The Relative Therapeutic Value of some Anæsthetics

The Relative Therapeutic Value of some Anæsthetics

Relat£ve Therapeut£c Value of some AnCEsthet£cs. 247 THE RELATIVE THERAPEUTIC VALUE OF SOME ANJESTHETICS. BY JAMES MATTHEWS, STUDENT, ROYAL VETERI~A R...

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Relat£ve Therapeut£c Value of some AnCEsthet£cs. 247 THE RELATIVE THERAPEUTIC VALUE OF SOME ANJESTHETICS. BY JAMES MATTHEWS, STUDENT, ROYAL VETERI~A RY COLLEGE, EDINBURGH. THE desire to obtain, by the veterinary profession at large, the recognition of the paramountly effectual and safe action of certain anresthetics as yet almost unknown by, or perhaps I should say, unused by its members, has induced me to . Jay the following remarks before the readers of the VETERINARY JouRNAL. While proceeding somewhat arbitrarily, and treating the subject under the two heads of the pharmacology and therapeutics of anresthetics, I shall premise a few remarks, not altogether inappropriate on this occasion. It must be remembered that although Edinburgh may feel justly proud that it was Simpson who, in 1847, first utilised chloroform in the alleviation of human suffering, it was only very long afterwards, much to the disadvantage, not to say discredit of our art, the disparagement of her sons, and the embarrassment of real progress of veterinary surgery, that a corresponding advance was made in our profession. This delay is to be accounted for by the insane divorce, against which I would most emphatically protest, which was so long maintained between medical and veterinary science, much to their mutual injury and retarded advancement. The science and art of medicine and the veterinary science and art are united in one common bond ; they are founded on the same basis, the institutes of medicine, branches of the same stem, the physiological ; and sprung from the same great trunk, the biological or science of life. The various agents employed to induce a state of anresthesia may be conveniently considered as (a) Local and (b) General, according as their action is confined to a limited area, annihilating sensation in peripheral nerves, or as it becomes general, attacking the great nerve centres, and thus abolishing sensation throughout the body. (a) Local AnaJsthetics are few, and may be comprised as extreme cold, ice, ether spray, carbolic acid, cocaine, and iodoform. Each of these suspends sensibility in virtue of a direct sedative action on the nerves themselves, and I would more particularly direct attention to the puissant utility of carbolic acid and iodoform as local anresthetics, which I consider deserve more extensive application in veterinary surgery. The simple painting on of pure carbolic acid, for example,. in the case of opening an abscess, would not only anresthetize but aseptisize, and this would be of especial advantage in evacuating matter near contaminating centres, as the anus, etc. The value of powdered iodoform as a local

The Veter£na1y Journal. anresthetic is very great indeed in the relief of pain in irritable ulcers and sores, and the simplicity of its application, the invariable comfort obtained, along with its excellence as an antiseptic and deodorant, warrant for it a much more extensive employment. I therefore venture to advocate the use of powdered iodoform as a local ana:sthetic to all painful discharging surfaces ; and, moreover, its value is much enhanced, as it is a stimulant, rapidly inducing healthy action in indolent wounds. Of late cocaine has found favour in the eyes of a number of practitioners, but my experience is that it is uncertain in its action. (h) Gen era!An(]Jsthetics.-G~neral ana:sthetics, however, are very numerous, and Dr. Ward Richardson , in a recent synopsis, includes no fewer than thirty-three different bodies in this category. I shall confine my remarks to three of these, however, viz., chloroform, ether, and alcohol, and mixtures of these three. Now, the state of unconsciousness induced by these anresthetics is pne in which voluntary motion and sensation are suspended, and the circulatory and respiratory centres are more or less untouched, their functions being duly carried on ; and the ideal ana:sthetic would be one which, while throwing the cerebral hemispheres, that is, consciousness and sensation, and the basal ganglia and spinal chord, that is to say, voluntary and refl ex motion, out of gear, would leave the medulla and its vital centres, the cardiac, vasomotor, and respiratory, untouched. Neither chloroform nor ether is judged by this standard a perfect ideal anresthetic, but of the two ether comes nearer this idealism than chloroform. Their physiological actions might be thus contrasted-chloroform depresses the heart, ether stimulates it ; chloroform paralyses the vasomotor centre in the medulla oblongata, ether has no such dangerous action. Chloroform therefore embarrasses much the respiratory function-a function largely maintained through a proper working of the vasomotor mechanism; this is not so with ether. Ether is therefore the safer, and under proper management the more effectual anresthetic. But it is to two mixtures of these that I would particularly draw attention. These are what are called the Vienna and the A. C. E. mixtures. The Vienna mixture consists of ether and chloroform in the proportion of eight to one. It was first used in Vienna, and so effectual was it found that a law was even passed that no other should be employed in the hospitals there in medical practice. I am not aware that it has yet found favour in veterinary work, but I now wish to bring it prominently before the notice of the profession. The other mixture, the A. C. E., cons-ists of alcohol, chloroform, and ether in varying proportions-a common ratio in medical practice being four parts of etl:er and two parts eac~ of

Treatment

of Impaction of the

Colon £n the Horse. 249

alcohol and chloroform. This is regular in its action, effective, and altogether a good combination; and I may mention that so innocuous ha~ it been found that no death has yet been recorded from its use. And, in conclusion, I would only reiterate that in a mixture such as this a near approach to perfection is attained, inasmuch as it combines the good effects of each constituent while minimising the eviis inseparable from all ; that is to say, anresthesia is established, but the vital functions of respiration and circulation are not interfered with more than is compatible with speedy restoration on the withdrawal of the anresthetic. I therefore wish to advocate not only a better recognition of the claims of these local anresthetics for use in veterinary practice, but the trial of such a mixture as I have now indicated as infinitely preferable to any single one, both as perfectly safe and certainly efficacious.

TREATMENT OF IMPACTION OF THE COLON IN THE HORSE. BY THOMAS W. C.\VE 1 M.R.C.V.S. 1 NOTTIN GHAM .

a student at the Royal Veterinary College, it was my lot to read a paper before the Students' Veterinary Medical Association on 11 The Stomachs of the Ox and their Diseases." In that paper I strongly opposed the administration of large and repeated doses of purgative medicines in cases of impaction of the rumen and omasum. In all works I had read treating upon these affections, the first thing recommended was the administration of purgatives; and my opposition to this course of treatment was based not on my own short experience, but upon the long practical experience of my father, who had repeatedly impressed upon me the futility of giving purgatives to relieve imp.action of the stomachs in the ox. His advice was to give no solid food of any kind, and endeavour to induce the animal to ruminate by stimulating the muscular action of the stomachs. This advice was proved to be valuable by the satisfactory results of such treatment. Since leaving college I have made a special study of the diseases of the bowels of the horse, and have come to the conclusion that the administration of purgatives to horses suffering from affections of the bowels is unwise and likely to produce serious results, especially in those cases so commonly met with, of impaction of the colon. During the past eight years, a very large number of these cases has come under the treatment of my father and myself, but during

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