NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
49
Three drachms of blood in the pericardium. Mitral valves a little thickened.
Apex of right ventricle attenuated.
O b s e r v a t i o n s .
H . M .
S .
A. 8 27 30.—Needle into heart.
B. 8 30 40. —Chl or of or m pushed t i l l st oppage of t he r espi r at i on :
revival by artificial respiration.
C. 8 38 0.—Needle thrust into the heart.
D. 8 41 0.—Ether administered struggling and similar irregu-
larities in the circulation, as are observed during
struggling under chloroform and the A.C.E. mixture.
E. 9 23 35. —Chl or of or m pushed: t he r espi r at i on st opped at 9h. 24m.
30s. The heart continued to beat till 9h. 32m. 20s.
November 5th.—No. 54.
Temperature or the room 24 Cent. Full-sized pariah dog. Chloro-
formed in box 10h. 9m. 15s. Dog fallen down 10h. 14m. 20s. Placed on the
table 10h. 15m. 25s. Stopped breathing 10h. 16m. 10s. Artificial respiration
tried without. effect. Post-mortem—Organs healthy; two ribs fractured. In
this case there was no doubt that chloroform had been carelessly administered
while the operation for tying the carotid was being performed.
November 5th.—No. 55.
Temperature of the room 24 Cent. Full-sized healthy pariah dog. Put
into the chloroform box at 10h. 29m. 25s. Placed On the table at 10h. 42m, 30s.
Artery ligatured at 10h. 51m. 30s. Connection made with the manometers at
l0h. 56m. 10s. One Ludwig and one Fick tracing showing administration of
et her wi t hout ai r, i t s fai l ure t o keep t he dog under and fi nal l y deat h from
pushing A. C. E. Post-mortem-two ounces of arterial blood in pericardium.
The needle had passed through the lungs into the left auricle. (In this as in
previous cases the upper line on the Fick tracing is produced by a system of
Marey's tambours connected with the needle in the heart.)
H . M
. S .
A. 10 57 0.—Needle thrust into heart. The depressing effect of this
measure is shown. in Fick reading 1.
B. 11 0 25. —Ether with the air excluded.
C. 11 21 20.—A. C. E. mixture pushed till death.
7
50
November 5th.—No. 56.
Temperature of the room 25½ Cent. Full-sized strong pariah. Chloro-
form given at 1h. 48m. 30s. Fallen down at 1h. 56m. 30s. Placed on the table
at lh. 58m. 10s. Artery ligatured at 2h. 6m. 45s. Canula inserted at 2h.
11m. 30s. Connection with manometers at 2h. 15m. 15s. In this experiment
it was intended to smother the dog with a tin mouth-piece carefully closed, but
after death it was found that a sponge with a small amount of chloroform upon
it had been accidentally left inside the mouth-piece. One Ludwig and one
Fick tracing showing—
Observations.
H . M . S .
A. 2 16 20.—Chloroform; stopped at 2h. 17m. 40s., needle into the
heart at 2h. 17m. 50s.
B. 2 20 5.—Simple asphyxia with a very small quantity of chloro-
form. accidentally left in the inhaler. At 2h. 27m. 0s.
the heart's action was arrested, probably owing to
v a g u s s t i m u l a t i o n , f o r 1 5 s e c o n d s(
r i d e
F i c k 7 ) .
The heart stopped finally at 2h. 30m. 0s.
Fick reading 8 shows clearly the gradual cessation of movement in the
needle thrust into the heart. Post-mortem examination showed general venous
c o n g e s t i o n ; s ma l l h æmo r r h a g e i n t h e l u n g s ; a s ma l l c y s t i n t h e wa l l o f t h e
heart, and a large suppurating lymphatic gland in the wall of æsophagus.
November 5th.—No. 57.
Temperature of room 26 Cent. Full-sized pariah. Chloroformed in box
2h. 37m. 15s. On the table 2h. 42m. 30s. Artery ligatured 2h. 49m. Con-
nection made with manometer 2h. 53m. One Ludwig and two Fick tracings.
