Scientific American Supplement, No. 275, April 9, 1881

by Various

The anaesthetics, when used in major operations, where time is needed for the operation, can be made more effective by a lesser quantity when given in conjunction with "rapid breathing." Drs. Garrettson and Hews, who have thus tried it, tell me it takes one-half to three-fourths less, and the after effects are far less nauseating and unpleasant.

As an agent in labor where an anaesthetic is indicated, it is claimed by one who has employed it (Dr. Hews) in nearly every case for three years, he has used "rapid breathing" solely, and to the exclusion of chloroform and ether. For this I have his assertion, and have no doubt of it whatever, for if any agent could break down the action of the voluntary muscles of the parts involved, which prevent the involuntary muscles of the uterus from having their fullest effect, it is this. The very act of rapid breathing so affects the muscles of the abdomen as to force the contents of the uterus downward or outward, while the specific effect of the air at the end of a minute's breathing leaves the subject in a semi-prostrate condition, giving the uterus full chance to act in the interim, because free of the will to make any attempt at withholding the involuntary muscles of the uterus from doing their natural work. It is self evident; and in this agent we claim here a boon of inestimable value. And not least in such cases is, there is no danger of hemorrhage, since the cause of the effect is soon removed.

In attestation of many cases where it has been tried, I have asked the mother, and, in some cases, the attendants, whether anything else had been given, and whether the time was very materially lessened, there has been but one response, and that in its favor.

Gentlemen, if we are not mistaken in this, you will agree with me in saying that it is no mean thing, and should be investigated by intelligent men and reported upon. From my own knowledge of its effects in my practice, I am bound to believe this gentleman's record.

I further claim for it a special application in dislocations. It has certainly peculiar merits here, as the will is so nearly subjugated by it as to render the patient quite powerless to resist your effort at replacing, and at the same time the pain is subdued.

It is not necessary I should further continue special applications; when its modus operandi is understood, its adaptation to many contingencies will of a sequence follow.

It is well just here, before passing to the next point of consideration, to answer a query which may arise at this juncture:

What are the successive stages of effects upon the economy from its commencement until the full effect is observed, and what proof have I that it was due to the amount of air inhaled?

The heart's action is not increased more than from seventy (the average) to eighty and sometimes ninety, but is much enfeebled, or throwing a lesser quantity of blood. The face becomes suffused, as in blowing a fire or in stooping, which continues until the breathing is suspended, when the face becomes paler. (Have not noticed any purple as from asphyxia by a deprivation of oxygen.) The vision becomes darkened, and a giddiness soon appears. The voluntary muscles furthest from the heart seem first to be affected, and the feet and hands, particularly the latter, have a numbness at their ends, which increases, until in many cases there is partial paralysis as far as the elbow, while the limbs become fixed. The hands are so thoroughly affected that, when open, the patient is powerless to close them and vice versa. There is a vacant gaze from the eyes and looking into space without blinking of the eyelids for a half minute or more. The head seems incapable of being held erect, and there is no movement of the arms or legs as is usual when in great pain. There is no disposition on the part of the patient to take hold of the operator's hand or interfere with the operation.

Many go on breathing mechanically after the tooth is removed, as if nothing had occurred. Some are aware that the tooth has been extracted, and say they felt it; others could not tell what had been accomplished. The majority of cases have an idea of what is being done, but are powerless to resist.