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remain ignorant of all others. The open method, or that of Syme and Simpson, is so well
and fully set forth in Sir Joseph Lister's article in "Holmes's System of Surgery," written
in 1861, that it appeared to me to be superfluous to describe it in the columns of a journal
like The Lancet; but since Surgeon-Major Lawrie has received numerous letters from
Europe concerning it, and has gone to the pains of describing it, I suppose I am wrong in
supposing that the ABC of the chloroformist's duties are pretty generally understood.
With regard to the second method to which I alluded, that in which Junker's inhaler
is employed, I must say that your correspondent is clearly wholly unaequainted with the
method, or he would not have permitted himself to indulge in such playful criticism. His
humour loses none of its point when read by a person who is familiar with Junker's apparatus.
I may just say that, with average intelligence and common-sense, the inhaler can be used
without necessitating Surgeon-Major Lawrie's suggestion being carried into effect, and the
patient compelled "to do it himself." Further, the argument which he addnees, viz., that
b e - c a u s e I h a d s e e n v a r i o u s d e g r e e s o f h e a r t f a i l u r e a n d c i r c u l a t o r y t r o u b l e , t h e r e f o r e m y m e t h o d s
are erroneous, is an instance of what logicians call a petitio principü, and proves too much. In
the first place, the open method, to which my remarks mainly referred, is precisely the method
which the Hyderabad Commission, following Syme, advocates. I as well as many others in
Europe, learnt the method before the session of the Commission. That Surgeon-Major Lawrie
has never seen the heart fail and that I have is not surprising, because he has never felt
the pulse or examined the action of the heart during chloroformisation, and I have. That
Surgeon-Major Lawrie has had many cases I do not for a moment doubt, only he has over
-looked them, and as, fortunately, in most cases respiratory rhythm is affected pari passu with
cardiac enfeeblement, he has seen the danger-signal quâ the respiration, and has taken mea
-sures accordingly.
I am further stated to give no fixed principle of chloroform administration, and in my
paper, to which reference has been made, I admit such is the case, and for the reason above
stated, that my object was argumentative rather than didaetic. In my lectures and practical
demonstrations I believe I am dogmatic enough, but personally I regard dogmatism in dis-
cussion upon scientific subjects in a scientific periodical as unseemly and valueless. In con-
clusion, may I draw attention to a sentence against which I am bound to enter a protest
? I t r u n s : " T h e H H y d e r a b a d C o m m i s s i o n h a s p r o v e d t h a t t h e r e i s n o s u c h t h i n g a s c h l o r o f o r m
syncope, and that in death from an overdose of chloroform the respiration always fails before
the circulation." I submit the Hyderabad Commission has done nothing of the kind; its
conclusions were based upon purely negative evidence, and were not warranted by the facts
before the profession, and I am strongly of opinion that any teaching which tells chloroformists
to ignore the pulse is fraught with danger. I am greatly obliged to Surgeon-Major Lawrie
for his courteous reference to myself, and can assure him that I constantly employ the open
method and obey the rules he, following Syme, advocates; but I also watch the pulse.
I am, Sirs, your obedient servant,
DUDLEY W. BUXTON.
Mortimer-street, Cavendish-square,
W.
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