The Absorption and Elimination of Volatile Substances Through the Lungs: Anaesthesia, Poisoning by Gases and Vapours in Industry, Treatment of Asphyxia

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Abstract
In the 1st lecture it is pointed out that the physiology of respiration is today based upon the fact that the pressure of CO2 in the lungs, in the arterial blood and in the centers in the brain is the same. Similarly the concentrations of any anesthetic vapor in the lungs, arterial blood and brain are almost instantly identical. Recognition of this principle should be the basis of the art of anesthesia. As the essentials of good anesthesia are rapid induction, uniform concentration of vapor and rapid termination, it is advantageous for the anesthetist to control respiration by the use of CO2 mixed with O. In the 2nd lecture the principles and factors determining the absorption and elimination of volatile substances through the lungs are defined quantitatively. The principal factors are the volume of air breathed per min., the volume of the circulation and the solubility of the particular gas in blood. For the treatment of poisoning by all gaseous substances other than the irritants and those which are decomposed in the body, it is of the first importance to induce as rapid an elimination as possible. This is effected by causing the patient to inhale air or O containing 5% CO2, thus inducing a large increase in the volume of breathing.

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