In these days when so much wonderful surgery is done and when everybody desires to have the advantage of all modern methods being employed in the treatment of their case, a little knowledge of anesthesia will be of service to the reader. Before the discovery of ether an operation meant torture to the patient. If you should visit some of the old operating~ rooms you would find rings in the floor to which ropes used to be attached in order to hold down the patient. Ether is the most commonly employed anesthetic, and is safe to inhale, sure in its action and gives the least mortality. Something like one person in 50,000 dies from the inhalation of ether against one in 15,000 to 30,000 when inhaling other anesthetics. It is not over pleasant to inhale, as it is somewhat pungent and choky to breathe when first inhaled. This sensation soon passes off. A longer time is required to produce anesthesia with ether than with chloroform, but its greater safety overbalances this slight disadvantage. Vomiting more frequently occurs after ether than after chloroform.
Chloroform is the next most commonly employed anesthetic. It is agreeable, quick in its action, and very little is required. It is the common anesthetic in European practice, yet its greater mortality, the sudden change in heart and lung action, render its usefulness much more limited in this country than that of ether. It is employed especially in cases complicated by lung and kidney disease in the young and very old.
The A. C. E. mixture, so called, is still a third antithetic, and is composed of a mixture of alcohol, chloroform and ether, and is frequently given to start a case with, as its inhalation is pleasant and its anesthetic properties quick. Its mortality rate lies between that of ether and chloroform. Some people take these anaesthetizes with perfect comfort; others, being timid, require a larger amount and give in to its soporific effects very slowly.
Of late Cocaine has been introduced into medical practice as a means of rendering the flesh numb and painless when injected under the skin about the site of the part to be operated on. It has the great advantage of maintaining the senses other than that of sensation and pain perfectly intact. By its use large operations may be done, and, in the case of minor operations, time and money are saved and bad after effects are avoided. Sometimes a temporary faintness occurs from the use of a too strong solution, but this can always be avoided by weaker solutions and overcome at the time by a little stimulant.
For many local operations requiring incisions in the skin, temporary anesthesia can be obtained by spraying the skin with a nature of chloride ethyl. This acts by rapid evaporation in a way to freeze the skin, not enough to impair the tissue but sufficient to allow rapid operating for two or three minutes duration.
There is a popular feeling that ether and chloroform leave their traces in the system for a long time afterward; such is not the case, however, and fear need never be entertained that the system win be left the weaker for it.
In the use of anesthetics proper certain rules are to be observed. Nothing solid is to be eaten for a number of hours previous to the inhalation. All artificial teeth must be removed and all waist bands and tight clothing should be loosened if not removed.
A little strong coffee or a little brandy and hot water maybe given by mouth to prevent the subsequent vomiting and nausea.
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