Page 31 |
Previous | 12 of 687 | Next |
|
|
small (250x250 max)
medium (500x500 max)
Large
Extra Large
large ( > 500x500)
Full Resolution
|
Loading content ...
THE CHARLOTTE MEDICAL JOURNAL, 31 rupted recovery. In others no improvement follows. Anaesthesia and Anaesthetics. By C. C. Hersman, M. D., Physician to South Side Hospital of Pittsburgh, Lecturer on Materia Medical and Therapeutics South Side Hospital Training School for Nurses, Past Surgeon P. R. R., Member South Side, Allegheny County and Pennylvania State Midical Societies, W. Va. State Medical Society (honorary), American Medical Association, American Medical Temperance Association, &c., &c. in Much of the surgeon's success depends upon the anaesthetist. In administering an anesthetic there is no such thing as minor surgery. A strong person with a full stomach runs greater risk from a "whiff" of chloroform while under the anesthetic than a weaker person properly prepared, who is kept under it for an hour; and if the surgeon is inclined to look lightly on it, the anesthetist should be all the more careful. Under no circumstances should the clothes fit tightly, and this applies to all anesthetics. The patient's meals should be interfered with as little as possible, but allow an interval of four or five hours between the last meal and the anesthetic. To give soup and light diets at hours other than the meal time is a mistake. Loose teeth should be noted, false teeth and tobacco removed, and take note whether the patient breathes freely through the nose. A faulty position of the head is the most frequent error, and this applies particularly to dentists and operations on the mouth. Flexion on the sternum or extension on the spine should be avoided during inhalation. Extension upon the spine brings the base of the tongue and epiglottis away from the opening of the larynx, making swallowing either difficult or impossible and allowing saliva or other foreign substance to enter it. Always keep the head in the long axis of the body. Idiosyncrasies are often nothing short of the fault or carelessness of the anesthetist. Opinion is still divided as to the most suitable anesthetic in general surgery. Of course, statistics show that ether is safest. But it cannot be denied that ether-bronchitis and ether-pneumonia may occur, and until some authentic inquiry is made into this frequency we do not know the precise comparative risks of ether and chloroform. Of course, chloroform is safer in hot than in cold climates, and administration of ether *Read at a meeting of the Allegheny County Medical Society, at Pittsburgh, Pa., Nov. 15,'98. high temperatures is difficult or impossible. Taken all in all ether is safer, but in well appointed hospitals, with an expert anesthetizer, I see few contraindications to chloroform. It is well enough to have other anesthetics at hand, as well as tongue forceps, gag, restoratives, etc., but the more one sees of anesthesia the less need he sees for anything save proper position and early and efficient artificial respiration. If pallor and feeble pulse occur from chloroform, ether is a good restorative, but often, I believe, valuable time has been lost by resorting to these when the anesthetist should have turned his attention to the respiration. Muscular men while passing through the stage of muscular spasm just prior to deep anesthesia may have their breathing arrested by the muscles of the jaw and neck becoming fixed. In this class of men I believe ether to be the safer. Close attention should be paid to the breathing. See that every breath enters and leaves the lungs. Too often the anesthetist has realized nothing wrong until cyanosis, lividity, pallor, or pulselessness has drawn his attention to the condition There is not one student in five who graduates that can put his theoretical knowledge to practical test when giving his first anesthetic. They should have clinical instruction as well Keep the lower jaw well forward. In laryngeal spasm rub the lips briskly with a dry towel. It is the custom to rush to the hypodermic syringe in case of weak pulse, when often the correction of bad breathing would right everything. It is too much the habit to attend altogether to the circulation. There is no better stimulation to the circulation than free breathing. In collapse from surgical causes resort to your strychnia, etc., but collapse from over-narcosis is to be treated from the respiratory side. The following are some of the solutions used by surgeons: 200 parts chloroform, 6o parts ether, and 6o parts alcohol. 3 parts chloroform, 2 parts ether, and i part alcohol. 1 part chloroform and 3 parts of ether. 2 parts chloroform and 1 part alcohol. 3 parts of chloroform and 1 part alcohol. ^ parts chloroform and 1 of oleum tera-bintheni. Chloroform 1 lb. to amyl nitrite 1 drachm. A. C. E. mixture. Chloroform and oxygen safest. This last mixture, it is said, anesthetises sooner than other mixtures with a smaller amount of chloroform ; the cheeks and lips
Object Description
Rating | |
Fixed Title * | NCHH-21: Charlotte Medical Journal [1892-1921] |
Document Title | Charlotte Medical Journal [1892-1921] |
Subject Topical | Medicine -- North Carolina -- Periodicals. |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Description | Absorbed Carolina medical journal in 1908 and continued its vol. numbering with v. 58. Vol. 4, no. 3 (Mar. 1894) misnumbered as v. 4, no. 5. |
Publisher | Charlotte, N.C. : Blakey Print. House, 1892-1921. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1899 |
Identifier | NCHH-21-014 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-21/nchh-21-014.pdf |
Document Sort | all; group-e; nchh-21 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-21-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-21 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2666817 |
Revision History | keep |
Description
Fixed Title * | Page 31 |
Document Title | Charlotte Medical Journal [1892-1921] |