An attempt was made to simply smother the dog with the padded mouth-
p i e c e ; b u t c o m p l e t e a s p h y x i a c o u l d n o t b e p r o d u c e d , a n d h e w a s e v e n t u a l l y
killed with A. C. E. mixture pumped into the mouth-piece with Junker's
inhaler. Fick readings 4, 6, and 7 show very well the slowing of the heart
produced by asphyxia. Post-mortem—Intense venous congestion.
O b s e r v a t i o n s .
H . M .
s .
A. 2 53 40.—Partial asphyxia.
B. 3 11 5.—A. C. E. mixture pumped into the mouth-piece with
Junker's inhaler till death. Respiration ceased at
3h. 16m, 0s. and the heart stopped at 3h. 20m. 15s.
51
November 5th.—No. 58.
Temperature of the room 26 Cent. Full-sized powerful pariah dog. Into
the chloroform box at 3h. 28m. 15s. Fallen down at 3h. 32m. 10s. Placed on
the table at 3h. 33m. 45s. and kept quiet with chloroform. Artery ligatured
at 3h. 40m. Canula inserted at 3h. 43m. 30s. Connection made with manome-
ters at 3h. 44m. 35s. One Ludwig and one Fick tracing. Asphyxia by means
of the mouth-piece was again attempted, but as this failed to kill the dog owing
to leaks, chloroform vapour was pumped into the closed mouth-piece with
Junker. Unfortunately directly after this a clot formed in the tube.
November 6th.—No. 59.
Temperature of room 22.5 Cent. Full-sized pariah. Into chloroform
box at 8h. 20s. Fell down at 8h. 9m. 45s. Placed on the table at 8h. 10m.
Temperature in rectum 100.4 F. More chloroform at 8h. 17m. 35s. and again
at 8h. 23m. 30s. Canula inserted at 8h. 26m. 30s. Connection made with
t h e m a n o m e t e r s a t 8 h . 3 2 m . 2 0 s . O n e L u d w i g a n d t w o F i c k t r a c i n g s s h o w i n g t h e
effect of asphyxiating the animal by holding a carefully-sealed inhaler over his
muzzle. The act of thrusting the needle into the heart did not cause an
y f a l l
o f
p r e s s u r e . T e m p e r a t u r e i n t h e r e c t u m 9 9 F . a t t h e e n d o r e x p e r i m e n t .
Post-mortem presented all the appearance of asphyxia. The needle had entered
the heart through the auriculo-ventricular groove and just reached the interior
behind one of the semi-lunar valves, No blood in the pericardium.
November 6th.—No. 60.
Temperature of room 23½ Cent. Large size dog. Into chloroform box
at 10h. 3m. Fell down at 10h. 12m. Placed on the table at 10h. 13m. Tem-
perature in the rectum 100.4 F. A little chloroform given at 10h. 21m. Artery
ligatured at 10h. 22m. 10s. Canula inserted at 10h. 25m. Connection made
with manometer at 10h. 27m. One Ludwig and one Fick tracings. Asphyxi
a
was f i r s t p r o d u c e d b y s m o t h e r i n g t h e d o g w i t h a n e m p t y i n h a l e r , a n d t h e n
chloroform was pumped into the still air-tight inhaler. Death resulted very
rapidly. From Fick reading 3 it was thought that the heart had stopped
simultaneously with the respiration, but, on opening the thorax, the heart was
found to be still beating and it continued to do so for some minutes. Post-
mortem appearances those of chloroform poisoning. Temperature after the
experiment 99 F.
52
Observations.
A. 10h. 28m. 0s.—Smothering with an empty inhaler. The. irregular
fall of pressure due to asphyxia, and to asphyxia combined with chloro-
form, is seen in Fick readings 1 and 2.
B. 10h. 32m. 5s.—Chloroform pumped into the air-tight inhaler.
Fick 3 shows the very rapid fall of pressure due to vagus stimulation in an
animal. already partially asphyxiated, and how quickly chloroform-poison-
ing and paralysis of the respiratory centre occurs under these circum-
stances. From Fick 3 and the absence of pulse it was thought by every-
body present that the heart had altogether stopped, simultaneously with
the respiration, at 10h. 33m. 0s., but when the thorax was opened at 10h.
36m. 30s., three minutes and-a-half alter the breathing stopped, the heart
w a s
f o u n d t o b e b e a t i n g v i g o r o u s l y , a n d i t c o n t i n u e d t o d o s ot
i l l 1 0 h .
