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chloroform four or five times daily in the Afsul Gunj and Residency Hospitals, and I hazard
the statement that they do so with a saroir faire that would be in no way discreditable to
speci al anæst het i st s.
To my reasoning, the whole theory of safe chloroformisation might be summed up in the
aphorism— Use pure chloroform, watch the respiration and keep it regular. This may appear to be
a most dogmatic assertion, and coming from one with my meagre experience may tinge of
presumption. Still, I have given chloroform for over eleven years; I have seen it given by
Surgeon-Major Lawrie for many years, and I have worked with both the Hyderabad Chloro-
form Commissions, and may on these grounds claim to be in a position to express an opinion
on the subject.
In conclusion, I would state that the more widespread the knowledge of the late Profes
- s o r S y m e ' s p r i n c i p l e s o f c h l o r o f o r m i s a t i o n , a n d t h e m o r e u n i v e r s a l l y t h e y a r e p u t i n t o p r a c t i c e ,
the greater will become the confidence of the profession in this much maligned anæsthetic, and
the fewer, I b e l i e v e , w i l l b e t h e d e a t h s u n d e r c h l o r o f o r m f r o m " a c c i d e n t a l c a u s e s . " T o
Surgeon-Major Lawrie the profession is indebted for his unswerving endeavours to restore
chloroform to its proper position amongst anæsthetic agents.
ARTICLE BY SURGEON-MAJOR EDWARD LAWRIE,
President of the Hyderabad Chloroform Commission.
[ Reprinted from the "British Medical Journal" of June 13th 1891.]
THE British Medical Journalhas performed a signal service to the Hyderabad Commis
- s i o n i n p l a c i n g b e f o r e t h e p r o f e s s i o n D r . J u l l i a r d ' s v i e w s o n c h l o r o f o r m a n d e t h e r . D r . J u l l i a r d
had a death with Chloroform. Then instead of learning to give it safely he took, apparently
with great reluctance, to ether. He has now learned to give ether safely and minimises its
disadvantages by giving morphia. People who have been taught to give chloroform with
safety are not likely to follow his example. Moreover the leading article in the Journal of
April 25th, 1891, is incomplete, and ought to have included the London statistics so opportunely
brought forward by Mr. Roger Williams in The Lancet of February the 8th, 1890.
According to Dr. Julliard's statistics, deaths from chloroform amount to 1 in 3,258 and
f r o m e t h e r t o 1 i n 1 4 , 9 8 7 a d mi n i s t r a t i o n s . Ac c o r d i n g t o Mr . Ro g e r Wi l l i a ms t h e s t a t i s t i c s o f
the London hospitals show that deaths from chloroform amount to 1 in 1,236 and from ether
to, in 2,754 administrations. On the other hand, the statistics of chloroform administered on
Syme's principles form an unbroken accord of inhalations from 1848 to 1891 without a death. The
British Medical Journalr e g a r d s D r . J u l l i a r d ' s f i g u r e s a s a " m o s t v a l u a b l e s t a t i s t i c a l s u m m a r y , "
but this summary would obviously be much more useful if it were accompanied by a descrip
- t i o n o f t h e m e t h o d o f a d m i n i s t r a t i o n p u r s u e d i n a l l t h e c a s e s f r o m w h i c h i t i s c o m p i l e d . T h e r e
are two distinct methods of chloroform administration in vogue. In one the pulse, as well as
the respiration, is taken as a guide: in the other, the pulse is never, under any circumstances,