^JSr^STHESIA 



301 



COMPARISON OF ETHER WITH CHLOROFORM. 



ETHEB. 



More diffusible. 



Inflammable. 



Irritating; may induce bronchitis, 

 pulmonary edema and pneu- 

 monia, unless properly di- 

 luted ( see drop method, p. 306 ) . 



Administered slightly diluted 

 with air. 



Reflexly, stimulant to heart, ex- 

 cept in enormous quantities. 



Reflexly, stimulent to vasomotor 

 centres, except as above. 



Respiratory centres not so easily 

 depressed as by chloroform. 



Larger quantity required. 



Less rapid; stage of struggling 

 and excitement longer. 



More expensive. 



Fatal from respiratory failure. 



CHLOROFOKM. 



Vapor heavier. 



Less irritating. 



Not inflammable. 



More danger from shock during 

 imperfect anaesthesia. 



Depresses powerfully, heart, res- 

 piratory and vasomoter centres 

 in large doses. 



Acts more quickly, profoundly, 

 and persistently. 



Smaller quantity required. 



Cheaper. 



Proportion of deaths to inhala- 

 tions, 5 times greater than with 

 ether.* 



Death occurs from respiratory 

 failure combined with circula- 

 tory depression, or later from 

 fatty degeneration of the inter- 

 nal organs, or from coma due 

 to acetone poisoning. 



Occasionally fatality results from 

 reflex inhibitory arrest of the 

 heart. 



It will be seen that all the advantages are in favor of 

 chloroform, except that of safety. " Ether is more expen- 

 sive than chloroform, but cheaper than a funeral." (Edes.) 



ACCIDENTS AND DAITGEES ATTENDING ANJ5STHESIA. 



Respiratory failure and asphyxia may occur from giv- 

 ing too much of the anaesthetic and from mechanical ob- 

 struction in the air passages. . The tongue may fall back upon 

 the epiglottis and prevent the free entrance of air. The 

 latter accident is obviated by pulling the tongue forward 

 with the hand, or, in the case of the smaller animals, by 

 means of forceps, or suture passed through the tongue. 

 Mucus, blood or vomitus may obstruct the mouth, pharynx, 

 larynx, or trachea, and should be removed if possible by 

 swabbing with absorbent cotton. To prevent excessive se- 

 cretion of mucus in the air passages, it is wise to give 

 tropine subcutaneously fifteen minutes before etheriza- 

 tion. The head should be extended and the lower jaw 

 of the patient held forward during anaesthesia, and no 

 impediment to the free movement of the chest is allow- 



* The mortality is about 1 in 3..500chloroformizations : and ahont 1 in Ifi.OOO ether- 

 izations in human practice. Chloroform is 3 1-2 times more depressant to nerve 

 centres, and 8 times more depressant to tlie heart than ether. 



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