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this point of view, I have found so little that was novel, and so little that was satisfactory to
myself, that I shall not occupy the time of this Congress with any conclusions drawn from
reported cases, or personal experience in chloroform accidents. I do not think myself that
the problem can b e solved by any such study of cases. Death is so near and so terrible,
time is so absolute, moments so important, that no surgeon would be willing or justified in
waiting for the effect of any one remedy; and when a man is dosed with alcohol, nitrite of
amyl, hypodermic injections of ether, digitalis, atropine, and other powerful agents; faradised,
slapped, douched, stood on his heal, subjected to chest movements for artificial respiration
and various other measures too numerous to mention; who can tell, if by chance he recover,
why he has done so? or who can point out, if by chance he die, what is the remedy whose
omission or commission has led to the fatal result?
The problem is a very complex one not to be worked out amidst the excitement. and
responsibilities of the amphitheatre. Only in the physiological laboratory can its various
elements he separated and studied each by itself. without regard to the individual life which
is at stake.
In the physiological laboratory two distinct paths open, each promising to lead to some
positive knowledge. We may, on one hand, enter upon the study of the minimum fatal dose
of the anæsthetic, and of the results by the consentaneous subsequent administration of its
supposed physiological antagonist: or we may investigate the effect of remedies upon functions
that are failing under the influences of the anæsthetic.
The objections to the first of these methods have been, in the present instance, over--
whelming. The accidents seem to be independent of the amount of anæsthetic inhaled; and
such a method of investigation would have required far more time than was available after I
had had the honour of being asked to address this body. Death is produced by chloroform
and ether through paralysis of the respiration and the heart, and the method of experimental
study which I have employed consisted in a study of the action or powerful agents upon these
functions when oppressed by chloroform, I have selected chloroform chiefly because it is
the more powerful agent of the two anæsthetics. and the more certain in its lethal results.
The experiments have all been made upon dogs, by one plan. The carotid artery
and also the trachea. having been connected with a recording drum. so that the movements
of the circulation and the respiration could be consecutively recorded. the animal was anæs--
thetised, and when the blood-pressure had fallen almost to zero. and the respiration had
ceased, or nearly ceased. as the case might be the remedy to be tried was injected into the
jugular vein, through a canula which had been previously inserted.
The more important remedies which have been used by clinicians for the averting of
threatened death during anæsthesia are ether alcohol, ammonia, nitrite of amyl, digitalis,
atropine, and caffeine, alterations of position, and artificial respiration.
Although, at least in America. hypodermic injections of ether have been frequently
employed even in ether accidents, such use is so absolutely absurd that it does not seem to me