3 9 m . 5 0 s . , n e a r l y s e v e n m i n u t e s a f t e r t h e c e s s a t i o n o f r e s p i r a t i o n ,
Experiment No. 60 affords an excellent example of the remarkable slow-
ing and even temporary cessation of the heart's action. which occurred again
and again. throughout. the Commission's enquiry at the same moment as the
respiration stopped. The heart always recovered itself and began to beat re-
gularly again before any steps were taken to restore the animal and without
any respiration taking place. (Vide Experiments Nos. 49. 162 and 178, and
compare with 60). The failure of the heart, if such it can be called, instead of
being a danger to the animal, is a safe-guard by preventing the absorption of
residual. chloroform from the lungs and its distribution through the system. If
the arrest of the heart in these experiments is due, as it appears to be, to
v a g u s s t i m u l a t i o n , t h e r e i s n o d o u b t t h a t t h e i n h i b i t i n g a c t i o n b e n e f i t s t h e
organ and, besides resting it, acts on it as a tonic.
November 6th.—No. 61.
Temperature of room 24 Cent. Full-sized pariah dog. Put into the
chloroform box at 10h. 42m. Fallen down at 10h. 55m. 30s. Placed On the
table at 10h. 57m. 45s. Temperature in the rectum 99.2 F. Artery ligatured
at 11h. 4m. A little chloroform given at 11h. 9m. Connection made with the
manometers at 11h. 10m. 15s. Temperature after death 98.2 F. Two Ludwig
and two Fick tracing's showing the effect of giving ether to an asphyxiated
animal. The extraordinary tall of pressure, which occurred at the commence-
53
melt of the ether inhalation, is noticeable. It was the accompaniment probably
of struggles and holding breath, though this was not noted on the tracing. As
ether did not appear to be going to kill the animal in a reasonable time, chloro-
form was pumped into the inhaler and death ensued rapidly. The second
Ludwig tracing is imperfect, on account of the float not working freely in
the tube of the manometer. The needle was found in the apex of the left
ventricle.
November 6th.—No. 62.
Temperature of tile room 25.5 Cent. Full-sized strong pariah dog. Put
into chloroform box at 2h. 25m. Fallen down at 2h. 32m. 30s. Put on the
table at 2h. 34m. 30s. Temperature in the rectum 101 F. Artery ligatured at
2h. 40m. 30s. Canula inserted into the carotid at 2h. 44m. Connection made
with the manometers at 2h. 46m. One Ludwig and one Fick tracing. A little
chloroform was given at first to quiet the animal and diminish the excursions
of the needle. Afterwards the empty inhaler was applied and made as air-tight
as possible, and. lastly, A. C. E. was pumped into the inhaler until death ensued,
The end of the experiment was interrupted by a clot. Temperature in the
rectum 99 F. after the experiment.
November 6th.—No. 63.
Temperature of the room 25 . 5 Cent. Medium-sized strong pariah dog.
Put into the box and chloroform given at. 3h. 19m. 10s. Fallen down at
3h. 30m. 15s. Brought on to the table at 3h. 31m. 15s. Temperature in the
rectum 101 . 6 F. Chloroform from time 10 time to keep him quiet. Artery
ligatured at 3h. 41m. 25s. Canula inserted into carotid at 3h. 42m. 50s. Glass
tube tied in. to the trachea at 3h. 50m. Connection. made with the manometers
at 3h. 53m.
One Ludwig and one Fick tracing. showing the effect of opening and
closing the tracheal tube (ride especially Fick readings 3 and 4). Chloroform
was afterwards pumped into the tracheal tube by means of Junker's inhaler
until death ensued.
November 7th.—No. 64.
Temperature of the room 21 Cent. Full-sized pariah dog, rather thin.
Put i nt o t he chl or of or m box at 7h. 46m, 30s. Fal l en down at 7h. 52m. 30s,
Placed on the table at 7h. 53m. and given a little chloroform from time to time
to keep him quiet. Artery ligatured at 8h. 5m. 10s. Temperature in the
rectum 98.2 F. A loose ligature placed under both vagi. Connection made
with the manometer at 8h. 20m. 15s. Three Ludwig and three Fick tracings.
