PROCEEDINGS OF NORTH CENTRAL OHIO MEDICAL SOCIETY.
TWENTIETH QUARTERLY SESSION.
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.