Recollections of Surgery before the Use of Anesthetics

Abstract

the vital forces, in which depression, of course, the muscular system largely participated ; while thus relaxed the replacing efforts were made, and it must be acknowleged that something waB gained and some replacements easily accomplished. But it was noticed that however faint and relaxed the patient might seem to be, as soon as the first attempts at reduction were made, the muscles were excited to resistance, and it soon became evident that we had not removed but ouly diminished the resistance which we desired to abolish. While cousciousneBB remained, and the spinal reflexes were not abolished, no method we were acquainted with would altogether prevent muscular resistance ; and sometimes, to our chagrin, the harsh and spoliative methods above mentioned, proved perfectly unreliable and unsuccessful in the very cases where we expected most from them. It is only when we compare the ease and promptness with which, under ether, we now reduce by manipulation alone a dislocation of the femur or shoulder, with the former laborious, tediouB and painful efforts with pulleys and straps, that we fully appreciate the great blessing of anesthesia in enabling us to abolish all opposition from muscular action iu the class of cases now under consideration. It seems as if we might fairly say that anesthesia, in this class of cases, is the most direct and positive addition to our surgical resources that the century has produced. For while all heartily concur in glorifying anesthesia as the aiuiihilator of pain in surgical operations, in no department can it claim so direct a share in the success of the surgeon's efforts as in this, and in none does it form so essential a part of the successful procedure.Iu conclusion, I cannot refrain from relating a circumstanco in this connection which gave us no little anxiety and annoyance during the reduction of a luxation of the hip, but which caused us all to smile when the procedure was over. During my term in the hospital we had come to rely for the relaxation of resisting muscles, on the introduction into the rectum of a small but strong iufusioii of tobacco. This usually produced its effect in«a few minutes, and was commonly followed by a depression and relaxation which was eminently favorable to our purpose; but the reduction being accomplished, perhaps, in a few minutes, the action of the tobacco continued for an hour to affect, and sometimes very seriously to depress the patient. We had come, therefore, to the plan of introducing into the rectum a cigar, instead of the more rapid and abiding infusion. This cigar had a string tied around its big end to enable us to withdraw it, and then being dipped for a moment into hot water was introduced by the small end into the rectum.The object of this plan was to enable us to remove the tobacco as soon as we had no longer any occasion for its effects. The case in question was that of a man with a dislocation of the femur, in which the pulleys and counterextending bands being all prepared, the cigar was introduced as usual, and we waited a few...