2

I procured, in 1861, a quantity of kerosolene1 of four different densities, and found the lightest of them, the boiling point of which was about 90°, to be an efficient anæsthetic by inhalation. When it was learned here that Mr. Richardson, of London, had produced a useful anæsthesia by freezing, through the agency of ether vapor, and had reduced the temperature to 6° F. below zero, it occurred to me that a very volatile product of petroleum might be more sure to congeal the tissues, besides being far less expensive than ether. Mr. Merrill having, at my request, manufactured a liquid of which the boiling point was 70° F., it proved that the mercury was easily depressed by this agent to 19° below zero, and that the skin could be with certainty frozen hard in five or ten seconds. A lower temperature might doubtless be produced, were it not for the ice which surrounds the bulb of the thermometer. This result may be approximately effected by the common and familiar "spray producer,' the concentric tubes of Mr. Richardson not being absolutely necessary to congeal the tissues with the rhigolene, as in his experiments with common ether. I have for convenience used a glass vial, through the cork of which passes a metal tube for the fluid, the air tube being outside, and bent at its extremity so as to meet the fluid tube at right angles, at some distance from the neck of the bottle. Air is not

1 The kerosolene was furnished by Mr. Merrill, Superintendent of the Downer Kerosene Oil Company, South Boston.

2 An account of these experiments may be found in this Journal, July 11, 1861. Reference is made to them in a paper "On the most Volatile Constituents of American Petroleum," by Edmund Ronalds, Ph. D., in the Journal of the Chemical Society, London, February, 1865. Mr. Ronalds there states that "the most volatile liquid obtained by collecting the first runnings from the stills employed in the process of refining petroleum has a specific gravity of 0.666." He had also received a specimen of "kerosolene" from Professor Simpson, of Edinburgh, at 0.633. It will be observed that the rhigolene has a specific gravity of 0.625.

admitted to the bottle, as in Mr. Richardson's apparatus, the vapor of the rhigolene generated by the warmth of the hand applied externally being sufficient to prevent a vacuuin and to insure its free delivery. By this apparatus 15° below zero is easily produced. The bottle, when not in use, should be kept tightly corked, a precaution by no means superfluous, as the liquid readily loses its more volatile parts by evaporation, leaving a denser and consequently less efficient residue. In this, and in several more expensive forms of apparatus in metal, both with and without the concentric tubes, I have found the sizes of 72 and 78 of Stubs's steel wire gauge to work well for the air and fluid orifices respectively; and it may be added, that metal points reduced to sharp edges are preferable to glass, which, by its non-conducting properties, allows the orifices to become obstructed by frozen aqueous vapor.

Freezing by rhigolene is far more sure than by ether, as suggested by Mr. Richardson, inasmuch as common ether, boiling only at about 96° instead of 70°, often fails to produce an adequate degree of cold. The rhigolene is more convenient, and more easily controlled, than the freezing mixtures hitherto employed. Being quick in its action, inexpensive, and comparatively odorless, it will supersede general or local anæsthesia by ether or chloroform for small operations and in private houses. The opening of felons and other abscesses, the removal of small tumors, small incisions, excisions, and evulsions, and perhaps the extraction of teeth, may be thus effected with ease and certainty; and for these purposes surgeons will use it, as also perhaps for the relief of neuralgia, chronic rheumatism, etc., or as a styptic, and for the destruction by freezing of erectile or other growths. But for large operations it is obviously less convenient than general anæsthesia, which it will never supersede. Applied to the skin, a first degree of congelation is evanescent. A long appli

cation is followed by redness and desquamation, which may be possibly averted by the local bleeding of an incision. If used on a large scale, the dangers of frost-bite and mortification must be imminent.

It may be superfluous to add that both the liquid and the vapor of rhigolene are highly inflammable.

NITROUS OXIDE GAS FOR SURGICAL PURPOSES, IN 1848.1

A RECENT number of this Journal contained an account of the removal of a cancerous breast by Dr. Sims, in Paris. I take the liberty of referring to the following extract from the records of the Massachusetts General Hospital, in April, 1848. In the operation therein described, which precedes that of Dr. Sims by twenty years, the inhalation of nitrous oxide was conclusively shown to be capable of producing a complete insensibility for surgical purposes. It was performed only eighteen months after the original discovery of practical anesthesia by ether in November, 1846, and at that time possessed the interest, which it no longer has, of a novel experiment connected with the development of a recent and great discovery. Anæsthesia by nitrous oxide was then abandoned, not only in view of the livid surface. and muscular rigidity, both doubtless due to asphyxia, but also on account of the inconvenience of the preparation of the gas on a large scale, and especially from the bulk of the apparatus required for its administration. This will continue to prevent the extensive employment of the nitrous oxide in surgical operations while agents so much more portable are at command. For the extraction of teeth, dental practitioners may prefer to keep upon their premises a reservoir of nitrous oxide rather than a permanent odor of ether; but the amount consumed in surgical operations alters the question. Again, pure nitrous oxide

1 Boston Medical and Surgical Journal, February 13, 1868.

gas will not support animal life, the discoloration of the surface noticed in the following operation illustrating this fact. And, lastly, while a patient may be so narcotized with ether vapor that fresh air can be let into the lungs without restoring him to consciousness during a long surgical operation, it is not so with the administration of nitrous oxide, where the admission of a little air is apt to arouse the patient, so that it is comparatively difficult to maintain a protracted and equable anæsthesia.

The following report of the case was made by Dr. John C. Dalton, the present distinguished Professor of Physiology, then house surgeon at the Hospital.

April 25, 1848. — M. H., æt. 45, married. Reports that eleven months ago she felt a peculiar sensation in the left breast. Since then, the breast has gradually become indurated and painful. The latter symptom has been much aggravated during the last three weeks, and an opening which took place near the nipple about a month ago has continued to discharge moderately since. Her general health has suffered somewhat. Now, the left breast is very hard and knobbed, with a brawny appearance of the skin, excepting over the most prominent protuberance, where it is smooth, red, and shining. Breast perfectly movable. No enlargement or induration in axilla.

27. The patient, having been placed on the operating table, was made to respire nitrous oxide gas through a valved mouthpiece and a flexible tube leading through a bladder to two large copper reservoirs filled with the gas. After several inspirations, the patient's lips and the most vascular part of the tumor began to assume a purple color. She remained quiet, however, and in a short time was evidently insensible, though the muscles were not perfectly relaxed. The tumor was then encircled by a double incision through healthy skin, down to the fibres of the great pectoral muscle.