« ПредыдущаяПродолжить »
From Dickens « Household Words."
fortable doze, with the expectation of awaSOME ACCOUNT OF CHLOROFORM.
kening relieved of a torment or a burden, can
make a surgical operation, it has, at last The globe whereon we live, called babit- been rendered. Every body is aware that, able, has now pretensions to that epithet during the extraordinary slumber induced which it could not boast of, in former times. by the inhalation of chloroform, operations Science, continually developing its capabili of the first magnitude and the greatest difties, is daily rendering it a more eligible ficulty may be painlessly undergone. Conresidence for a gentleman-a more commo- sciousness is suspended, sensation placed in dious dwelling-place, indeed, to all. Say abeyance. Muscles, tendons, bones, even that the path of life is thorny still; yet, nerves, are cut and sawn through with little what with gutta percha—for soles and other or no inconvenience to their proprietor. A things-steam, electricity, and other helps man is lopped and pruned like a tree; he is and appliances, it has become a decidedly carved and hewn, and squared, as if he were more passable thoroughfare than it was. a log; and is, indeed, the mere apathetic Philosophers, by simply giving their minds subject of medical carpentry. to the study of Nature, have
btained re Whilst the bodily edifice is under surgical sults more valuable than the considerations repair, for the advantage of being enabled for which, according to the myths of the to avoid the annoyance attending the cognimiddle ages, their predecessors were glad to zance of that process, by taking, with ease dispose of their souls. The amount of and convenience, an excursion into the land human comfort has been greatly augment- of sleep, every lifeholder of the tenement in ed; the sum of human wretchedness has question is indebted to Dr. Simpson of Edinbeen diminished by a very large figure. burgh. The peculiar power of chloroform Among the reductions of this kind that have to produce insensibility was determined by been accomplished in modern times, the most his researches. For some time previously, signal, unquestionably, is the abolition of sulphuric ether, the discovery of Dr Jackphysical pain, in so far as it has been effect- son and Mr. Morton of Boston, in America, ed by the discovery of the anæsthetical prop- had been in use for the same pur pose. There erty of chloroform; that is, of the remark. were, however, objections to its employment. able power possessed by that substance, A larger quantity of it than was consistent when inhaled, of annulling, for a time of with safety, required occasionally to be adgreater or less duration, the sensibility of ministered to produce the desired effect. Its animal bodies.
odor was disagreeably strong and permaOf the numerous ills that flesh is heir to, nent; and, what was worse, it not unfreone, by no means the least grievous, is the quently excited irritation in the chest. In contingency of having to part with an un- search, therefore, of a more safe and comsound limb, or otherwise to undergo the pro modious anæsthetic agent, Dr. Simpson tried cess of being dissected alive, commonly call. a series of experiments, principally on his ed a surgical operation. It has long been own person, with a variety of volatile suban axiom in chirurgical science, that the op- stances; and the result was, his announceerator should endeavor, to the extent of his ment, in 1847, of the desideratum as being ability, to perform bis vivisection “tuto, supplied by chloroform. cito, et jucunde"-safely, speedily, and pleas The existence of this substance, chloroantly. Modern advancement in anatomy form, had been known to chemists since and physiology, and refinement in dexterity, 1831, in which year it was discovered by had enabled surgeons to comply, in a great Soubeiran. Very little later, in 1832, an measure, with the two former requisitions ; independent discovery of it was made by the latter still remained certainly unfulfill- Liebig. Dumas, in 1835, was the first to ed. The horrors of ancient surgery had been ascertain its exact chemical composition. mitigated; but all that skill and knowledge When, in our nursery days, we used to could do or suggest failed, signally, to make read of some wonderful balsam, by means things pleasant, in any considerable degree, whereof well-disposed magicians and benevto the individual under the scalpel. So far olent fairies were wont to charm away the agreeable, however as the prospect of a com- pain of injuries inflicted by dragons and
ogres on the persons of good knights and ed to be a simple element, but a substance serviceable giant-killers, a very natural de analogous to one, constituted by the two sire arose in our minds for information con- proportionals of carbon and one of hydro. cerning the nature and composition of the gen in the formic acid. Here it must be marvellous remedy. Those who are not remembered that a chemical compound difconversant with chemical details, and who fers essentially from a mechanical mixture. may, in spite of hope to the contrary, one Things mixed mechanically are separable day have a tooth to be extracted, or a nail particle from particle; sulphur from charto be plucked out-not to suggest more for coal; chalk from cheese. In a chemical midable interference of a manual or anatom- compound, the least particle that can be got ical description with the living mechanism by mechanical sub-division contains the same —will probably feel a similar, and at least chemical constituents as the whole mass. an equal curiosity, with regard to the rather The smallest conceivable quantity, for inmore practically interesting subject of chlo- stance, of formyle, consists of carbon and roform.
