194
THE CHLOROFORM COMMISSION IN INDIA.
[Reprint of an article from the " pioneer" of November 6th 1889.]
The arrival of Dr. Lauder Brunton and Surgeon-Major Bomford in Hyderabad, to re
-peat and extend the chloroform experiments which were carried out last year in the Nizam's
capital, is of interest not only to the medical profession, but to the public generally : and some
account of the scope of their investigations and their bearing on the practice of surgery mar
not be out of place. Chloroform was introduced to the medical profession by the late Sir
J.Y.
Simpson of Edinburgh, who first employed it in midwifery in the year 1847.It was very
soon afterwards used in surger y in Edinburgh by the late Mr.Syme, and its position as an
anæthetic quickl y became established. Itw a s s o m e l i t t l e t i m e b e f o r e S y m e c o u ld
l a yd
o w n
precisely the principles on which the safe administration of chloroform depends, and meanwhile
deaths occurred elsewhere, discussion arose in the profession as to their cause, and the public
became alarmed and acquired a dread of chloroform which thenceforth limited its advantages.
In the year 1855 Mr. Syme published a lecture in the Lancel in which he showed that
there was an important difference in practice in the administration of chloroform in Edinburgh
and in London. In Edinburgh, surgeons were guided as to the effect of chloroform entirely
by the respiration ; in London, par t ly by the respiration and partly by the circulation, so that
it was, and s t i l l i s , t he r ul e i n London t ow a t c h t h e p u l s ec
a r e f u l l y t h r o u g h o u t t h e
adminis
-tration. The teaching by the two schools amounted to this : in Edinburgh it is held that
chloroform never affects the heart directly, and that signs are always g iven b y the respiration
whereby danger can invariably be averted ; in London it was taught that one, if not the greatest,
danger of chloroform lies in the fact that it sometimes affects the heart directly, and that its
administration is never free from risk. S yme's lecture wa s couched in polemic terms and
increased the divergence of opinion between the Edinburgh and the London surgeons, and from
time to time deaths from chloroform
c o n t i n u e d t o o c c u r .
I n
1864 a Commission was
a p p o i n t e d b y t h e R o
y a l
M e d i c a l a n d C h i r u r g i c a l S o c i e t y t o e n q u i r e i n t o t h e a c t i o n o f c h l o r o f o r m w i t h
special reference to its effect upon the heart. T h i s C o m m i s s i o n p e r f o r m e d f e w r e l i a b l e
experiments, but neverthel e ss arrived a t t he conclusion t hat chloroform does directly affect the
heart. In I870 Syme and Simpson died still adhering to their original opinion a nd never
having had a fatal accident with chloroform. Between 1870 and1880 Syme's principles were
graduall y lost sight of, and the Opinion that chloroform affects the heart gained ground, and
was fortified by another Commission which was appointed in Glasgow in 1879, and, like the
previous one, did not hesitate to condemn chloroform upon altogether insufficient data. As the
belief in the safet y of chloroform has decreased, two remarkable phenomena have come about
:(1) deaths from chloroform have increased in exact proportion to the amount of attention
bestowed upon the heart and circulation; and (2) an effort has been made to substitute there
or some other anæsthetic for chloroform.