BRITISH MEDICAL ASSOCIATION.

Evening Star, Issue 11673, 4 February 1902, Page 4

BRITISH MEDICAL ASSOCIATION.

NEW ZEALAND BRANCH. The proceedings of the Congress opened this morning at eleven o’clock.

ADirmSTBATXOJr OF CHLOROFOBWL Dr Roberts read a paper upon the ministration of chloroform. While supportmg the administration of chloroform as an anaistnetic, he argued that owing to the number of accidents that occur extreme cauIjou was necessary to ascertain first whether the patient was a suitable subject for chloroform. The administration of the drug was always associated with danger, aud whether tlm patient was suitable or not, the operator s safeguard in all cases was to administer the anaesthetic in as small doses as possible. In his own practice be used chloroform with very great caution, and although he had used it in very many cases he had never met with an accident.

Dr Collins (Christchurch) said his experience. was that the greatest danger in administering chloroform was in the ease of strong young men and robust patients. If such patients were placed in bed for a week they would be in a better condition for taking chloroform.

Dr Mickle said public attention had been aroused to this subject, and it was necessary that tbeir Association should give some deliverance upon it. He agreed with Dr Roberts, after an experience of over thirty years, that slow administrations in small doses, and using no more than was actually necessary for ihe purpose, was the surest safeguard against accident. After frequent use of this anesthetic there was a tendency on the part of practitioners to become careless. and he was satisfied that the accidents that resulted from the use of chloroform were the result of careless administration. He found that an epidermic injection of strychnine was a safeguard in many cases. He was inclined to think that ether was a far safer anaesthetic than chloroform, but with care the latter was a safe anaesthetic. The time might arrive when, as a result of careless use of chloroform, lie public would insist upon ether. Dr Will inclined to the view that many deaths attributed to chloroform were traceable to other causes, and he deprecated toe officious interference of bystanders in cases where cliloroform was administered. Death occurred sometimes as the result of shock from, the operation or from organic trouble quite outside of chloroform, and he thought it was not. fair to place the whole responsibility of accidents upon the anaesthetic employed. Dr Maude preferred a combination of chloroform and ether in his practice, and he tried ns far as possible to drop chloroform and adopt ether. His experience was chat patients required special treatment before the administration of chloroform.

Dr Thomas remarked that this subject had a special interest for him, as only recently in Christchurch a mnnber of letters appeared in the newspapers condemnatory of chloroform. One correspondent went the length of stating that where a medical practitioner administered chloroform and death resulted he was guilty of an act of runnier. The only two an {esthetics they had in the present condition of medical science were chloroform and ether. Out of between 5,000 and 4,000 cases, he only remembered six deaths, three while he was a stndent and three since he bad been in practice. Speaking from his own experience, he had doubts as to whether chloroform or ether were responsible for the most, accidents. His practice when using chloroform was the open-air method. He did *>ot like administering chloroform in dentistry operations, as the patient was not always m a suitable position, owing to the operation to be performed, for the administration of the .anaesthetic. He thought the public should be assured that chloroform, being stronger than ether, was a safer anaesthetic if administered with care. Dr Mullins remarked that the chronic invalid was the best subject for chloroform, and in such cases there was the presence of that philosophic calm so desirable where important operations had to be performed. He recommended administration of morphine in conjunction with chloroform to ensure safety. Dr Cleghom thought a very safe ouhle to the practitioner when administering chloroform was to ascertain the tension of the pulse. There was no drug that reduced the tension of the pulse so well as morphia. He found that patients accustomed to alcohol always took chloroform badly. Dr Brown said the profession cou'o safely follow the conclusions arrived at by Dr Roberts upon this subject. His rule to always have a sense of responsioilily. to administer slowly, and give ne more than was actually necessary was a safe pna to follow. He deprecated the public wilting letters to the' Press condemning the use of chloroform, and attributed this clas? of correspondence to the, intemperate laudation of ether by its votaries, and possibly the injudicious actions of some medical * men were responsible for what appeared. They had listened that day to a paper by a man who knew whnt be was writing about, and he assured them, that there was uo danger where care was exer-* cised. He deprecated smoking for at least twentv-four hours before taking chloroform,'and condemned the hysterical attacks that had been made upon the anaesthetic.

Dr Fulton said it was a common error on the part of the people that persons suffering from heart disease could not with safety undergo chloroforming. He administered it in two such cases himself with good results. Drs Hudson, Boyd, Mason, Henry, and Whitfcon also spoke, after which Dr Roberts replied, and was accorded a hearty vote of thanks for his paper. rsmuENCE op ats-esthetics n* prodpctwo LUNG TROUBLE. At the afternoon assembly Dr Hendry read a paper upon ‘ The Influence of Anesthetics in the Production of hmf Trouble.’