hydrogen, Formyle has never been proChloroform is a bright colorless liquid, duced separately, so as to be shown by itself; in appearance resembling spirit of wine, but chemists, on certain theoretical grounds, which it further resembles in being extreme- conclude that the carbon and the hydrogen ly volatile, but differs from it remarkably in of the formic acid exist therein in a state of being much more dense; for it is consider. special combination, as a distinct thing ; so ably heavier than water, in which it sinks. that formic acid consists not in a mutual Unlike spirits of wine, too, it is not inflam- partnership between carbon, oxygen, and mable. It has an agreeable, fragrant, ethe hydrogen individually, but of a particular real, fruit-like smell, very similar to that of arrangement of carbon and hydrogen on the a ripe apple; and a sweet taste. Chloroform one hand-making formyle—with respect to boils at one hundred and forty.one degrees, oxygen on the other. In like manner, also, and its vapor exceeds in density that of the chloroform is ultimately resolvable into atmosphere in somewhat above the propor- chlorine, hydrogen, and carbon ; the formyle, tion of four to one. The ready volatility of to which the three parts of chlorine are ada fluid comparatively so ponderous as chlo joined, consisting of a peculiar union of two roform may appear singular.
of carbon with one of hydrogen. Formyle Chloroform, considered as a noun-substan- is called, technically, a compound radical • tive, may be said be an abbreviation, that is, a substance resembling an element, not to employ the more equivocal expres- but chemically divisible. Further remark sion, alias. In legal phraseology-according on the radical principle of chloroform must to the statutes of chemistry—it is called per- be left to the professed chemist—and punchloride of formyle, signifying formyle uni- ster. ted with its maximum of chlorine. More It is, however, worthy of observation that, strictly still, it is denominated ter-chloride as Dr. Simpson has pointed out, the discovery instead of per-chloride, to denote that the by Soubeiran, Liebig, and Dumas, of the proportions in which the chlorine is combi- formation and composition of chloroform, rened with the formyle are three of the former sulted from inquiries and experiments into one of the latter. Now, formyle is a sub- stituted by them, with the sole object of instance supposed to be the base, or funda- vestigating a point in philosophical chemmental, or essential constituent part of an istry. They had no notion, no surmise, of acid called formic acid. Formic acid is so the wonderful agency of chloroform on the termed from having been first discovered in animal system. Had they been asked to red ants, the Latin for ant being formica ; what practical purpose they expected their it consists of three proportions of oxygen, researches would tend, they could only have in combination with one of hydrogen and answered, generally, that every addition to two of carbon. But if such is the composi- the stock of human knowledge is of some tion of formic acid, what, it will be asked, use or other, although we may be unable to was meant by the statement that its base is conjecture or foresee its precise utility. Such formyle? This seeming puzzle is solved by a reply would have seemed great foolishthe explanation, that formyle is not conceiv-ness to those rather numerous sages of every
day life, who are continually asking what is one or two tea-spoonfuls—of the liquid is the good of this or that scientific investiga. dropped upon the sponge, and the instrution, and who would have triumphed glori- ment is adapted to the face of the patient, ously in the fancied superiority of their who is directed to breathe gently and quietly
common sense,” if no definite and categori. into and out of it. If no inhaler is at hand, cal answer could have been given to this a hollow sponge, or a handkerchief rolled sagacious demand of theirs, in reference, as into a cup-like form, will suffice. In a short they, perhaps, would facetiously have said, time the eyes become suffused, occasionally to Chlori-and-ter-formo-what-dye-call-it. a slight struggling, not from pain, but from
There are several methods of obtaining a species of intoxication, ensues; then the chloroform ; the best is that of distilling a muscles become relaxed, the breathing sonomixture of rectified spirit of wine, water, and rous, and total insensibility and unconsciouschloride of calcium. Four pounds of the last ness supervene. Loss of consciousness, hownamed substance are mingled, in a large re ever, does not invariably accompany cessatort or still, with twelve pounds of water tion of bodily feeling, insensibility to pain and twelve ounces of spirit, and distilled as being sometimes caused, the patient, neverlong as a dense liquid, which sinks in the theless, remaining aware of what is going water that it comes over with, is produced. on. There are a few cases in which mere This is chloroform-in the rough. It is excitement is produced, and which must be rectified by re-distillation at the tempera- considered failures. In the majority of inture of boiling water, freed from moisture stances, both consciousness, sensibility, and by digestion with chloride of calcium, and the power of voluntary motion are alike finally distilled with sulphuric acid. Its suspended; and in this happy state of obpurity is indicated by perfect transparency livion, the subject of an operation may be and want of color. The admixture of water carved without caring about it more than if would give it a milky appearance; the he were a leg of mutton; may have a limb presence of chlorine, a yellowish tint. As removed with no greater inconvenience than chlorine is a substance most acrid and irri- he would suffer from having his hair cut. tating to the air-tubes, and one of which the Some persons, under the influence of chloroinhalation, even in a small quantity, would form, even during the most terrible stages of be fatal, it is, of course, in the highest degree a capital operation, fall into a state of sleepessential that chloroform should contain no waking or somnambulism, imagine themvestige of it, in a free or uncombined state; selves on a visit, or a journey, and actually that is, over and above the three propor- spend in an agreeable dream the time which tionals in union with, and neutralized by, the the surgeon is occupying in their dismemone proportional of formyle.
