Frühe Erlanger Beiträge zur Theorie und Praxis der Äther- und Chloroformnarkose Teil 1. Heyfelders klinische Versuche mit Äther und Chloroform

Zusammenfassung

Am 24. Januar 1847 führte Professor Johann Ferdinand Heyfelder die erste Äthernarkose an der chirurgischen Universitätsklinik Erlangen durch. 108 seiner Schwefeläthernarkosen beschrieb er detailliert in seinem bereits im März 1847 erschienenen Buch Die Versuche mit dem Schwefeläther. Ebenfalls 1847 wandte er als Erster Salzätherinhalationen zu Narkosezwecken an. Ab Dezember 1847 begann Heyfelder mit Chloroformnarkosen. In seinem 1848 erschienenen Buch Die Versuche mit dem Schwefeläther, Salzäther und Chloroform beschrieb er seine Erfahrungen mit diesen drei Anästhetika. Zusammenfassend plädierte er für die Anwendung des Chloroform. Ausdrücklich forderte er einen „Gehülfen“, der sich voll und ganz der Anästhesieführung und dem Patienten widmen solle – ein Vorläufer des modernen Anästhesisten.

Abstract

The era of modern anaesthesia in Germany began on January 24th, 1847. This day, professor in ordinary Johann Ferdinand Heyfelder anaesthetized a patient with sulphuric ether in the clinic of surgery and ophthalmology of the University of Erlangen. By March 17th, 1847, Heyfelder had performed 121 surgical procedures under ether. The operations in majority were teeth-extractions, and a few more complex operations such as the treatment of a harelip or of lip cancer or the resection of the shoulder joint. Heyfelder described in detail 108 of these inhalations in a little book entitled The experiments with sulphuric ether. This monograph published in March, 1847, represents one of the first complete dissertations on sulphuric ether in the German literature. In a special chapter he analyzed the development of various physiological and psychological parameters during etherization. Heyfelder also examined blood and urine of some etherized patients and reported that he did not find any important or specific alterations. In 1847, Heyfelder was probably the first to apply salt-ether in man. After 4 administrations he concluded that salt ether acted more quickly but shorter than sulphuric ether. Advantageous were its application without problems and ease of induction. Disadvantageous were its high volatility, its price and the difficulty of getting it in a pure form. From December, 1847, on Heyfelder started to use chloroform. He was now able to perform more major operations, for example the total resection of the hip-joint. In his book The experiments with sulphuric ether, salt ether, and chloroform he describes a great number of anaesthetic administrations using these 3 agents. In his summary Heyfelder concluded, that chloroform was undoubtly superior to sulphuric ether mainly because it was a quicker acting and longer lasting agent and leads to deeper narcosis. Moreover its application was much easier for it needed no special apparatus. However, because of its great anaesthetic potency, Heyfelder particularly demanded great caution in the application of chloroform. Explicitely he expected an assistant for chloroformizations, whose only duty was to supervise the inhalations and the patient – a forerunner of the modern specialized anaesthesiologist.