3 - History of Anaesthesia Society

-mtient, by mans of a cylinder fitting belaw, closely to the face. The
sponge, however, when soaked in ether, is almost impenetrable to air,
and tends to clrip from its 1-r surface.
'My own pattern (mde by Allen and Hanixry) is an aluminium 'cylinder' 7
inches in height, and shaped to fit tine face, with a Sorbo sponqy r ubr
pad at the lower end.
'The ether is held by an oval game pd, 7 inches by 5, and at least 8
layers thick, preferably hemned so that it can 'be rvashed and used again.
This is placed on top of the cylinder, and thrust down into it, on to
the bars across the 1mer end, by a mller cylinder munted on a
handle. This gives a flat gauze surface, down which all ether poured
into the inh3ler nms, so that the ptient's breath rmlst pass through
it; while owing to its flatness, there is no tendency to driming.'
DR consirlered that his inhaler had the following advantages:
'1. It w ill give a very high concentration of ether with a percentage
of CO2 much as in tFle Clover inhaler.
2. It is very economical, its consqtion being only one
third of that of the open method. In on lent alone at GK~ilt
Omond Street this difference meant a s £50 a year.
3. It is sinple, cheap, easily cleaned between anaesthetics, and has
that priceless quality for 'nospit31 equipnt of surviving after
being d rom on a stone floor.
4. It does not cover tile yes, thus avoiding what I think to ke one of
the main causes of panic in children.'
DB then described his main points on how to use his inhaler:
' 1. Start the induction with a single drop of sther in the inhaler.
Anyone who thinks this is too little is recmded to experiment
on himself.
2. Keep the mask closely on the face, and as soon as the patient is
breathing one strength of the ether easily, increase it. A fairly
wide experience of inducing all types of cases with ether has
convinced me that the main causes of failure are starting with too
strong a vawur, and taking the mask off for no particular reason
except to see if the patient is still underneath it.
3. As soon as the patient is deeply anaesthetisd, with dilated
ppils and easy breathing, hang a weighted hooked imuthpiece on
the top of the inhaler and puntp ether vapour through it. If this
provokes coughinq, gag t3e muth open and hang the tube in
it to continue the anaesthetic, again carefully avoiding giving
one breath of etherless air.
DB then corrmented that he found this method quicker and better than
inducing with ethyl chloride and charging to ether, as it avoided the
'no-MS-landr when thn pltient is clxning out of deep ethyl chloride
into sha1101~ ether, and an expsrt surgeon and anaesthetist team could do
almut eight cases an hour.