Weekly national intelligencer. [volume] (Washington [D.C.]) 1841-1869, 1852-12-04
IMPORTANT MEDICAL SUGGESTIONS.
yRox run BosroS YRAvgLLER.

FROM THE BOSTON TRAVELLER
REMARKS BY Dr. j. C. WARREN to the Medical
Glass and Other Gentlemen on Me Death BY Chorcorm,
Accdentaly Administered the Massachusetts, General
Hospital, November D, 1852.
The in this hospital few days since of two
unfortunate cases. of which proved fatal renders 1t
desirable that an explanation should be made Of their
course and cause shall attempt this explanation the
more readily will afford great practical lesson which
you may again have opportunity Of witnessing
The hospital was founded about thirty years since.
The most distinguished Of community, the
Lowes Bowditches Quincys, Sullivans, Appetons and
others among those who devoted their time, talents
and property 10 the erection Of the institution and who
have continued to support it by their paternal
These pledge to the community that it has
been conducted with all the wisdom human ingenuity
could furnish.
Among the regulations which they have thought judi
cous for annual election of the medical officers
This regulation does not involve the necessity Of removal
of all these officers they changed only when 1t is
thought necessary expedient and this necessity does
exist frequently regard to the house surgeons pupils
and the apohecary When it takes place in the latter
office considerable time is required for the new ncum-
bent acquaint himself with the and practices
Of the institution and it is obvious that such change,
involving immense number OF details, cannot occur
without oversights and mistakes. No mistakes,
previous those connected with the late accidents
number Of operations to be performed and the
patients to be etherzed For this eherzaton chlorc
suphuric ether is usually employed. Chloroform, the
popular ayore used in this institution, except
external application; but this occasion it was
introduced from the fact that it had been poured into
bottle labelled with the title Concentrated Chloric
Ether This bottle then marked concentrated chlorc
ether, placed the table and employed for these
operations without suspicion part that ii not
the article designated by the label It's snrans The
escaped the observation Of those who administered
from the fact that there is resemblance in the sensible
qualities of the two articles SO that three persons
etherzed with chloroform instead Of chloric ether.
Many Of you will Immediately inquire why we object to
the use OF substance employed by men Of science and
men without science, all the world the article
best adapted to produce ansethesa, insensibiy
pain The ground of objection the use of choro-
form is its tendency to produce dangerous consequences
in certain number of cases. The published fatal
Of choroorm known be less than thirty and
it is well understood that many have the pub
lie eye The appearance of fatal in 1S48 led
publish my remarks the Effects of Choroform and
Strong Chlorc Ether as Narcotic Agents Besides the
Boston edition OF these remarks editions published
in the Medical Journals of Philadelphia and of London
and by these various publications the dangers of chloro
form were made sufficiently known. Most, if ALL my
colleague surgeons in the hospital influenced by the
considerations which had guided me- CONQUERED disap
proving its In the mean time sulphuric ether in
the enthusiasm for choroorm had been almost forgotten
and the question whether should return it.
The objections to its were its pungent odor its sti
mulating power its extensive diusibty the subsequent
dead smell and finally its great disposition to produce
nausea and headache in those exposed its influence.
At that period many physicians engaged in search
ing out new an@sthetcs and some of thought might
be useful TO unite in this investigation An article used
In medicine for a number of years back and also
favorte drink the chorc ether of commerce. attracted
our attention We made trial of it. and found posses
sed no anasthetic properties Having witnessed in the
dstaton Of chloride Of lime and alcohol the production
nuth Of ha,p
much more powerful than the rest consulted an able
chemist and found that by Redistribution Of part of it
with the addition Of two parts of alcohol there was form
ed beautiful chorc ether which we hoped might be
safe, efectua and agreeable. We therefore made eau
uous trial of its effects patient in the hospital whose
irritabiy was such aso prevent investigation Of his
disease the ether having been administered the exami
nation Immediately effected with perfect ease and
Proceeding with great care we gradually ex-
tended its use to all where chloroform had been
employed, and found it agreeable safe and efectua
Soon after, the having been introduced at the
meeting of the American Medical Association in Balt-
more, was called say what knew Of its effects
and the remarks then made being favorably received
published account Of in connexion with the work al
ready already alluded to, recommending substitute
for chloroform.
Objections taken to this substance on account of
its alliance TO chloroorm and articles were written to
show that il could not be used with safety but did not
think myself justified in abandoning its use Perhaps it
will be thought ought 10 have replied these objections
but having already employed much time and labor in
the Investigations relating this ether and having fairly
placed in the hands Of the public could consider
1t duty to 60 into controversy for its support Since
then have given il in great number Of cases. and no
fatal occurrence has followed the administrations
During the past summer two three deaths are said
to have occurred from the Of the ncure Of choro
FORM under the Of choric ether article different
from the true choric ether pointed out in te proceed
ing papers IL consists Of mixture Of alcohol and chic
roform in the proportion Of two one without dista-
ton The mixture was adopted doubt more eco
nomical than the distilled compound chorc ethera fact
which accounts for its introduction and substitution for
the other but lhaye never used it Intentionally except
for the purpose Of experiment and by the aid Of Dr.
Hayes have obtained pure distilled compound chloric
ether as mentioned above From this article far as
know, no fatal cases have ever occurred#
This ether Is used in this city, in Salem in New York
the South and West and is considered beautiful and
valuable article. Families who have employed il here
have sent from Europe to obtain IL Cbloroform. as
already stated Notwithstanding the mortality which has
followed its USE is more extensively employed all over
world than other article and this happens because
it is speedy its effects than any thing else Sui
phurc ether although there been scarcely an or very
few authentic accounts Of its fatal effects wide British
and Foreign MedcoC hirurgical Rev.. jan 1852 is not
known to be employed to any great in other places
than Boston
shall proceed to give account Of three cases
in which choroform accidentally administered in
this hospital last Saturday In my account shall en-
deayor TO avoid the use of names, delicate and
proper but would say that all who aided me on this
occasion performed their duties with activity and with
credit
Three cases presented themselves for operation The
first contracted hand The patient was etherzed
with the supposed chorc ether In OF three min
utes anmthesa being produced the operation was per-
formed under the continued administration Of the same
article during from FIVE to ten minutes The patient
Iu.l IL