Ludwig II, is during( a )
a s h o r t a d m i n i s t r a t i o n o f c h l o r o f o r m(
b )
l i g a t u r e o f
the right vagus after the chloroform was stopped, causing very marked
and continued depression ;( c )
a r t i f i c i a l . r e s p i r a t i o n (
d ) d i v i s i o n o f t h e r i g h t
vagus (e) peripheral irritation of the right vagus. electrically (coils distant 10
cent.), with at the same time the pushing of chloroform on an ordinary cap for
a little over two minutes ; (f) artificial respiration and gradual recovery
Ludwig tracing is during (g) p e r i p h e r a l i r r i t a t i o n o f t h e r i g h t v a g u s ( F i c k
reading 9) (h) irritation of right vagus. peripheral as before, and pushing of
chloroform at the same time (Fick reading II . )
f o r a b o u t o n e m i n u t e (
. i ) grad-
ual recovery without artificial respiration ; ( .j) the same experiment again,
irritation of right vagus and pushing chloroform, for over two
m i n u t e s ; (
k ) r e c o v e r y a g a i n w i t h o u t ; a r t i f i c i a l r e s p i r a t i o n . b u t i n t h e c o u r s e o f r e c o v e r y ,
irritation of the right central vagus ; and (l ) l i g a t u r e a n d s e c t i o n o f t h e l e f t
vagus. Ludwig tracing III . is during (m) irritation a the periphery of both
vagi with pushing of chloroform at the same time for about two minutes ; ( n)
opening and placing a tube into the trachea; ( o) chloroform accidentally squirted
into the trachea and gradual. death of the animal. The time of the 22 Fick
readings is noted on the Ludwig tracings. Temperature in the rectum after
death 98 . 4 F.
A. 8h. 20m. 30s.—Chloroform administered. Irritation of right
vagus at 8h. 22m. 0s. causing almost total arrest of the pulse from
8h. 22m. 0s. to 8h. 23m. 45s. During this period there were only
25 pulsations registered, and most of these pulsations occurred during
the last 45 seconds (ride Fick 2). Chloroform was pushed to stoppage of
the respiration and the animal was restored by artificial respiration. The
v a g u
s w a s d i v i d e d a t 8 h . 2 7 m . 0 s .
B. 8h. 29m. 50s.—Irritation of the peripheral end of the right vagus
when the animal was out of chloroform. The slowing of the heart and
great fall of blood-pressure caused by stimulation of the vagus are well
shown on the Ludwig tracing. The administration of chloroform was
55
commenced during more or less complete inhibition of the heart (vide Fick
5 and 6) from 8h. 30m. 10s. to 8h. 32m. 0s. The respiration ceased at
8h. 32m. 0s. and the chloroform cap was removed. Artificial respiration
was not begun until 8h. 33m. 55s. and natural breathing was restored at
8h. 39m. 0s.
C.8 h . 5 3 m . 3 0 s . — I r r i t a t i o n o f p e r i p h e r a l e n d o f r i g h t , v a g u s
followed by rapid chloroform administration at 8h. 53m. 40s. (vide Fick
11). At 8h. 54m. 1 5s. the vagus irritation was stopped, and the admin-
istration of chloroform was discontinued at 8h. 54m. 30s. At 9h. 1m. 30s.,
when the animal was coming round spontaneously, irritation of the peri-
pheral end of the right vagus was again commenced while chloroform was
pushed simultaneously and. continued until 9h. 3m. 40s. The respiration
entirely ceased at 9h. 3m. 10s. and recommenced spontaneously at 9h.
4m. 10s. The chloroform cap was removed, but the blood-pressure
continued to fall, owing to the residual chloroform in the lungs, until
9h. 4m. 40s. (vide Fick 13). The central end of the right vagus was
irritated from 9h. 6m. 55s, until 9h. 7m. 50s. and this caused v ery slow
respiration. The left vagus was divided at 9h. 9m. 40s.
