LAUGHING-GAS AS AN AN ÆSTHETIC.

Otago Witness, Issue 904, 27 March 1869, Page 18

LAUGHING-GAS AS AN AN ÆSTHETIC.

(Daily News. ) In the early part of the last year the attention of the medical and dental professions was recalled to the value of protoxide of nitrogen, moi c commonly called laughing-gas, as an antesthetic agent, and especially by Dr. Evans, of Pari3. The ( results were somewhat curious. Instead of entering into a calm and critical examination of the asserted merits of the gas, scientific men with some warmth arranged themselves into opposing sections ; whilst some at once condemned the use of the agent as dangerous in any case, others declared that it was calculated to supersede chloroform. However, after a while, more moderate views were entertained, when experience wan enabled to produce proof of its utility at least in certiin minor operations. At this junctare, Dr Evans, with a view to correct estimation of the utility of the anaesthetic, placed at the disposal of the committee of management of the Dental Hospital of London the sum of 1.100 to be expended in experiments to test the value of the gas as an anaesthetic. This led to the appointment of a subcommittee of the staff of the Dental Hospital to act in concert with a similar representative of the Odontologicai Society in carrying out the investigation, and the report of their proceedings is just made public. The joint committee proposed to themselves to examine the question under several heads :—l,: — 1, to ascertain how far this agent was an efficient anses'hetic ; 2, if so, whether it was as safe or a safer anaesthetic than those in general use ; 3, what were its special advantages and disadvantages aa compared with other anaesthetics ; 4, to ascertain how it acted as an anaesthetic, in order to know how best to prevent or treat alarming symptoms that might follow ita use ; 6, how best to prepare it ; 6, how best to give it ; 7, whether there were any speoial states of system in which it should not be given. The first step taken was the institution of numerous experiments on dogs, cats, rabbits, guinea-pigs, mice, and birds, from which it was concluded that the pure gas, so administered as to be free from air, was a powerful ansesthetic, of more rapid action, but more evanescent in its operation than chloroform and other anaesthetics in use ; that if given too long it would produce death ; but that even when death appeared imminent from its use, the admission of fresh air to the individual inhaling it quickly caused the disappearance of all uncomfortable or dangeroua symptoms. Having got bo far, the committee of investigation exhibited the gas on human Bubjects, and their further conclusions are baaed upon the observation of the action of the gas in 1380 care-

' fully noted cases. In regard to man the comparative advantages of Litrous oxide are its rapid action — the time for the production of the required insensibility being from 63 to 81 Beconds ; the rapidity with which patients recover, viz., in from 100 to 150 seconds from its first administration, the patients being able to get up and walk away -"within four minutes, without ary unsteady gait or unpleasant feeling ; its tasteless and its i) on- irritating character ; the freedom of patients from nausea, and the absence of any after effects which sometimes follow chloroform. Its disadvantages as an anaesthetic for man are, its unsuitableness for long operations, or those followed by^much pain ; where delicate operations are to be performed the muscular twitchings it sometimes produces are inconvenient; the difficulty of making it, and the necessity in its administration of cumbrous apparatus ; and, lastly, the difficulty of obtaining it pure. It follows from these facts that, for what are termed iv medical phraseology capital operations, those which are Bevere and prolonged, the agent has at present no claim to be used as an anaesthetic; but it acts well in minor cases, where the operative procedures are short and not severe, and for this reason it is of greatest use in the extraction of teeth, be it one or several. There is little doubt that the nitrous oxide gas will supers ad c chloroform generally with dentists. In America the gas has been exhibited in 200,000 cases, with only one death ; the gas being given oftentimes more than once at a sitting. There do not appear to be any special conditions of the system, age or temperament, or the like, which forbid the use of the anaesthetic. Children are most readily affected by the gas, remain the shortest time anaesthetised, and recover more rapidly than others. The reverse is the case with females. One very curious illustration of the mode of action of the gas is mentioned by the committee (who, by the bye, are to pursue their enquiries). In «ome cases patients awake with the same idea in the mind that was present when they became unconscious : for patients who have raised their heads, for example, each time they heard the seconds counted before becoming insensible, have been noticed to begin beating time with the same hand as consciousness was being restored. Another patient, who before inhaling apologised for hia nervousness, continued his apologies as he recovered consciousness. Well, the gist of the investigation made by the representatives of the odontologica,l profession is satisfactory for the public. It is to substitute in dental operations for chloroform, the inhalation of which is not only always attended by a certain amount of danger but followed by many disagreeables, an agent which rapidly produces a transient insensibility sufficiently long, and not too long, for the operator to do what he wants, and does nntn r-tr -t entail danger or discomfort. This is clearly a great boon. It may be that further experience will show that the agent is sufficient for minor surgery, but that point is not well settled yet. And so the old laughing gas, which has caused so much, amusement in the past, has been invested with a utility little imagined.

A writer in the Leisure Hour calculates that a copy of the Time 3. with its full supplement, contains about 20,^00 lines or 200,000 words, and is equal to a printed octavo volume of 500 pages. The most rapid writing of a lawyer's clerk, if he wrote for ten h'iur3 a day, would not be able to transcribe it in less than a fortnight.

When doctors disagree there is a proverbial difficulty in choosing who shall decide between them ; and the difficulty is enhanced when the disagreement proceeds to the length of fisticuffs. On Wednesday last Mr Vaughan wai called upon to pronounce judgment at Bow street between two learned physicians, who had punched each other's heads in support of their rival claims. It was stated that Dr Beck and Dr Edmunds are both connected with the British Lymgln Hospital, the one as governor, the other as consulting physician. If we can credit the police report, Dr Beck entered the board-room of the hospital on Tuesday, and then and there made derisive gestures suggestive of the intent to pull Dr Edmunds's nose. A smart slap upon the face raised the ire of the medical adviser, and he retorted by a blow with an umbrella. 1 hen the pent-up tide of passion burst forth; Dr Edmunds, according to his own account, was punched, belaboured, and cuffed, till the breath was well nigh out of hia body ; but, happily, a policeman appeared on the scene, and his assailant waa given in charge. Dr Beck contends that this version is incorrect ; and that he was in reality the aggrieved party. Mr Vm^han seems to have thought that both parties were in tha wrong ; for he did not commit Dr Beck to prison, but discharged him with a fine oFTjS, under h-avy recognisances to keep the peace. Probably the decision was right ; hut we would not envy the patients of the Lying-in Hospital, if their mode of treatment were to depend on the result of pugilistic affrays between Dr Beck and Dr Jidmunda.