ETHER AS AN ANÆSTHETIC. [3]
BY DR. A. C. KELLOGG, DECORAH, IA.
For over a quarter of a century ether, as an anæsthetic, has stood at the front of all anæsthetics, as the safest, most reliable agent to use in all surgical operations. Being a faithful advocate of this time-tried friend, which has done so much for humanity, a brief description of its qualities and effects will constitute the theme of this paper.
Sulphuric ether is prepared by distilling alcohol with sulphuric acid. For many years after its first discovery the profession were not aware of its anæsthetic properties, but looked upon it as a mere chemical curiosity. Amusing incidents are related of many who inhaled it for the exhilarating and intoxicating effects it produced. But to the late Dr. Horace Wells is probably due the gratitude we truly feel for giving to the profession its true anæsthetic properties, in the painless performance of all surgical operations, no matter how severe. Since that date it is used almost exclusively in all the leading hospitals, medical and dental colleges throughout the land.
Very few deaths have been reported from its administration, and, indeed, if that proper care and knowledge of the agent be used, together with a pure article, and an intelligent understanding of the pathological condition of the patient, the death rate would sink to a minimum, and I doubt not that if a death should occur, after all these precautions, its true reason might find an explanation in some other cause.
If it is desired to anæsthetize a patient, the most important thing to consider is the possession of a pure article of ether. There are several reliable makes. Squibbs' sulphuric ether, for inhalation, being one of the most reliable for uniform purity and freedom from heavy oil of wine, acetic acid, fusel oil, sulphurous acid, or excess of water and alcohol. Every operator should acquire the knowledge of testing ether, if it contain any of these adulterations, using none for inhalation but the purest article that can be procured. Just here it might be well to state that pure sulphuric ether has a specific gravity of 0.725°, boils at 96° and has a density of vapor 2.586. This latter fact should be borne in mind, and when administered in the evening the lamp or light should be kept away from the inhaling apparatus and bottle, for ether is inflammable, several accidents being reported where this precaution was not observed.
To insure the best results from ether, it should not be inhaled after a full meal. Dr. Turnbull recommends a biscuit or cracker, and a glass of wine or a tablespoonful of brandy, half an hour before, always avoiding for several hours previously the annoyance of a full stomach. Serious complications and deaths have resulted from lumps and particles of indigested food becoming lodged in the trachea and glottis, from the act of vomiting, as ether, with many people, produces vomiting, and a recent meal is often reproduced.
The apparatus for administering ether is very simple, consisting in a towel or newspaper folded in cone form, with a moistened sponge at the apex to receive the fluid. During the first part of inhalation it is well to hold the cone a little distance from the patient's face, that the first few inhalations may be mixed with atmospheric air, otherwise an oppressed, smothered feeling may possess the patient. This feeling happily passes away in a few minutes, and the cone may be held close to the face, bringing the patient under its influence as soon as possible; better results are obtained, the after-effects pass away sooner, and there is less danger of nausea than when administered slowly, taking a long time to bring the patient under its influence.
It is well to observe that the temperature of the room be warm and well ventilated, avoiding all draughts. The patient should be in a recumbent position—better perfectly horizontal, all tight garments around the waist and throat should be loosened, allowing perfect freedom to the organs of respiration. With a finger on the pulse, an ear to the breathing and an eye to the patient, the operator is to judge when anæsthesia is complete.