D. 9h. 14m. 20s.—Electrical irritation of peripheral ends of both vagi,
causing an immediate fall of the blood-pressure almost to zero. Chloro-
form administration was pushed during complete inhibition of the heart's
action at 9h. 14m. 30s. There was entire absence of pulse-tracing for
more than one and-a-half minutes, the blood-pressure remained nearly at
zero, and the breathing became slow. The irritation and the administra-
tion of chloroform were both stopped at 9h. 16m. 0s. The blood-pressure
rose immediately to nearly its former height. It then gradually
f e l l , e x a c t l y a s i t d o e s i n c h l o r o f o r m a d m i n i s t r a t i o n w i t h n o r m a l b r e a t h i n g ,
and rose again spontaneously at the end of one minute. The fall of
pressure after the cessation of vagus stimulation constitutes the most
interesting ph enomenon in this observation. From 9h. 14m. 20s. to
9h. 16m. 0s. cardiac inhibition, with sudden and prolonged fall of blood-
pressure, was caused by stimulation of the vagi. The arrest of the
circulation, due to stoppage of the heart, prevented the chloroform, which
from 9h. 14m. 30s. was saturating the air deep down in the lungs. from
getting into the blood. But when the circulation was resumed at
9h. 16m. 0s. the chloroform was forthwith taken up by the blood, and
the respiration was no longer a factor in the process, except to eliminate it
from the lungs. The effect of the uncontrollable absorption of chloroform
into the blood was, not to give rise to any paralysis or weakening of the
heart, but simply to produce the ordinary regular and gradual fall of the
blood-pressure, which is associated with narcosis of the nerve centres in
the medulla, in normal chloroform inhalation. The trachea was opened at
9h. 19m, 0s. and a tube inserted at 9h. 19m, 50s.
E. 9h. 25m, 0s.—Chloroform was accidentally squirted into the
trachea. Respiration stopped at 9h. 28m, 45s.; slight thoracic movements
o c c u r r e d a t 9 h . 3 1 m . 2 5 s ; a n e e d l e w a s i n s e r t e d i n t o t h e h e a r t a t
9h. 33m. 30s; and the heart-movements were perceptible until 9h. 35m. 20s.
The artery was cut and the pressure fell to zero at 9h. 36m. 0s.
November 7th.—No. 65.
Temperature of the room 23½ Cent. Full-sized pariah, but very old. Put into
the chloroform box at 10h. 43m. 30s. The dog escaped from the box, butw a s
put into it again at 10h. 45m. 15s. Fallen down at 10h. 56m. Placed on the
table at 10h. 56m. 45s. and given enough chloroform from time to time to keep
him quiet. Temperature in the rectum 100 . 8 F. at 11h. 4m. 20s. Artery liga-
t ured at 11h. 7m. Canul a i nsert ed i nt o t he art ery at 11h. 6m. Loose l i gat ure
placed under both vagi. Connection made with manometers at 11h. 20m. 5s,
Three Ludwig and. three Fick tracings during ( a ) rapid chloroform admin-
istration until respiration ceased and for about a quarter of a minute after-
wards, i.e.. for 1 minute in ; (b) gradual recovery without artificial respira-
tion ; (c) double ligature and division of the right vagus ; (d) irritation of the
peripheral end of the right vagus. together with pushing of chloroform by the
ordinary cap for 2½ minutes. The distance of the coils was changed from 10
cents, to 5 cents. in the middle of the experiment ; (e) gradual recovery without
artificial respiration ; (f) irritation of the central end of the right vagus
(Fick. reading 7 ) ; (g) pushing chloroform for nearly one minute and stopping
the respiration, necessitating resort to (h) artificial respiration ; (i ) i r r i t a t i o n o f
the central end of the right vagus again (F ick 10); ( ,j ) irritation of the periphery
of the vagus again with chldoroform pushed as before for five minutes ;( k )
spontaneous tendency to recovery assisted after 3½ minutes by a short artificial
respiration ; ( l ) ligature and division of left vagus ; (m ) pulling at the vagi ;
( n) irritation of both vagi, pushing chloroform for just over 5 minutes, while
57
artificial respiration was employed whenever the respiration stopped so as to
ensure the chloroform entering the lungs. Afterwards the dog took a few
shallow respirations and then died in spite of artificial respiration.
Temperature in the rectum just after death 98 F,
Observations.
A.
11h.22m. 50s.-Pushed chloroform;breathing stopped at 11h.
