GALION, OHIO, December 18, 1885.
The president, Dr. MITCHELL of Mansfield, called the meeting to order,
and owing to the number of papers to be presented and the brief time for
the session, ordered the omission of reading of minutes of last meeting
and all miscellaneous business. E. H. Hyatt of Delaware, was first
called, and excused on the ground that he could not do justice to his
subject, “The Use and Abuse of Alcohol from a Professional Standpoint,”
in so short a time.
Dr. R. HARVEY REED of Mansfield, the appointed lecturer, read a paper on
Anæsthetics, in which he gave a brief review of the different general
and local anæsthetics in use and the different compounds of the same.
He referred to the elaborate experiments of Dr. Watson of Jersey City,
which showed the following mortality on rabbits:
Sulphuric ether, 16.66
Chloroform, 62.50
Bromide of ethyl, 50.00
Alcohol, chloroform and ether, 75.00
Alcohol, chloroform and ethyl, 66.66
And on dogs:
Sulphuric ether, 00.00
Chloroform, 00.00
Bromide of ethyl, 100.00
Alcohol, chloroform and ether, 60.00
Alcohol, chloroform and ethyl, 80.00
In these experiments the doctor found it necessary to resort to
artificial respiration on dogs as follows:
Sulphuric ether, None
at
all.
Chloroform, 2
times.
Alcohol, chloroform and ether, 3
times.
Alcohol, chloroform and ethyl, 5
times.
The author referred to a number of experiments he had made on frogs, in
which vivisection was made, and the heart exposed and chloroform applied
direct, from which they died in from ten to twenty minutes, and when
bromide of ethyl was used in fifteen to thirty minutes, but when ether
was used, and even much freer than either of the others, they did not
die at all.
In repeated experiments, he said, he had found the use of electricity
unreliable in resuscitating the heart under these circumstances.
After referring to the mortality reports which showed 405 deaths from
chloroform against seventeen from ether, he said: “I feel that every
time I use chloroform as an anæsthetic I am trifling with a dangerous
compound, and that it will only require time and perseverance in its use
until I will share the fate of many others, whose misfortunes ought to
be a timely warning to us against its dangerous effects; and if not
heeded an accident will be all the more inexcusable.”
He condemned the use of so-called “vitalized air” as being an uncertain
and unstable compound: being one of the nitro-oxygen series mixed with
chloroform, its effects were uncertain and often very injurious, which,
he said, “should be reason enough to deter any conscientious physician
from using it or even recommending it.”
For administering anæsthetics the author recommended a clean folded
towel as being more preferable than anything else, as it was just as
efficient and decidedly better from a sanitary standpoint.
He recommended watching the pulse closely while administering
chloroform, and the respirations when ether was administered, lest in
the former the cardiac ganglia become affected and suddenly arrest the
heart's action, or in the latter the nerve cells of the medulla from its
toxic effects abruptly interfere with the breathing.
In closing the author said: “From the brief review of the anæsthetics
most familiar to the profession from a practical standpoint we have
arrived at the following conclusions:”
_First_—Of all general anæsthetics known pure sulphuric ether stands at
the head for safety, efficiency and every day practical use.
_Second_—Hydrochlorate of cocaine stands at the head of all known local
anæsthetics.
_Third_—Ethidene promises to rival ether and merits a more general and
extended trial.
_Fourth_—No surgeon should give any anæsthetics without being prepared
to resuscitate the patient on the shortest possible notice if necessary,
among which preparations nitrite of amyl stands preëminent.
_Fifth_—No person should be entrusted with the administration of any
anæsthetic who is not thoroughly familiar with its physiological action
and practical administration.
_Sixth_—The indiscriminate use of anæsthetics should be strenuously
guarded against, and especially the practice of leaving such dangerous
compounds in the hands of the laity to be given _ad libitum_ whenever
they may deem it necessary.
_Seventh_—The judicious use of anæsthetics under all necessary
circumstances should never be omitted, for when properly used by skilled
hands they are a glorious haven of peace in the midst of a stormy sea.
DR. J. CAMPBELL of Galion reported a case of embolism, in which the
diagnosis was uncertain, the symptoms grave and the disturbance of the
circulation extremely severe, distinguished physicians differing widely
as to the pathological conditions, and the autopsy revealed adhesions of
the right lung and of the pericardum. Left lung compressed, left heart
hypetrophied and stenosis of aortic orifice. On motion the case was
referred to the committee on publication, and Drs. Hackendorn, Ridgway
and Mitchell, who had seen the patient, were requested to give their
views.
DR. N. B. RIDGWAY reported a case of laceration of perinæum with
operation within an hour, with complete success, on which remarks were
made by Drs. Reed, Larimore and Kelley.
DR. KELLEY presented a clinical case of blindness in right eye of a
girl, from the concussion of a snow ball striking the arch of the orbit.
The society adjourned to meet in Mansfield March 25, 1886.
J. F. MARKEL, Secretary.