Page 273 - My FlipBook

LOCAL AX/ESTHESIA. 271

Rapid breathing as a pain obtunder.—A method first suggested
bv the late Dr. VV. G. A. Bonwell, and from which he claimed a
similar effect to that of ether, chloroform and nitrous-oxide gas
in their primary stages, and to render the patient sufficiently un-
conscious to any acute pain from any operation, where the time
consumed is not over from twenty to thirty seconds. " While
the special senses are in partial action, the sense of pain is ob-
literated and, in many cases, completely annulled, consciousness
and general sensibility being preserved." "To accomplish this,
each patient must be instructed how to act and what to expect.
As simple as it may seem, there is a proper and consistent plan
to enable you to reach full success. Before the patient com-
mences to inhale he is informed of the fact that while he will be
unconscious of pain, he will know full or partially well any
touch upon his person ; that the inhalation must be vigorously
kept up during the whole operation, without for an instant
stopping ; that the more energetically and steadily he breathes,
the more perfect the effect. It is obligatory to do so, on account
of its evanescent effects, which demand that the patient be
pushed by the operator over energetic appeals to 'go on.' It is
verv difficult for any one to respire over one hundred times to
the minute, as he will become by that time so exhausted as not
to be able to breathe at all. For the next minute following the
completion of the operation, the subject will not breathe more
than once or twice. Very few have force enough left to raise
hand or foot. The voluntary muscles have nearly all been
subjugated and overcome by the undue effort at forced inhalation
of one hundred and seventeen, the normal standard.
" The heart's action is not increased more than from seventy
(the average) to eighty and sometimes ninety, but is much en-
feebled, or throwing a lesser quantity of blood. The face be-
comes suffused, as in blowing a fire or in stooping, which con-
tinues until the breathing is suspended, when the face becomes
paler. (Have not noticed any purple, as from asphyxia by a
deprivation of oxygen.) The vision becomes darkened, and a
giddiness soon appears. The voluntary muscles farthest from the
heart seem first to be affected, and the feet and hands, particularly