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ANNOTATION FROM THE LANCET,J A N U A R Y 2 5 T H ,
1 8 9 0 .
In our annotation on the report of the first Hyderabad Chloroform Commission in our
issue of March 2nd, 1889, we strongly deprecated anything like slipshod carelessness in the
administration of chloroform, or anything likely to lead to such carelessness. Nothing, we are
certain, could have been farther from the minds of either of the Commissions than to inculcate
carelessness, and a careful perusal of the practical conclusions which we printed last week will
show how necessary the Commissions consider care to be, and how stringently they inculcate
it. Yet one of our contemporaries, in referring to the report of the Commission, says :
“ Henceforward chloroform is as safe as a glass of whisky-and-water. That is the net result of
the Hyderabad Chloroform Commission.” This may be true of chloroform carefully adminis
-tered, but the least carelessness or inattention may lead to the most serious results, as was
well shown by the cases of accidental death from chloroform amongst the animals used by the
Commission. We think the instance is worthy of particular note in which the chloroformist
was present in body but absent in mind, and allowed his attention to wander from the respira
-tion of the animal to the performance of the operation. Instead of being an immense relief to
every practitioner who has to administer chloroform, the conclusions of the Hyderabad
commission will have precisely the opposite effect. For ifa d e a t h
o c c u r s d u r i n g t h e
administration of chloroform present, the administrator may satisfy himself that such death
was due to the effect of chloroform on the heart, and was unavoidable. But if' the conclusions
of the Hyderabad commission are correct, this will no longer be possible, f or their deliberate
conclusion is that deaths from chloroform are preventable, and that their occurrence in the
future will indicate carelessness in the chloroformist. It would be monstrous to make such a
conclusion retrospective, and to say that all deaths that have already occurred were due to
carelessness, because imperfect knowledge leads to a similar result, and it is only when the
exact dan g ers and mode of obviating them become known that the responsibility of avoiding
them arise. No one thinks a blaming a commander when his ship strikes a sunken rock
not marked on his chart, but when once the danger has been clearly indicated he is regarded as
blameworthy if he does not avoid it. The work of the chloroform Commission has not altered
the properties of cliloroform in the leat
; ano v e r - d o s e w i l l k i l l a s
r e a d i l y a s
e v e r , b u t w e t r u s t
their attempts to define more clearly the way in which it kills, and the mode in which death
may be avoided, will have the desired effect of preventing deaths in the future, just as
marking the situation of a sunken rock will prevent further shipwrecks.— The Lancet,
25th January 1890.
LETTER FROM MR, WOODHOUSE BRAINE.
TO THE EDITORS OF “THE LANCET.”
SIRS,—It may appear almost ungenerous to criticise the conclusions at which the
Hyderabad Commission has arrived, when all its members have thrown themselves heart and
soul into the labour, and have spared no pains to get at the truth of the great question as to
whether chloroform ever produces a fatal result by cardiac failure before the respiratory func
-tions are affected ; but if I remain silent I shall probably be considered as acquiescing in those
conclusions, and therefore I trouble you with this letter.