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lungs, it might produce a condition approaching asphyxia. I do not say that that is the effect, but I suggest whether the rapid breathing does not produce an approach to asphyxia, if the air does not remain a sufficient time in the lungs to perform its function. Possibly the physiological function requires that the air should enter the lungs and remain there for a moment or so. Now, if we increase the respiration without increasing the amount of the pulse, it may produce such a condition as I have indicated. I am merely throwing this out as a theory which suggests itself to me. I would like Dr. Bonwill to give his views on the subject. I introduced it at the end of my paper, first, because it is not a true anesthetic, and, in the second place, not having any chemical character, being physiological purely, it was rather out of the bounds of observation. Desiring to adhere more strictly to the chemical features of the subject, I simply suggested it in hopes that it would stimulate discussion. In my own case rapid breathing makes me extremely giddy, but I am made giddy very easily; using a blowpipe will produce that effect upon me. My own experiments with the method have been prevented by this unpleasant circumstance. I have no doubt that rapid respiration would interefere with some of the natural functions, and therefore diminish sensibility. We have diminished sensibility from sleep, which is a suspension of some of the natural functions, and I cannot see why we should not have it from the disturbance of other functions. At the same time, I do not see how it can be considered as true anesthesia.

Dr. Bonwill. For eight years my gasometer, holding one hundred gallons, has been idle. I gave nitrous oxide with great pleasure before I thought of rapid breathing, but since then I have used no anesthetic. Dr. Brown-Sequard informed me in 1881 that he read my article on rapid breathing, and knew there were certain physiological facts bearing on the subject, and that he illustrated it in his lectures before the students. [Dr. Bonwill related a number of cases in which he had successfully operated while the patients were under the influence of this process.] In this act the breathing is five times as fast as usual. When running one must keep up rapid respiration to maintain the proper supply of oxygen in the blood. While the ordinary pulsation is not over eighty, and in rapid breathing is not over ninety, the respiration increases from twenty to one hundred. ISFow^ while the lungs are making one hundred respirations, and the heart maintaining its ordinary pulsations, five times the amount of oxygen is put into the blood, which, mingling with the carbon of the blood, sets free carbonic acid gas. I believe, from all that I have seen, that it is this excess of oxygen in the blood which causes the temporary insensibility to pain.


Br. Chupein. How long must a patient breathe before this effect is produced?

Dr. Bonwili. It would be almost impossible for one taking one hundred respirations per minute to breathe over a minute or a minute and a quarter; the next minute he would hardly take two respirations, showing that there was an over-oxidation of the blood. The first clinic that I ever gave before any public body was before the class of the University of Pennsylvania. It was a complete success. To that I had the attestation of the students, dental and medical. As far as extracting teeth is concerned, the secret of success lies in the fact that, as carbonic acid gas escapes so quickly, one must operate while the patient is breathing rapidly and before he is exhausted. If live, eight, or ten seconds are lost in getting something ready, or in hunting for an instrument, the result will not be as satisfactory.

Dr. Guilford. I would like to inquire how oxidation of the blood can take place when the oxygen is breathed in and out so rapidly.

Dr. Bonwili. I gave you an illustration of that a moment ago, in the case of a man running.

Dr. Guilford. I understood Dr. Leffmann to say that, when air was breathed rapidly into and out of the lungs, it did not have time to perform its work.

Dr. Bonwili. But take the illustration I gave of a man running. There the action of the heart is quicker, in order to support the increased physical exertion. If there is not the same proportion of air going into the lungs while the heart is propelling the blood so rapidly and forcibly, what will be the result? It will produce asphyxia &t once; but, as long as the man takes that amount of air into the lungs which is needed by the increased action of the heart, the increased respiration makes it all right.

Dr. Guilford. But what is it that takes place in your method of rapid respiration? Is it asphyxia?

Dr. Bonwili. 'No; it is the opposite of asphyxia. Asphyxia comes from a want of oxygen in the blood; this comes from an over-supply of oxygen. The secret is in the heart not pulsating in proportion with the respiration, so as to allow the heart's action to correspond with the action of the lungs.

Dr. Leffmann. I think Dr. Bonwili means that the rapid lung action introduces an overcharge of oxygen into the blood. 1 do not agree with him in that. I think the insensibility is due to the influence exerted upon the nerve terminals by the depression produced by the defective oxygenation of the blood.

Dr. Bonwili. But is it possible that carbonic acid gas can be set free in the blood unless there is a proper amount of air given to it?

Dr. Leffmann. I think it is possible to accumulate carbonic acid in the blood for a short time, even though no oxygen is allowed to pass in through the lungs.

Dr. Bonwill. In a person deprived of oxygen, what is the color of his skin?

Dr. Leffmann. I should think it would be the same as when nitrous oxide was inhaled.

Dr. Bonwill. It would not be red or flushed, would it?

Dr. Leffmann. No.

Dr. Bonwill. Well, that is the reverse of what you see in my operation, when carbonic acid gas is set free in the lungs, by the large amount of oxygen put into the system. You do not see the same condition of the surface of the skin as you do in asphyxia. It is a fact testified to by many that it takes a minimum quantity of ether or chloroform to affect the patient after he has breathed rapidly first. Why should that be?

