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time, and they will continue so to do as long as chloroform is administered. I have the less
hesitation in quoting these particular cases, for in each of them the anæsthetic was given
without any inhaler, all forms of which the Commission condemns. Referring to the three fatal
cases above mentioned from Snow’s work on Anæsthetics, I find :—
CASE 1.—Hannah G—, aged fifteen, of Winlaton, near Newcastle, operation to be
performed being evulsion of a toe–nail, a similar operation having been performed under
ether a few months previously. On Jan, 28th, 1848, chloroform was administered upon a
handkerchief, a drachm being poured on it, patient being seated in a chair. In half a minute
Dr. Meggison, the administrator, finding no change in the breathing or alteration of the pulse,
tested her sensibility by pinching the cheek, and finding no reflex, told the surgeon he might
commence. Patient moved when the incision was made, and more chloro form was about to be
given, when the following events happened : lips suddenly became blanched, and she spluttered
at the mouth, Cold water was dashed on the face, and the patient laid on the floor.
V e n e s e e – t i o n
i n t h e a r m a n d
i n
t h e j u g u l a r
v e i n
w a s p e r f o r m e d , b u t n o
blood flowed, The entire pro-
ceedings from the commencement of inhalation is said to have been two minutes. From the
lips becoming suddenly blanched in the above case there is every reason to conclude that the
heart was suddenly paralysed. The patient breathed for a little after this, and was able to
swallow, though with difficulty. (Dr. Snow’s remarks.)
CASE 2.—Patrick C—,age not stated. March, 1848. Disease, fistula. Had taken chloro
–
form once previously. Time of inhalation about one minute. Qucantity consumed half a drachm.
Lapse of time till death about one minute. Patient on his side, chloroform was administered on
a handkerchief or towel. Immediately the operation was commenced the patient became pulse
– l e s s , h i s p u l s e p r e v i o u s l y b e i n g f u l l a n d n a t u r a l . He
r e t h e p e r i o do
f i n h a l a t i o n w a s v e r y s h o r t ,
one minute, and the evidence of paralysis of the heart distinct.
CASE 3.—J. V—, aged seventeen. Hôtel D i e u , L y o n s , J a n u a r y , 1 8 4 9 .Amputa
–
tion of finger. Chloroform was dropped upon gauze spread over the face, leaving a free pas
— s a g e f o r
a i r .
A t
t h e
e n d o f f i v e m i n u t e s
p a t i e n t s t i l l f e l t a n d
s p o k e , a t t h e e n d o f s i x m i n u t e s
he became restless and still spoke. One drachm and a half of chloroform had now been
given; pulse regular and good. _He now struggled violently, and within a quarter of a minute
the pulse at the wrist became imperceptible. The gauze was removed, no pulse any where to
be felt, and no cardiac sounds audible, Respiration continued,
and ceased in half a minute.
Means of resuscitation were employed, and respiration reappeared in two minutes’ time, and
then again gradually ceased. The pulse did not return.
And now we come to the practical conclusion which are generally the first read, and
are usually the most interesting parts of the whole paper, no matter on what subject it is
written. It is difficult to see how the Committee arrived at its first practical conclusion as to
the position of the patient on the back being the best. This position is not
so com fortable to
the patient as when l yi ng on hi s si de; any of t he anæst het i c fl ui d acci dent al l y spi l t fal l s on hi s
face instead of on the pillow, and, in fat people especially, the diaphragm does not descend so
well owing to the weight of the fat on the abdomen pressing on it, Again, in this position the