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These views of the action of chloroform were confirmed by the Commission of the Medico--
Chirurgical Society, London, in 1864, and again in 1879 by a committee of the British Medical
Association, in their report on the action of anæsthetics (British Medical Journal, 1879, Vol. I.,
pp. 1 and 921), stated that "chloroform has sometimes an unexpected and apparently capri--
cious effect on the heart's action. Chloroform may cause death in dogs by primarily paralysing
either the heart or the respiration. The variations in this respect seem to depend to some
extent on individual peculiarities of the animals (?) In most cases respiration stops before the
heart's action, but there was one instance in which respiration continued when the heart had
stopped, and only failed a considerable number of seconds after the heart had resumed."
The whole work of the committee tended to prove the conclusions arrived at by Dr.
Snow, that under certain conditions chloroform did affect the heart before the respiration,
though failure of the respiration was the most common cause of death.
The Hyderabad Chloroform Commission have come to a conclusion similar to that arrived
a t by Mr . Wa kl e y i n 1818, a nd t he Co mmi s s i o no f t h e S o c i e t y o f E m u l a t i o n o f P a r i s , i n 1 8 5 2 ,
viz., in death from chloroform the heart continues to beat after the respiration has ceased,
results in contradiction to the previous London Commission of 1864, and the Glasgow Com--
mission of 1874.
There may he several objections taken to the unreserved application of the conclusions
of these experiments to man.
First, there is the difference which may exist in the action of chloroform on the heart
of man and of animals. There is the possibility that the habits of life, the taking of stimulants
and narcotics, especially the habitual use of drugs like tobacco—for the condition of the vagus
centre is shown to be of great importance in relation to chloroform narcosis—may have some
effect, if not altering the behaviour of the heart muscle or its innervation, at least in modify--
ing that chain of events upon which depends the absorption and distribution of the chloro--
form by the blood. Amongst other points of difference between man and the animals experi-
-mented on are the relation of the vital capacity to the size of the animal, and the interference
wi t h c o mp l e t e f i l l i n g o f i t s l u n g s , r e s u l t i n g f r o m h o l d i n g o f t h e a n i ma l
It has often been shown that the suddenly fatal cases are rare in human subjects
which there is any impediment to the free expansion of the chest, e.g., Clover has pointed out
that a phthisical patient is less likely to take a fatal dose of chloroform than one With
healthy lungs, because his chloroform-absorbing capacity is diminished. Again, it has been
noted that few patients die suddenly from chloroform, when it is inhaled lying on the side; also
few, if any, sudden deaths are reported in case of ovarian tumours. The explanation of these
cases is that the interference with full expansion of the lungs by the position or the presence
of the tumour prevents the lungs taking in the necessary fatal dose.
On the other hand, the greater number of the suddenly fatal cases occur in people with
healthy chests and large vital capacity, e.g., in reducing dislocations of the shoulder, and in