8
solution the lives of thousands of people and the happiness of thousands of families may depend.
Both in Europe and America clinical experience and physiological experiments have led to the con-
clusion that it has a paralysing action on the heart, while ether exerts such an action in a very minor
degree, if at all. In consequence of this ether is now largely used in this country as well as in America
for producing anæsthesia in surgical operations, in spite of the greater pleasantness and convenience
of chloroform. It is almost impossible to believe that the conclusion at which European and Ameri-
can surgeons and scientists have arrived is, after all, destitute of foundation, and little better than all
idle dream. When we find, then, that Dr. Lawrie and the Nizam's Commission have arrived at an
entirely opposite conclusion, it is natural that we should hesitate to accept it. A consideration of
the report of the Commission appears to show that the number of experiments performed was not
only large, but the results were so uniform that the conclusion arrived at, that chloroform does
not paralyse the heart, but kills by stopping the respiration, may fairly be taken as correct for the
animals experimented on and for the conditions under which the experiments were performed. But
if we grant this, we are at once confronted by the next problem : Why do the results of the Nizam's
Commission differ from those of European and American investigators ? Is it because the experi-
ments in India were carried on in a warmer climate ? Or is it because the animals experimented on
were peculiarly resistant to the action of chloroform These questions can only be answered by
further experiments, which can hardly fail to be of practical utility, even if they afford only a partial
solution of the problem. For Surgeon-Major Lawrie states in his letter, which appeared in our issue
of May 11th, that the results of the experiments carried out by the Commission tallied exactly with
his own experience. In the correspondence which occurred on the subject in "Thee Lancet" some
writers agreed with Dr. Lawrie, while others supported the opposite view. 'We may perhaps fairly
call these two views those of the Edinburgh and London schools. In the Scotch capital failure of
respiration is regarded as the chief or only danger, while ill the metropolis failure of the heart is more
feared. It is quite possible that the surgeons in both cities arc right, and that the habits or mode of
living of the people may lead to differences in the resisting power of the cardiac or respiratory appa-
ratus respectively. The proportion of gouty patients is much larger in London than in Edinbur!,11,
and when we consider that the natives of India appear to resemble the Scotch in their comparative
immunity from cardiac paralysis by chloroform, it wiftbe advisable for the Commission to ascertain, if
possible, what the conditions are which enable the heart either in dogs or men to resist the power of
chloroform or which lead to its stoppage dulling the administration of the drug. It may not be
possible to work out completely all the questions which may arise, but if the Hyderabad Commission,
with the aid of Dr. Lauder Brunton, can settle definitely the question whether chloroform does or does
not affect the heart directly, a most important practical object will have been attained by means of the
Nizam's generous offer.
10. The opinions held by the medical. profession in Great Britain may be
fairly judged from the above -itiotations from " The Lancet." There is no doubt
they were and are largely influenced by the experimental results obtained by
various observers, and more especially by the Committee of the Royal Medico-
Chirurgical Society and of the British Medical Association or Glasgow Com-
mittee. Both these Committees arrived at the conclusion, from a very limited
number of experiments, that chloroform lowers the blood-pressure, while ether
does not, The Glasgow Committee went further, and not only stated that