259
to us the inquiry form sent out. If this has been mislaid, we will gladly furnish fresh forms.
The constant tale of deaths which are so lamentable surely claims of the profession some
personal effort towards establishing a satisfactory clinical record of the behaviour of human
b e i n g s u n d e r a n æs t h e t i c s , a n d , i t ma y b e , t h r o wi n g l i g h t u p o n t h e b e s t wa y t o a v o i d f a t a l i t i e s .
AN ADDRESS ON ANÆSTHESIA. delivered before the International. Medical
Congress, Berlin, August, 1890, by H. C.
WOOD, LL.D., Philadelphia.
[Reprinted from the "British Medical Journal," August 16th, 1890.]
THE most brilliant modern achievements of the science and art of medicine in the
direct saving of life are connected with surgery. These great achievements have been render-
ed possible by two epoch-making discoveries-antisepsis and anæsthesia. The long array of
fatal cases of poisoning by carbolic acid, by iodoform, by corrosive sublimate, and by other
antiseptic agents; the hundreds of deaths from chloroform, ether, and other anæsthetics, all
bear witness to the verity of that strange law, in obedience to which the progress of the human
race is so often at the sacrifice of the individual. Antisepsis has outgrown the dangers of its
youth, and to-day the measures that are meant to save very rarely kill. On the other hand,
the death roll of anæsthesia is daily added to—added to, according to my belief, at a rate that
has not changed in forty years. Though this be true, from far-off Australia comes the
news that jury and judge have condemned to heavy penalty a chloroformist who had lost his
patient; and in England itself a well-known medical journal lends support to such a verdict
by affirming that “deaths from chloroform are preventable, that with due care they may be
avoided,” and that, therefore, When they occur they are the result of ignorance and careless--
ness. If this be true, five hundred deaths and more—the result of ignorance or carelessness!
Five hundred surgeons, including such names as Billroth, Jaeger, Simpson, McLeod, Agnew,
Hunter McGuire, and others of equal rank, guilty of manslaughter! And still the carnage
goes on. Surely, under such circumstances, the subject of anæsthesia is worthy of the attention
even of this, the most learned medical gathering of the nations that the World can furnish.
Antisepsis, the gift of the Old World to humanity; anæsthesia, the gift of the New World,
which made the fruits of antisepsis possible—surely it is fitting that I, standing here to-day
before you all as the representative of the newer civilisation, should be the chosen mouthpiece
for the renewed discussion of this old but pressing theme.
In attempting a fresh study of a well-threshed-out subject. I propose to take advantage
of t he modern physi ol ogi cal met hods, and t o endeavour t o di scover by experi ment s upon t he
lower animals how anæsthetics kill, and what drugs or measures are most powerful in putting
aside their lethal effects. This brings us face to face with the question. How far is it possi-
ble to adapt experiments to the needs of practical medicine, and to reason from the dog to the
m a n ? A f u l l d i s c u s s i o n o f t h i s s u b j e c t w o u l d n o t h e o p p o r t u n e , b u t i t d o e s s e e m n e c e s s a r y f o r
our purpose to devote a few minutes to the pointing out of certain general guiding principles.
It ought to be acknowledged as a fundamental axiom, that no amount of experiments
can overthrow a clinical fact, although when a contradiction between experimental and bed-
- s i d e o b s e r v a t i o n s e e m s t o a r i s e , s u c h c o n t r a d i c t i o n c h a l l e n g e s t h e c o r r e c t n e s s o f t h e a l l e g e d