Dr. Guilford. To me one of the most remarkable facts about nitrous oxide gas is that it is taken into the system as nitrous oxide gas, and is eliminated from the system without change in its character. The fact that nitrous oxide gas produces a state of insensibility does not prove that the effect is due to asphyxia. The presence of air might interfere with the functions of other agents, but when these other agents exercise their function, the asphyxia may only be incidental. Our object is to get rid of the asphyxiating effect, and obtain a physiological function. If that has been obtained, as it is now claimed to have been, I think it is by a judicious mixture of air and gas.

Dr. Tees. Dr. Leffmann has touched upon the physiological effect upon the lungs of an increased supply of air, and also upon the effect produced in laboratory work by blowing through a small pipe. I would like to ask him whether the same effect would not be produced by breathing through a small orifice, and limiting the supply of nitrous oxide gas in the lungs?' ,

Dr. Leffmann. Yes, sir; I think it would.

Dr. Tees. At a meeting of the Odontography Society, in 1863, when nitrous oxide was first introduced in Philadelphia, and when our college professors even were ignorant of its effects, it was made and administered for the extraction of a root; there was this bluish pallor and snoring; and fearing the operator, an eminent dentist, was allowing the gentleman to breathe too long, I advised him to remove the bag, and expostulated with him for not doing so at once, telling him that the bag was then full of carbonic acid gas. He denied this, and wished to know where it came from. I said, "From the lungs," and appealed to Prof. Morton, professor of chemistry in the Philadelphia Dental College, for the truth of my statement. The professor agreed with me, saying, "The bag is full of it." Who was right?

Dr. Leffmann. Prof. Morton was right. The nitrous oxide gas may not form carbonic acid; but there is still carbonic acid formed in the lungs by natural process.

Dr. Tees. I think that this discussion points to the fact that the bluish pallor of the countenance shows a deleterious effect, and that the natural appearance, as seen in gentle sleep, indicates the proper condition for the patient to be in. Therefore, I suggest that the members of the society who administer nitrous oxide make it a matter of investigation, and at a future meeting give us the benefit of their experience.


CONNECTICUT YALLEY DENTAL SOCIETY. At the annual meeting of the Connecticut Valley Dental Society, held at Springfield, Mass., November 13 and 14, 1884, the following officers were elected for the ensuing year: Geo. L. Parmele, Hartford, Conn., president; S. B. Bartholomew, Springfield, Mass., first vice-president; J. K. Davenport, Northampton, Mass., second vicepresident; G-eo. A. Maxfield, Holyoke, Mass., secretary; A. J. Mms, Turner's Falls, Mass., assistant secretary; W. H. Jones, Northampton Mass., treasurer. C. T. Stockwell, Springfield, Mass., H. M. Miller, Westfield, Mass., J. P. Parker, Bellows Falls, Yt., executive committee.

ST. LOUIS DENTAL SOCIETY. The annual meeting of the St. Louis Dental Society was held on Tuesday, January 6, 1885, when the following officers were elected for the ensuing year: James W. Whipple, president; A. J. Prosser^ vice-president; A. H. Fuller, corresponding secretary; J. L. Foster, recording secretary; W. N. Conrad, treasurer.

A. H. Fuller, Corresponding Secretary, No. 2626 Washington avenue, St. Louis, Mo.


The forty-first annual meeting of the Mississippi Yalley Association of Dental Surgeons will take place in the lecture-room of the Ohio College of Dental Surgery, Cincinnati, Ohio, at 10 o'clock A.m., on Wednesday, March 4, 1885..

A cordial invitation is extended to all members of the profession to be present. A. Berry, Corresponding Secretary,

No. 95 West Seventh Street, Cincinnati, Ohio.



The Connecticut Yalley Dental Society is endeavoring to collect and tabulate statistics to determine the duration of the average artificial denture, and with this object in view has prepared a blank form for convenient registration of facts bearing thereon. Dr. E. A. Stebbins, Shelburne Falls, Franklin county, Mass., will send a blank form, arranged under eighteen headings, to any dentist requesting it, and willing to aid in making up the record.

BUCHANAN EEDIVIVUS, Dr. John Buchanan, the dean of the Pine-street Eclectic Medical College, Philadelphia, notorious for its traffic in fraudulent diplomas, has been again arrested on the charge that during the year 1884 he made, signed, uttered, and published written instruments purporting to be diplomas of certain medical institutions, to the prejudice of others' rights, and with intent to defraud. Eobert Gr. Moore, a witness at the hearing, testified that Dr. Buchanan had instructed him to write the names of Drs. Gross, Pancoast, Meigs, and Pepper, and others which he did not remember, on diplomas of the Philadelphia University, Pennsylvania University, University of Pennsylvania, and Eclectic Medical College. He was committed in default of two thousand dollars' bail on the charges of conspiracy

and forgery.

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Modern Medical Therapeutics: A Compendium of Kecent Formulae and Specific Therapeutical Directions, from the Practice of Eminent Contemporary Physicians, American and Foreign. By George H. Napheys, A.M., M.D., etc. Edited by Joseph F. EdWards, M.D., and D. G. Brinton, M.D. Eighth edition, enlarged and revised. Octavo, pp. 629. Philadelphia: D. G-. Brinton, 1885. Price, cloth, $4.00; sheep, $5.00.

The first edition of this book, published in 1870, is before us,—a little volume of less than four hundred pages, contrasting significantly wTith the portly volume now under notice. The fact that in the interval the eighth edition has been reached tells of its appreciation by the medical profession, and tells also of the thorough successive revisions necessary to keep it abreast of the times.

This volume is not, as might be supposed from its title, a mere list of formulae. It takes up in order diseases of the nervous,

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