitrous- oxide gas were exhibited. 2. In order that the patient be thus brought as speedily as possible under its full influence, the vapour should be allowed to pass into the air-tubes by both the » Medical Gazette, February 26, 1847, and Braithwaite's Retrospect of Medi- cine, Vol. xv. 1847, p. 409. + Lancet for May 29, 1847, p. 553. t Stntistical Tables of the Royal Infirmary of Edinburgh for 1842, p. xix.; and for 1843, p. .wiii. In the reports of other years the operations are unfortunately not tabulated on the same plan, and do not show the mortality dependent upon them.