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the heart inspected. The organ was found to be greatly dilated in all its parts, while
extremely feeble rhythmic contractions were still present, utterly incapable of discharging the
contents of the cardiac chambers. Rhythmic compression of the ventricles was then employ-
ed, and kept up for nearly twenty-five minutes, at the end of which the regular action of the
heart was restored—more than thirty-five minutes after the collapse had occurred. The
ordinary blood-pressure was soon regained, the respiratory centre speedily showed signs of
activity, the conjunctival reflex was restored, and the condition of the animal kept up through
the whole duration of a long experiment as if no collapse had occurred.
CASE III.—Corresponded in all its details so closely with the history of Case II., that
it is unnecessary to relate the sequence of events in detail. The spontaneous respiration
continued for ten minutes after the exposed carotid artery had become collapsed and
pulseless. Recovery was brought about in the same way as in Case II.
The phenomena presented by all these cases were most closely observed, and recorded
i mmedi at el y af t er war ds. The f eat ur es of t he col l apse showed a r emar kabl e r esembl ance t o
what has oft en been descri bed as occurri ng under t he i nfl uence of chl oroform i n man. Care
was taken to leave no room for doubt as to the nature of the spontaneous respiratory move-
ments which went on so long (ten minutes) after the circulatory failure. They were no
deceptive movements of the chest without proper entrance of air; each respiratory effort
was attended by free passage of air into the thorax. The reason why the spontaneous
breathing movements continued long even after vigorous artificial respiration was instituted
was, in all probability, that though abundance of air was supplied to the lungs by artificial
respiration, the collapsed state of the circulation prevented the due conveyance of oxygen
from the lungs to the respiratory centre in the medulla oblongata; hence that centre went on
sending out impulses to the respiratory muscles.
It is evident the collapse was not dependent upon vaso motor paralysis; firm pressure
immediately applied to the abdomen produced no beneficial result, as it would have done had
the heart not been rendered functionally incapable by the influence of that chloroform.
It is extremely probable that a condition of cardiac failure occurred in some of the ex--
periments of the Second Hyderabad Chloroform Commission. In their Report* (Section 25)
they state that it is never in any case certain that artificial respiration will restore the natural
r espi r at i on and bl ood- pr essur e, no mat t er how soon i t i s commenced af t er t he r espi r at i on st ops.
And they found that in some cases, even after the spontaneous respiration had been restored,
t he pr es s ur e cont i nued t o f al l and r es pi r at i on agai n ceas ed; ar t i f i ci al r es pi r at i on t hen f ai l ed.
Such results were in all probability due to the heart being greatly dilated and unable to perform
its functions.
OccasionalO c c u r r e n c e o f s l o w i n g o f t h eH
e a r t ' s A c t i o n u n d e r C h l o r o f o r m.
— A t e m p o r a r y
but marked slowing of the cardiac rhythm under chloroform I have seen in various intances.
Such a change was first illustrated, as an effect of chloroform, by the tracings of the Chloro--
form Committee of the British Medical Association (Glasgow Committee) in 1879. As far as
n u a r y 1 8 t h , 1 8 9 0 .