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to require any experimental evidence of its futility. Ether in the blood acts as ether, whether
it finds entrance through the lungs, through the rectum, or through the cellular tissue; and
the man who would inject ether hypodermically into a patient who is dying from ether, should,
to he logical, also saturate a sponge with the ether and crowd it upon his unfortunate victim.
Instead of simply stating the results obtained in my experiments, I have thought it
would be more interesting to show reproductions from some of my tracings. The first drug
that I shall report upon is caffeine. I have injected it during the cardiac failure produced by
chloroform, in doses varying from 3 to 7 1/2 grains, and have never been able to perceive any
distinct alteration in the arterial pressure, and no consistent distinct change of the pulse either
in number or force. So far as the experiments go, they certainly indicate that the drug has
no influence upon the heart that is being overpowered by chloroform. I may also state here
that it is not possible in any of my tracings to make out any influence exerted by caffeine
upon the respiration.
Wi t h a t r o p i n e I h a v e ma d e a f e w e x p e r i me n t s , t h e r e s u l t s b e i n g a l mo s t a s n e g a t i v e a s
with caffeine. Ten cubic centimiêtres of a 2 per cent. solution of the atropine injected into
t he j ugul ar vei n of a chl or of or med ani mal , al t er ed t he r at e of t he pul s e beat , but had no
apparent effect or influence upon the arterial pressure, or upon the respiration, and in no
w i s e p r e v e n t e d f i n a l c a r d i a c a r r e s t .
Of all drugs, that which I think is usually most relied upon by clinicians as a cardiac
stimulant in anæsthesia as in other cases of heart failure, is alcohol. The chemical and phy-
relations of alcohol to ether and
are, however, so close, that many ye
ars ago I became very doubtful of the value of this drug as a stimulant to a heart depressed by
an anæsthesia.
These doubts continually grew stronger from what I saw and read as to the effects of
the administration of alcohol anæsthesia and were finally changed into
conviction by the experiment of R, Dubois,* who found that in the animal to which had been freely
given, much less chloroform is required than in the normal animal, to anæsthetise or to kill:
or, in other words, that alcohol intensifies the influence of chloroform and lessens the fatal dose
.
In my own experiments with alcohol an 80 per cent. fluid was used, diluted with water.
The amount injected into the jugular vein varied in the different experiments from 5 to 2
0 cubic centimêtres, and in no case have I been able to detect any increase in the size of the
pulse, or in the arterial pressure produced by alcohol, when the heart was failing during
advanced chloroform. anæsthesia. On the other hand, on several occasions the larger amounts
of alcohol apparently greatly increased the rapidity of the fall of the arterial pressure, and
aided materially in extinguishing the pulse rate.
The effects of ammonia upon the failing heart of chloroform anæsthesia have been
experiments uncertain; sometimes distinct, although very fugacious, and sometimes i
m-perceptible. Twenty cubic centimêtres of a 10 per cent. solution of aqua ammoniæ fortior
* Progress Mid., 1883 xi. 951.