berment. The delight of a sufferer who, The production of chloroform by the pro- after weeks and months of torture, is cast cess just described is the result of a some into a quiet slumber, and after having enwhat complex decomposition. Suffice it here joyed a particularly pleasant nap, finds that to state that the carbon, hydrogen, and he has left his misery behind bim on the chlorine, which constitute that substance, ex- operating table, may be imagined. ist in the spirit, water, and chloride of cal Not the least remarkable peculiarity of cium, and that the action of heat, in the dis- chloroform is its peculiarity of being applied tillation of the mixture, causes those elements in obstetric practice; for, most singularly, to rearrange themselves in the shape of the whilst, when so employed, it fully produces terchloride of formyle.
its anæsthetic effect on the system, it does And now, the chemist having placed not at all interfere with that peculiar muschloroform in the surgeon's hands, in what cular action which is requisite for the permanner does the latter proceed to employ formance of the process adverted to. The the gift? Chloroform is most conveniently question of the propriety or impropriety, in administered on a sponge, placed in a small/ a medical sense, of its general administration silver or plated vessel, with flexible edges, in obstetric cases, is a professional one, which made to fit accurately over the nose and cannot be discussed here; it may, however, mouth, which have been first anointed with a be remarked, that the fact that it has been little cold cream. A small quantity-say successfully employed in any cases of the
kind, must narrow that question to the con-, violently dislodges the head of the shouldersideration of what and how many such may bone or the thigh-bone from its socket. This be eligible for recourse to it. Against its accident, if not remedied, would deprive use in that department of medical practice, him of the means of earning his bread. The however, objections have been urged with bone being out of its place, the business of which it certainly is within the province of the surgeon is to pull it in again. But this common sense and common morality to deal. duty is more easily prescribed than accomThe prevention of the sufferings attendant plished. All the powerful muscles surroundon parturition, by anæsthetic agents, has ing the joint, contracting violently, are exbeen denounced as unscriptural” and “ir. erting their whole force to retain the head religious;" an attempt to contravene the of the bone in its unnatural position. Un. judgment of Providence on the mother of all der the most favorable circumstances of the living. This objection was not started by the case, as treated by old-fashioned surgery, prejudice and imbecility of ordinary fanat- the reduction of the dislocation is effected
it was gravely advanced by educa with the aid of pulleys, by slowly tiring out ted and even by scientific persons; nay, it the opposing muscles, till at last they yield was actually put forward in the “ Edinburgh from very fatigue, and allow the bone to reMedical and Surgical Journal,” for July, turn to its place. But this is not always 1847. Dr. Simpson found himself obliged practicable, and it has not unfrequently been to write a pamphlet in reply to it; and he judged necessary by surgeons to subdue the certainly most fully exposed its unsound- muscular action by bleeding, and the adminness and absurdity. For this demonstration istration of remedies, such as tartrate of a very moderate amount of argumentation antimony, which produce an extreme and is, however, sufficient. The severity which overwhelming prostration of the vital powhas inflicted bodily suffering is qualified by ers. Downright intoxication, even, has been the
mercy which has granted medicines and recommended by some authors for this purremedies, without prescribing any limit to pose. By the inhalation of chloroform, the their employment, whether for cure or for required muscular conditions are readily oballeviation. If it is morally wrong to use tained; the patient sinks into insensibility, chloroform in obstetricy, it is also wrong to declaring that he feels “quite jolly,” and give a common anodyne, or composing the pulleys having been previously adjusted draught; nay, it is sinful to administer any to the limb, the dislocation is reduced withkind of medicine whatever to any sick per- out force, difficulty, or pain. son : sickness, alike with all other evils, Still more striking must be the service of being presumed to be the penalty of trans- chloroform in a case wherein the object is a gression. Compound extract of colocynth reduction of displaced parts, which, if not is an impiety at this rate, and black draughts practicable by ordinary means, must be efare irreligious. But apart from particulars, fected by an operation,-a step to which what are we to think of the understanding any seriously exhaustive measures are very that could conceive the evasion of a penalty undesirable preliminaries. Chloroform, moreimposed by Infinite Power and Wisdom! over, affords most valuable assistance in the The Edinburgh mind, at any rate, is not that performance of operations, perhaps of a diffi. which, one would suppose, could have im. cult and delicate nature, upon infants, whos : agined the possibility of frustrating a decree acquiescence in the surgeon's proceedings is of Omnipotence and Omniscience.
