New-York tribune., 1872-03-23
DANGERS or AN NHISTHETlCS
REGENT CASES or DEATH UNDER ANB5rHEsIA
SOME OF THE CASES DURING LAST YEAR
TO WHOM IT rs PRRILOUs-DR. CURTIs'5
OPINION OF ITS UNIVERSAL sAEErY--1rs MEN

| tai EFFECTS.
| The case of the lady who died suddenly on
| Wednesday, after the inhalation nitrous oxide
| Laughing gas which she had taken for the pur-
pose Of relieving the pain OF dental opera
| ton, ia TO bs Investigated by coroner's jU-y
composed Of medical men. Deputy Coroner Beach.
| who has made an autopsy of the body. found
Organic disease and came 10 the conclusion thas
death resulted from congestion of the lungs supern
duced by the anesthetlc agent and the nervous con-
dton OF the deceased !! hoped the facts OF the matter
WILL as far as possible be brought ont by the coroners
jury They may rehec. neither upon the careiuness OF
the operator the value OF the annhetc agent but
they will be OF great the medical tlcuty and
the public in general.
A few months ago, another lady died in dentists
chair in Brooklyn while under the shetic influence
The operator first administered laughing but 1t did
not have the desired effect and next day he admins
tered chlOroform. under She influence Of which she
died. At the post-morem examination all the organs
found perfectly healthy and the examining physi-
clan gave his opinion that death caused hy nervous
shock paralysis OF the heart from the effects OF the In
halaon Of a moderate dose OF choroforIn. The cor
oners jury rendered verdict TO the effect, and,
probably without much scientific knowledge the sub
pct said In the verdict would urge the disc
OF chloroform except in the most which
nigh require the agency Of 80 powerful an anRsthetc.
NoDtdy who has had experience or observation In sur
gical Practice will doubt that the discovery of an9sthe
sla has proved of infinite the human t Is
mnisered in thousands of every year private
practice ind IN the large hospitals with perfect safety
But that t'ere dangers connected with it in some
cases, owing to certain conditions OF the system
cuiiarities OF constitution, cannot be doubted
Dr DawsohOf Cincinnati has given Ia Tie Cincinnati
Lancet (Janusy, lsyp list of twelve cases OF death
from the use OF ssoroform. We have the authority
of Dr. Conner of Philadelphia that there at least
eght cases on record the office of the SurgeOnG Cen
by in
Dr. Briggs OF Nashville reports in The Ndshriie Jour
nal Or Medteine Hebruary, 1sID fatal case which
fell under his observation Dr. Bancroft Of Denver had
fatal case the sd of last March The operation
slight one and less than half OF choroform
was used. but the patient died under it. In Cincinnati
IN October last, there fatal The PhtIa-
dephio Medical and Surgical Reporter iarch, 1871 re-
ports fatal case in Michigan under Dr. Porter In this
case the lady took choroform for dental operation
which performed and she drove away, but expired
after reaching her house.
In the British medical journals OF last may be
noticed the record of several cases OF death under
anashetics The London Lancet Jan. 2S 1SID reports
hospital where u slight operation performed
on a male patient, and but one dram and a half OF
ch0roform used. yet the died under it. The
Lancet Dee a. 1870 contains report OF another fatal
The British Medical Journal (March 25. 1S7D
reports fatal where three and half
drains OF ohorOform were used. and the alleged
OF death paralysis of the heart
Tho journal (Apri 90 1o reports two other fatal
cases, in OF which dram and half OF cblOroform
but the amount consumed in the other is
not mentioned. Sir James Simpson himself, tine great
Scotch surgeon who had much to do with the intro
ducon of anesthetcs surgical operations. had
OF death under his own hands about two years ago.
shortly before his deceas. The patient woman 81
years Old and the chloro0rm administered by the
hands OF Sir James bmself.
CAUSES or DANGER.
An able medical writer in recently discussing the In
creasing mortality from chloroform. said that the
greater with this than with any other anrstbec
but he added that every anesthetc thus far discovered
has had its victims This writer argued that it time
for the medical profession to take into consideration.
with much accuracy possible. two very important
questions.
First: What conditions OF the system-acquired OF
hereditary-aud what pecuareS Of constitution, for
bid the administration OF the agent
Second BY what mode, II any can this any other
anasthetic be safely administered
would appear collected facts that the heart OF
all the organs is the most frequently assailed by the
deadly influence of the anesthetic poison The lungs
the next in frequency to yield to its Psychological
action cases the stomach. the brain, and the
tongue by falling back are the organs or parts
first To receive the shock Of the toxic proper
ties of the anesthetic. DIT. A. sH Smith
OF this city recently read paper before the Medical
Library and Journal Association One OF the Causes
OF Death from Chloroform" aud ho advanced the view
that the serious results induced by this agent in
might be due to its local anesthetc action upon
the respiratory organs Not only the air-ces
posed directly to the yapor, but the blood brought
to the lungs Is loaded with tho anaSthetic. He
thought that the effect OF this double dose might be to
deaden the 6eso dc resprr that instructive sensation
which analogous TO the feelings OF hunger and thirst
impels the reflex act OF respiration. DR. Richardson
sert that when "a weakened and dilaed right side Of
the heart. with enlarged hemorrhoida veins.
varicose veins OF the lower extremities and
large, full. yet tense VEINS in the lower
part of the body" is met with. the admins
traton OF chlorofOrm is hazardous in the extreme.
Another contra-indcatng condition is where the
kidneys diseased in certain ways and still another
i fatty degeneration Of the heart, which condition
hard to determine, for every sign and symptom Of 1t
may be absent while yet 1t exists Hard drinkers
rule should not DO subjected to the
anas;besia OF ohlOrOform for them it has
more than ordinary dangers. Many practitioners
employ small quantities OF choroform, especially in OBJ
stetrca cases. induce incomplete aneshesia hoping
to alleviate pain without producing total insensbty But
experience proves that anasthesa may be dangerous
when IL Is partial when 1t is complete To the Obste-
trcian chloroforn invaluable, but it should be
fined to cases mperatively demanding its employment
Curtis of Cincinnati has recently put forward
views administration OF chlofoorm in connection
with the report Of death from its He holds that
many surgeons too hasty in putting persons under
the an9sthetic influence. He himself determined to
give choroform very slowly and TO urge large nhala
tons of atmospheric air As patients seemed inclined
TO refuse full inspirations to avoid nlaliDg the
choroform. he gave it loosely through silk hand
kerchief and slowly tha from Is TO 30 minutes
required to prepare the patient for operation Civ
ing It fast enough TO diminish sensby the force vol
uue OF pulse darken the color OF the surface
He never gave more than was necessary 10 prevent
sensation pinchng the surface to learn when this
accomplished and renewing the Inhalation during opera
ton only when he found sensation returning Soon after
the introduction Of chor0form into surgery Boston
geon, while operating a patient under its influence,