Subject Topical | Medicine -- North Carolina -- Periodicals. |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Description | Absorbed Carolina medical journal in 1908 and continued its vol. numbering with v. 58. Vol. 4, no. 3 (Mar. 1894) misnumbered as v. 4, no. 5. |
Publisher | Charlotte, N.C. : Blakey Print. House, 1892-1921. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1899 |
Identifier | NCHH-21-014-0017 |
Form General | Periodicals |
Page Type | all; article; article title |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | charlottemedical141899char_0017.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Issue Number | 1 |
Page Number | 31 |
Health Discipline | Medicine |
Full Text | THE CHARLOTTE MEDICAL JOURNAL, 31 rupted recovery. In others no improvement follows. Anaesthesia and Anaesthetics. By C. C. Hersman, M. D., Physician to South Side Hospital of Pittsburgh, Lecturer on Materia Medical and Therapeutics South Side Hospital Training School for Nurses, Past Surgeon P. R. R., Member South Side, Allegheny County and Pennylvania State Midical Societies, W. Va. State Medical Society (honorary), American Medical Association, American Medical Temperance Association, &c., &c. in Much of the surgeon's success depends upon the anaesthetist. In administering an anesthetic there is no such thing as minor surgery. A strong person with a full stomach runs greater risk from a "whiff" of chloroform while under the anesthetic than a weaker person properly prepared, who is kept under it for an hour; and if the surgeon is inclined to look lightly on it, the anesthetist should be all the more careful. Under no circumstances should the clothes fit tightly, and this applies to all anesthetics. The patient's meals should be interfered with as little as possible, but allow an interval of four or five hours between the last meal and the anesthetic. To give soup and light diets at hours other than the meal time is a mistake. Loose teeth should be noted, false teeth and tobacco removed, and take note whether the patient breathes freely through the nose. A faulty position of the head is the most frequent error, and this applies particularly to dentists and operations on the mouth. Flexion on the sternum or extension on the spine should be avoided during inhalation. Extension upon the spine brings the base of the tongue and epiglottis away from the opening of the larynx, making swallowing either difficult or impossible and allowing saliva or other foreign substance to enter it. Always keep the head in the long axis of the body. Idiosyncrasies are often nothing short of the fault or carelessness of the anesthetist. Opinion is still divided as to the most suitable anesthetic in general surgery. Of course, statistics show that ether is safest. But it cannot be denied that ether-bronchitis and ether-pneumonia may occur, and until some authentic inquiry is made into this frequency we do not know the precise comparative risks of ether and chloroform. Of course, chloroform is safer in hot than in cold climates, and administration of ether *Read at a meeting of the Allegheny County Medical Society, at Pittsburgh, Pa., Nov. 15,'98. high temperatures is difficult or impossible. Taken all in all ether is safer, but in well appointed hospitals, with an expert anesthetizer, I see few contraindications to chloroform. It is well enough to have other anesthetics at hand, as well as tongue forceps, gag, restoratives, etc., but the more one sees of anesthesia the less need he sees for anything save proper position and early and efficient artificial respiration. If pallor and feeble pulse occur from chloroform, ether is a good restorative, but often, I believe, valuable time has been lost by resorting to these when the anesthetist should have turned his attention to the respiration. Muscular men while passing through the stage of muscular spasm just prior to deep anesthesia may have their breathing arrested by the muscles of the jaw and neck becoming fixed. In this class of men I believe ether to be the safer. Close attention should be paid to the breathing. See that every breath enters and leaves the lungs. Too often the anesthetist has realized nothing wrong until cyanosis, lividity, pallor, or pulselessness has drawn his attention to the condition There is not one student in five who graduates that can put his theoretical knowledge to practical test when giving his first anesthetic. They should have clinical instruction as well Keep the lower jaw well forward. In laryngeal spasm rub the lips briskly with a dry towel. It is the custom to rush to the hypodermic syringe in case of weak pulse, when often the correction of bad breathing would right everything. It is too much the habit to attend altogether to the circulation. There is no better stimulation to the circulation than free breathing. In collapse from surgical causes resort to your strychnia, etc., but collapse from over-narcosis is to be treated from the respiratory side. The following are some of the solutions used by surgeons: 200 parts chloroform, 6o parts ether, and 6o parts alcohol. 3 parts chloroform, 2 parts ether, and i part alcohol. 1 part chloroform and 3 parts of ether. 2 parts chloroform and 1 part alcohol. 3 parts of chloroform and 1 part alcohol. ^ parts chloroform and 1 of oleum tera-bintheni. Chloroform 1 lb. to amyl nitrite 1 drachm. A. C. E. mixture. Chloroform and oxygen safest. This last mixture, it is said, anesthetises sooner than other mixtures with a smaller amount of chloroform ; the cheeks and lips |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-21/nchh-21-014.pdf |
Document Sort | all; group-e; nchh-21 |
Article Title | Anaesthesia And Anaesthetics |
Article Author | C. C. Hersman |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-21-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-21 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2666817 |
Revision History | keep |
Tags
Comments
Post a Comment for Page 31