206
Dr. Brunton commenced by stating that the conclusions arrived at by the Commission
had already been published by " The Lancet", but he thought that the main value of their work
lay in the number of experiments that had been done, which had been recorded graphically, and
which would be printed and circulated so that they might be available to all, and the conclusions
of the Commission concerning them might be criticised, and, where necessary, corrected.
Syme attributed the absence of fatalities in the use of chloroform at Edinburgh to two facts—
that very pure chloroform was used, and that plenty of it was given. It occurred to the
speaker that one reason of the deaths from chloroform might be the neglect of the second of
Syme's dicta ; for many of the deaths appeared to be due to shock, and to occur at the beginning
of an operation. Syme taught also that in administering chloroform one should watch the
respiration and not mind the pulse ; and Dr. Lawrie, in the first H yderabad Commission,
in s tituted a series of experiments to showt h a t t h e r e s p i r a t i o n f a i l e d b e f o r et
h e p u l s e . I n t h e
first Commission 141 animals were used, and they all died of respiratory failure. The second
Commission was inaugurated to repeat and extend these experiments, and 430 animals were
used with a similar result ; in the entire 571 animals the respiration failed before the heart.
It might be said that two chief theories were promulgated regarding the action of chloroform :
one, which might be called the Edinburgh theory—that chloroform paralysed the respiration,
but did not paralyse the heart ; and the other, which was chiefly current in London—that
chloroform paralysed the heart, and that this was the chief source of danger. It had occurred
to Dr. Brunton that the small amount of beer drunk in Edinburgh might lessen the
l i a b i l i t y t o f a t t y d e g e n e r a t i o n o f t h e h e a r t a n d m i g h t h a v e s o m e t h i n g t o d o w i t h t h e d i f f e r e n c e i n t h e
mortality. The Committee of the British Medical Association in Glasgow found that chloroform
sometimes paralysed the heart, and that this might happen in an unforeseen way which could
not be prevented. The experiments of the Commission were directed towards determining
the action of chloroform upon the heart, and careful tracing of blood-pressure were
taken.
An ordinary manometric apparatus was used, the carotid of the animal under chloroform being
exposed in the usual way, the distal e n d b e i n g t ie
d a n d
t h e p r o x i m a l
c o n n e c t e d w i t h
a
mercurial manometer ; the tube between the mercury and the manometer being filled with sol-u-
tion of bicarbonate of sodium. Instead of using a quick recording drum, which would give an
immensely long tracing, slow drum was used revolving only once in half an hour. This,
though it recorded the effect of respiration only, showed nevertheless sufficient for practical
purposes. But in order to register any particularly interesting variations found on the slow
drum with more
accuracy, the glass tube connecting
the
artery with the manometer was
furnished with a branch, and this led to a second manometer and a quick drum. With
this apparatus, by simply shifting a clamp, a " S a m p l e , ' ' s o t o s p e a k , o f t h e c a r d i a c a c t i o n
c ould be taken on the quick drum at any interesting moment. To avoid errors from inertia
the quick drum was worked in connection with a Fick's manometer. They found that the
difference between chloroform and ether, so far as their effects on blood -pressure was
concerned, was just what Claude Bernard had pointed out years ago, that they both acted in a
similar manner, but that chloroform was the more powerful of the two. Under chloroform
the pressure sank comparatively quickly, and on its stoppage and the adoption of artificial res--
piration it gradually rose again. If ether was used there was a much slower fall of pressure, and
artificial respiration produced a similar rise. If air strongly charged with chloroform were