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happens in every case of chloroform inhalation without exception, whether in man or in animals,
where the breathing is perfectly regular. Any one who is taught to give chloroform in the
right way can obtain the same sequence of events clinically, which the tracings pourtray experi--
mentally; and I undertake to produce them invariably in any laboratory or operating room in the
world. My students do it here every day, and if we can do it anybody can do it. The irregula--
rities in the tracings of the Glasgow Committee, and Professor Macwilliam's more recent bogey
of dilatation of the heart, are due to obstruction of the circulation in the lungs through interference
with, or irregularity of, the respiration. The proof of this is furnished by the experimenters
themselves. The Glasgow Committee state that in their experiments the anæsthetic was ad
-ministered in a cloth, saturated with chloroform, held over the face, i.e ., with insufficient air.
In Professor Macwilliam's experiments the chloroform was pumped into the lungs with bellows.
Professor Macwilliam states that only a certain percentage of chloroform, 1 to 5 per cent., was
allowed to get into the air, in the experiments he performed in this manner. Before we can
accept his conclusions, however, he is bound to demonstrate that air containing from 1 to 5 per
cent. of chloroform, blown into the trachea with bellows, is incapable of producing obstruction
of the circulation or respiration in the lungs. Obstructed circulation in the lungs and a
rapidly falling blood-pressure are more than enough to account for the dilatation of the
whole heart; which occurred in his experiments and which he wrongly attributed to the direct
action of chloroform. It is amusing to contrast Professor Macwilliam's statements regarding
the danger of dilatation from the direct action of chloroform on the heart in the laboratory
with Dr. James Dunlop's clinical experience, as narrated in The Lancet of September 27th,
1890, that in typical cases of death from the direct action of chloroform the heart is empty and
flaccid. Perhaps Mr. Alexander Wilson will assert that Professor Macwilliam's statements "are
only a little fuller and more complete" than Dr. Dunlop's, and that they are "not incompa--
tible," which is the view he takes of Erichsen's teaching that the pulse should always be taken
as a guide, and Syme's teaching that it should never be taken as a guide in chloroform
administration.
I am satisfied to leave the question of chloroform administration to the judgment of
the readers of the MEDICAL CHRONICLE. I have always understood that, next to saving life,
the prevention and relief of pain are among the most important duties of our profession.
According to the teaching of the Hyderabad Commission, pain may safely be prevented and
relieved with chloroform by any intelligent and properly taught medical practitioner; and there
can be no question that every medical man ought to be able to give a dose of chloroform
with as much precision and certainty as a dose of morphine, or of any other poison. The
practical outcome of the disastrous teaching of the Glasgow Committee, backed up by Professors
Wood and Macwilliam, is that the relief of pain by chloroform is to be handed over to special--
ists, who alone are to administer it, though their own declarations and statistics show that they
cannot give it with safety. Exactly in proportion as this teaching gains ground the bulk of the
profession suffers loss in credit and in pocket, and the advantages chloroform confers are most
seriously restricted and curtailed. There is no more necessity for the anæsthetist, with his inhaler
and other apparatus, than for a hypodermic morphia injectionist, or other poisonist. If the
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