The question considered : is it justifiable to administer chloroform in surgical operations, after its having already proved suddenly fatal in upwards of fifty cases, when pain can be safely prevented, without loss of consciousness, by momentary benumbing cold? / by James Arnott, M.D.

  • Arnott, James, 1794-1885.
Date:
1854
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Licence: Public Domain Mark

Credit: The question considered : is it justifiable to administer chloroform in surgical operations, after its having already proved suddenly fatal in upwards of fifty cases, when pain can be safely prevented, without loss of consciousness, by momentary benumbing cold? / by James Arnott, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    In these the skin and adjacent textures are alone concerned, or parts, at least, accessible to the benumbing influence of cold ap- plied to the surface. Let the list of cases be consulted in which chloroform has proved fatal, and it will be seen how few there are in which insensibility could not have been produced by be- numbing cold ; or, as more accessible, let the three fatal cases, recently occurring at three of our principal Hospitals, and in the short space of a month (from the 25th of September to the 20th of October), be taken as an example. The first reported, at Uni- versity College Hospital, was a case of strangulated rupture. Here the parts, from being immediately beneath the surface, are quite within the influence of cold ; and congelation, in such a case, has other and great advantages. Not only is the muscular spasm, which contributes to prevent the return of the intestine, likely to give way under its action, but it also checks the inflam- mation already perhaps existing in the strangulated part, as well as obviates that which may be produced by the wound. The French writers include the operation for strangulated hernia, amongst those in which etherization is not advisable, on account of certain constitutional afiections attending it, and particularly a tendency to syncope.* The second case occurring at St. Bartholomew's Hospital, was a maligant ulcer in the vagina, to which a red-hot iron was to be applied. To this benumbing cold might have been as easily applied as to the womb, the neck of which, I have, in uterine cancer, kept congealed for half-an-hour at a time ; and considering that a case is re- j ported in the Medical Times and Gazette (June, 1853), where the ipain attending the application of the actual cautery to the knee * In an essay on strangulated hernia in the Lancet of 1843, I have mcntioncil the advantage of keeping up a long continued and perfectly uniform degree of cold in certain cases of that disease, by means of a current of water passing through two 'ble tubes and a thin bladder placed upon the part. Congelation will probably persedo this, by doing all that can thus bo accomplished, in the course of a very few inutcs. It would also be a valuable adjunct to the plan I have there suggested, of 'thdrawing the intestine from the strangulating ring by distending it from below.