Helena weekly herald. [volume] (Helena, Mont.) 1867-1900, 1882-09-28
No. As.
ANESTHETIC AGENTS.
How and When to Use Them.

Philadelphia Telegraph
Few topics discussed in medical circles of
late have attracted the popular attention that
has been given to the papers OF DR.. Sims
and DR.. johnson on the use of anesthetic
agents. the former recounting before the
New York Academy of Medicine some cases
exemplifying the danger of employing new
compounds in this. capacity; and the latter
before the Medico-Legal Society, raised the
question of when, and under what circum-
stances, the practitioner is justified in using
chloroform, ether, amylene, bromide of ethyl,
ETC., to subdue pain. In both papers the
statistics of mortality from the use of the
drugs set wildly before the minds of the
audiences assembled the fact that a certain
risk of fatal accident always accompanies
the use of anesthetic agents of ali descrip-
tions, chloroform being the most perilous of
all in the proportion Of ten to one. 1t has
been shown by evidence that the risk is not
always contingent upon the presence Of dis
ease of the heart or of pulmonary troubles;
but that chloroform, under the ordinary
methods of administration, may produce
sudden death without the cooperation of
either of these causes. Taking the latter as
the typical anesthetic, as it undoubtedly has
proved itself the most efficient, the question
raised by DR.. Johnson as to when a medical
man is justified in using it, is one of the
gravest importance, particularly when it is
considered that only few years ago many
physicians were in the habit OF allowing pa
tients of average intelligence to apply it in
attacks of neuralgia, when they were not
present to superintend the administration.
A few sudden deaths led to the exercise of
more caution, but did not result in any ex-
peri.nents calculated to determine whether
there is any mode Of administering the allie
viative, by means of which release from
pain may be secured while the peril is OBJ
waited. Paul Bert, recently Minister of
Public Instruction and member of the In
stitute of France, whose remarkable expert
ments in destroying the bacteria of anthrax
by aerostatic pressure attracted general at
tention several years ago, appears to have
taken up the problem left unsolved by medi-
cal practitioners and to have furnished facts
that may lead to its solution. His expert
ments were conducted with dogs, sparrows,
and mice confined in air-tight compartments,
containing in mixture withspure air a6given
percentage of chloroform, ether, amylene,
bromide of ethyl, ETC., with a view to de-
termine what proportion of the anesthetic
was necessary to produce Inconsistencies
without death, in the first instance, and in
the second, what proportion proved most
rapidly fatal. His researches developed this
curious fact-that in all cases except pro-
toxide of nitrogen, the fatal dose is exactly
double the dose required to produce insensi-
bility. When he confined mice in a vapor
composed of six grams Of chloroform to 100
liters of air, for example, he found that in
sensibility ensued with normal rapidity, but
there was no danger of death from protrac
ton of the experiment; but when the pro-
portion of chloroform was raised to twelve
grammes per 100 liters, death ensued very
soon after Inconsistencies supervened. This
rule he found to hold good throughout the
series and he thus established what he pro-
poses to call the working zone of anesthesia.
In practice he found that a compound of
nine grams of chloroform to 100 liners of air
was extremely efficient in producing insen-
sibility, the animal remaining perfectly un-
conscious for two hours under the scalpel of
of the experimentalist without any atten-
ton being required. The working zone in
anesthesia, is as thus demonstrated very
narrow; and, as an anesthetic acts not ac-
cording to the actual quantity inhaled, but
according to its proportion to the volume of
air mixed with it, a very small quantity may
prove fatal when air is excluded, while
very large quantity may fail when air is
freely admitted. Hence the deaths so often
recorded by surgeons from extremely small
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