Treatise on gynæcology : medical and surgical . 76), more especially in The patient is anaesthetized in bed, and taken to the amphitheatre in a ward-carriage (Fig. 17), thus avoiding the disagreeableimpression produced by the sight of the surgical preparations, andfacilitating the first steps in the administration of the chloroform. ANAESTHESIA IX GYNAECOLOGY. 35 We must bear in mind that if amesthesia be unduly prolonged, itmay have a serious effect upon the nervous system and upon the kid-neys. The fatal results of many cases reported under the head ofshock, may be traced t
Treatise on gynæcology : medical and surgical . 76), more especially in The patient is anaesthetized in bed, and taken to the amphitheatre in a ward-carriage (Fig. 17), thus avoiding the disagreeableimpression produced by the sight of the surgical preparations, andfacilitating the first steps in the administration of the chloroform. ANAESTHESIA IX GYNAECOLOGY. 35 We must bear in mind that if amesthesia be unduly prolonged, itmay have a serious effect upon the nervous system and upon the kid-neys. The fatal results of many cases reported under the head ofshock, may be traced to the depressing effects upon the nerve cen-tres of an anaesthesia prolonged to two or three hours. It is not im-possible that many of the so-called rellex symptoms occurring afterutero-ovarian operations may be due to the same cause; more partic-ularly what has been termed the guttural-reflex symptom, character-ized by incessant and painful 1 have had the oppor-tunity of observing this symptom after long operations other than. Fig. 17.—Rolling Carriage Used at the Lourcine-Pascal for Transporting Patients from Bed to the Operating Boom. -abdominal, and I feel convinced that it is due to real chloroform-poisoning. Further, the absorption of a large quantity of chloroform or ether,and its consequent elimination by the kidneys, may determine an in-tense renal congestion with or without albuminuria. I first calledattention to this fact in a work published in the Annales de Gyne-cologic in July, 1884 (De la valeur des alterations du rein conse-cutives aux corps fibreux de luterus pour les indications et le pronos-tic de lhysterectomie ). This is what I wrote at the time: The longduration of anaesthesia in operations, especially hysterectomies, hasdoubtless a large share in the causation or aggravation of renal affec-tions in the patient. Chloroform absorbed in great amount cannotiail to have an action upon the renal epithelium, and thus interfere 36 CLINICAL AND
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