extremely to be wished for, and not usually There is, nioreover, another description of to be obtained. To say nothing of the real cases in which the powers of chloroform are blessing to mothers, and all humane persons, available for the purposes of the medical involved in the prevention of the poor little practitioner. The relaxation of the muscles creature's suffering. of the limbs which it affects, renders it em Chloroform has also been administered inently serviceable in reducing dislocations. with advantage in cases of less serious inA powerful man, some such a Hercules as terest, which sometimes occur in hospital one of those sturdy specimens of the Anglo- practice. A specimen of the disorder in Saxon race in the employ of Messrs. Barclay question is that of Mr. Simpcox, related by and Perkins, meets with an accident which | Shakspeare, in the second act of “ Henry
the Sixth.” In short, the cases alluded to form are such as were raised against the are cases of shamming. A knave desirous circulation of the blood, and vaccination, and of hospital diet and accommodation, and possibly against rhubarb and senna, at their hospital leisure, presents himself with a first discovery. They partly proceed from stiff knee or elbow joint. A little chloro- a lazy dislike to learn any thing; partly form is administered for the relief of this from that conservative instinct, which in affliction; and the rogue, having been re some minds supplies the place of intelligent duced to a state of insensibility, awakes circumspection as a safeguard against the with his limb precisely in that position in dangers of innovation. which he protested that he could not place The alleged abuse of chloroform for crimit by any means.
inal ends has attracted the attention of It is also worthy of mention that the ben the Legislature, and a Bill for the Prevenefit of chloroform has been extended to the tion of Offences has been presented to the brute creation. During the unconsciousness House of Peers by Lord Campbell, in which it produces, a leopard has had a leg ampu- rather prominent and discreditable mention tated. So remarkably savage a species of is made of that anæsthetic fluid. A wellbeast, indeed, has it charms to soothe, that written pamphlet, by Dr. John Snow, will even bears, under its tranquillizing influence, place this subject in a rational light before have been relieved of cataract-couched, if any one desirous of investigating it. Here the phrase may be hazarded, in slumber. it is sufficient to remark that chloroform, in
But are there no objections to the use of order to prove effectual, requires a voluntary chloroform deserving of serious considera- inhalation of some length; that animals, to be tion? There are, indeed, some very grave affected by it, must be caused to breathe it objections to its use. An advanced stage of by main force; and that, in short, it is no pulmonary disease, malformation or disease more easy to stupefy any one against his will of the heart, or tendency to apoplexy, would by means of chloroform, than it is by means of be objections of this nature; and an objection brandy-and-water. There can be little doubt which comprehends them all, would be the that the persons who represent themselves employment of this agent by an incompetent to have been robbed under its influence were person; that is, by any body not thoroughly mistaken as to the cause of their anæsthesia, acquainted with medical science. The prac- which was, in all probability, traceable, not tical value of these objections may be esti- to the terchloride of formyle, but to a cermated from the fact, that, out of ten thou- tain combination of carbon, oxygen, and sand cases of operation in which it was em- hydrogen, termed technically hydrate of ployed at St. Bartholomew's Hospital, not oxide of ethyle, otherwise alcohol, otherwise one death took place in consequence of its ardent spirit, in some one or other of its administration. Were this all we knew, various forms and combinations. No doubt, however, the question of its influence on the a rogue may employ the terchloride of for. ultimate result of operations, would have myle in furtherance of his base designs; but still to be settled; but surgeons do not ap- it must be with that concurrence on the part pear to consider that it acts at all prejudi- of his victim which the juvenile bird-catcher cially in the manner here indicated. finds necessary in the application of the
It is alleged that the whole number of re- chloride of sodium, or common salt, to fowl. corded “ Deaths from Chloroform" does not ing purposes. exceed twenty. In some of these no medi It may be inquired, in what manner does cal man was present; in others, it was ad. chloroform produce its extraordinary effect ministered without precaution, and in ex on the nervous system! The chloride of cess; in some, again, death seems to have hydrocarbon, the nitrate of ethyle, benzoin, been owing to other causes. There appears which is a bicarburet of hydrogen, aldehyde, to be no reason for supposing that stupe bisulphuret of carbon, and sulphuric ether faction by chloroform would be at all more all differ from it more or less; the nitrous likely to be followed by fatal results, than oxide or protoxide of nitrogen differs from casual intoxication, as contradistinguished it entirely in chemical composition ; yet they from habitual drunkenness.
agree with it in a greater or less degree in The other objections to the use of chloro- | the property of producing insensibility to