History of medical practice in Illinois - Bushnell Historical Society

232 History of Medical Practice in Illinoisthetics in labor, which had been both wide and deep, had disappeared.Regarding the administration of chloroform or the A.C.E. mixture he hadthis to say: "The administration of chloroform should not be carried tocomplete anesthesia. Just enough should be given to modify the pain—notenough to produce unconsciousness. It is a pretty safe rule to pour a littlechloroform on a sponge and give it to the patient herself to inhale a littlewhenever she feels the pain, the sponge dropping from her hand if shegets too much. The time for its use is at the beginning of the expulsivepains, when they become severe, and its exhibition should cease immediatelyupon expulsion of the head." 15What seems to have been the first mention of a case of air embolism inIllinois is described thus: "A young physician of our city, of the homeopathicpersuasion, and possessing perhaps somewhat above the average intelligenceof his 'school,' undertook to assist dilatation of the uterus in acase of confinement by the use of Barnes's dilator. The latter was introducedpresumably in the proper position, and pumped full of air. In a fewminutes the woman gave evidence of asphyxia, and soon expired. Uponwithdrawal of the instrument it was found to have burst during the processof distention. The case was subsequently made the subject of a coroner'sinquest, at which was taken the evidence of the attending and otherphysicians, together with that of the husband and neighbors of the de-the time of the operation and death." Theceased, who were present atfollowing is self-explanatory and for that date was highly instructive:"Being called upon by the coroner March 12, 1889, to perform an autopsy 16upon the body of Mrs. Angenora Opdycke, at the vault in Springdalecemetery, we found that the deceased had been dead some four or fivedays, decomposition having set in. Upon opening the abdominal cavity,we found that the uterus contained a male fetus, apparently at full term,the placenta partially detached from the walls of the uterus, and twoor three coagula of blood. Presentation normal, and allthe pelvic organsfree from any evidence of disease or injury, and that death was caused bythe introduction of atmospheric air into the uterine sinuses." This wassigned by D. W. Magee, M.D., and J.D. Furry, M.D.The coroner's jury reported: "After hearing the report, testimony, andopinions of several physicians, we cannot find that any blame attaches tothe doctor. At the same time, taking into consideration the fatal resultsin this case, we are inclined to condemn the use of this dilator when expandedwith air."15 It would seem that history is repeating itself and that the newest importation fromEngland is not at all new to Illinois. There is a trend at present toward the use oftrilene administered by the patient with a specially devised mask which falls away assoon as the patient begins to get too much anesthesia.16This was one of the early autopsies in Illinois.