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CLINICAL LECTURE BY SURGEON-MAJOR E. LAWRIE.
GENTLEMEN,—In the case of operation for the removal of the uterus and its appendages
for sarcoma, which you witnessed yesterday, chloroform was administered, and the patient
was kept fully anæsthetised for one hour and a-half by Miss R. Furdonji, a fifth-year Parsi
lady student, without assistance or interference from anybody. You are aware that, while I
hold myself entirely responsible for the safety of my patients, chloroform is always given here
by students with complete immunity from accidents, and you may find it difficult to understand
why there should be any difference of opinion as to its safety. Unfortunately, a difference of
opinion does exist, and it is my duty to indicate to you the fallacies contained in the latest
addition to the controversy on anæsthetics,—the address on anæsthesia at the Berlin Interna
-tional Congress. In the opening paragraph of his address Professor Wood says: "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
judge and jury 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 affirm
-ing that death from chloroform are preventable, that with due care they may be avoided, and
that, therefore, when they occur they are the result or ignorance and carelessness. If this be
true, five hundred deaths and more,— the result of ignorance and 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."
Professor Wood scoats the idea that all the deaths that have occurred from chloroform are
due to ignorance and carelessness, and in a strictly limited sense he is right. The majority
of the deaths from chloroform have been due to wrong teaching, and it is not the unfortunate
chloroformist in far-off Australia who ought to be punished for losing his patient, but those
leaders of our profession who, by their obstinate and persistent advocacy of erroneous principles,
send forth from our medical schools year after year numbers of young medical men who are
ignorant of the proper method of chloroform administration, and are confessedly unable to
administer it with safety. A portion of Professor Wood's address consists of an attempt to
divert the question of anæsthesia into a side issue on the qualities of different races of dogs
and he puts forward the amazing and ridiculous contention that the heart of a dog in India
is much less sensitive to chloroform than the heart of a dog bred in northern climates. If this
were true, it would only be necessary to raise the temperature of our operating rooms to 80º
to ensure perfect safety. Operations must in future be performed in the hothouse, that is all.
Professor Wood says: "Further, in a recent letter to me, Sir Joseph Fayrer affirmed the
extraordinary safety of chloroform in India, and stated that he knew of no death from it as
having occurred in that country, although its use is universal." Sir Joseph Fayrer left India
in 1871. Since Sir Joseph left that country the old Scotch principle of chloroform administra
-tion which was in his time almost universal has been largely replaced by other principles, and
several deaths have taken place. I know of six, and five of the six have occurred since 1879.