23m. 34s.;chloroform cap removed 11h. 23m. 50s;breathing restored
spontaneously without artificial respiration.
B.
11h. 30m, 0s.—Chloroform pushed with simultaneous irritation of
peripheral end of right vagus. The slowing of the pulse due to vagus
stimulation is shown in Fick 4. Breathing stopped at 11h. 32m. 35s,
and recommenced spontaneously at 11h. 33m. 20s. Fick 7 shows the
tracing of the respiration and pulse during irritation of the central end
of the vagus. The respiration was not stimulated, but arrested by the
irritation of this portion of the nerve.
C.
11h. 38m, 5s.—Chloroform pushed till. 11h. 38m. 55s., when the
respiration stopped and the pulse tracing disappeared (vide Fick 8). The
animal was restored by artificial respiration. The central end of the right
vagus was irritated from 11h 41m. 50s. to 11h. 42m. 20s. The effect in
slowing the respiration, and of this on the pulse, is well shown in
Fick 10.
D. 11h. 51m. 55s.-Irritation of the peripheral end of right vagus
followed at 11h, 52m. 0s. by chloroform. The irritation and chloroform were
kept up till 11h. 57m. 0s. Respiration stopped at 11h. 54m. 0s. There were
a few gasps at 11h. 57m, 10s. Artificial respiration was not commenced
till 12h. 0m. 40s. The animal recovered. The first respirations are seen
in the Ludwig tracing between 12h.1m 0s. and 12h. 2m. 0s. The effects
of stimulation of the vagus in. slowing the heart and circulation are dis-
played in readings 13, 14, 15, 16 and 17 Fick. The left vagus was divided
at 12h. 4m. 55s.
E. 12h. 12m. 45s.—Irritation of the peripheral ends of both vagi and.
chloroform administration kept up till 12h. 18m, 0s., the chloroform being
inhaled by artificial respiration when natural respiration failed. Death
F-4
S
58
ensued. Experiment No. 65 proves that inhibition of the heart's action, due
to stimulation of the vagi during continued chloroform administration, pre-
vents rather than assists the fatal effects of prolonged chloroform inhalation,
and that lowering of the blood-pressure either suddenly or gradually with-
out weakening of the heart is in no sense a danger.
November 8th-No. 66,
Temperature of the room 21 . 5 Cent. Full-sized pariah dog. Into chloro-
form box at 9h. 25m. 30s. Fallen down at Oh. 33m. Placed on the table at
9h. 35m. 45s., and given chloroform now and again. Canula inserted into
left carotid. Loose ligatures placed under both vagi and a large-sized glass
tube tied into the trachea. Connection made with the manometers at 10h. 6m.
The animal was first asphyxiated and then given ether through the tracheal
tube by means of Junker's inhaler. Death ensued rapidly.
November 8th,-No. 67.
Temperature of the room 23 Cent. Full-sized pariah dog. Into the
chloroform box at 10h. 30m. 15s. Fallen down at 10h. 48m. 0s. Placed on
the table at 10h. 51m. 30s. Temperature in the rectum 99 .0 F. Ligature of
the carotid at 11h. 3m. 30s. Tube placed in trachea and loose ligatures under
both vagi. Connection made with manometers at 11h. 16m. One Ludwig
trace and one Fick (one Fick reading is incorporated with the Fick readings
of 68). Chloroform was administered by the Junker inhaler attached to the
tracheal tube and death occurred very rapidly. Before the chloroform was
given the sciatic nerve was irritated. Artificial respiration was tried for
several minutes in vain, though it kept up a certain amount of blood-pressure,
and ammonia was held opposite the opening of the trachea. Post-mortem
examination showed that there was nothing abnormal in the heart or other
organs. Rupture of the liver had occurred and there was much blood in the
peritoneum, but this can only have occurred after the death of the dog, as
artificial respiration was very gently applied for a long time. Temperature in
the rectum after death 99 . 4 F.
November 8th.—No. 68.
Monkey (fair-sized Macacus).Chloroformed at 2h. 10m. 45s. in box.
Temperature of the room 24 . 5 Cent.Fallen down at 2h. 23m. 15s. On the
table at 2h. 27m. 45s and kept quiet with chloroform from time to time.