279
every 1,236 cases of chloroform administration at St. Bartholomew's and the other large
London hospitals where the pulse is taken as a guide. Then we have Professor Wood's state-
ment that "carnage" still goes on when chloroform is given in accordance with his own
principles; and now we have Dr. James Dunlop asserting that the pulse must be attended to
as well as the heart, and boasting that only three cases are killed by chloroform in Glasgow
alone every year.* Why are we to continue to study only the experience of those surgeons
who cannot give chloroform safely? Why does not The Lancet ask the men who do not have
deaths to give us their experience for a change? It is imperative that, in addition to clinical
experience of the latter variety. The Lancet should call for the opinion of the whole profession
on the anæsthesia controversy. The report of the Hyderabad Commission was published in
the leading medical journal last January, and many letters and criticisms on it have appeared
since. A careful study of The Lancet for 1890 will enable every general practitioner in
Great Britain to form an impartial opinion as to the merits of the case. The votes of the
majority will then decide whether the teaching of the Hyderabad Commission or that of Pro-
fessor Wood is thought to be more likely to conduce to the interests of the profession and the
public; and I have no fear what, the verdict will be.
Finally, Dr. Du n l o p s t a t e s t h a t " e v e r y i n t e l l i g e n t a s s i s t a n t I h a v e h a dd
u r i n g t h el
a s t
ten years has felt happier during an operation when ether was used than when chloroform was
administered." This is not at all surprising. No assistant can give chloroform happily or
safely if he is always in dread that his patient may die suddenly. As long as the belief
prevails that one of the dangers of chloroform is sudden death by stoppage of the heart, and
the chl oroformi st wat ches t he pul se for si gns of heart fai l ure, deat hs wi l l occur. It i s
h i g h
time this reproach to our profession and opprobrium of modern surgery should be put an end
to: and if surgeons will not put an end to it themselves,t h e a d m i n i s t r a t i o n o f c h l o r o f o r m
should be prohibited by law until the teaching with regard to chloroform syncope is altered and
brought into conformity with the conclusions of the Hyderabad Commission.
LETTER FROM SURGEON-MAJOR P. R. GABBETT.
To THE EDITORS OF "THE LANCET".
SIRS,—Having noticed in your columns several letters and adresses on the administra--
tion and effects of chloroform, and the diversity of opinion that appears to exist on this import--
a nt que s t i on. I s houl d l i ke t o r e c or d wha t I ha ve mys e l f wi t ne s s e d dur i ng t he pa s t e i ght e e n
months. By the kind permission of Surgeon-Major Lawrie, the Principal of the Hyderabad
Medical school. Ih a v e b e e n
p r e s e n t a t
n u m e r o u s a n dsevere operations performed by tha
t s u r g e o n a t t h e A f z u l G u n j H o s p i t a l : a n d d u r i n g t h i sp
e r i o d I h a v e n e v e r s e e n t h e s l i g h t e s t
ill-effects result from the administration of chloroform, though sometimes in abdominal operations
the patient has been kept under the influence of the anæsthetic for from an hour and
a-half to two hours. It has always been give n b y o n e
o f t h e n at
i v e s t u d e n t s o f t h e s c h o o l ,
either male or female, apparently with the greatest confidence and case on their part, following
* It is fair to Dr. Dunlop to state that he is the apologist of others, and that in some of the deaths under chloroform
which he reports the respiration is believed to have been watched, and not the pulse. It is evident, however, that it is no
good to watch the respiration in chloroform administration if disaster is deliberately courted by the adoption of a plan so
fraught with danger as making the patient count.