Administration of Chloroform.

Marlborough Express, Volume XXXVI, Issue 39, 15 February 1902, Page 6 (Supplement)

Administration of Chloroform.

DISCUSSION AT THE MEDICAL

CONGRESS.

During a discussion on Dr Roberta's paper oh the administration of chloroform, at the Dnnedin Medical Congres?, Dr Collins (Wellington) said his experience was that the greatest danger in administering chloroform

was in the case of strong young men and robust patients. If such patients wera placed in bed for a week they would b3 in a better condition for taking eloroforrn. Dr Mickle agreed with Dr Roberts, after an experience of over thirty years, that slow administrations in soiall doses and using no more than was actually necessary for tbe purpose, was the surest safeguard against accident. After frequent use of this anaesthetic there was a tendency on the part of practitioners to become careless, and he was satisfied that accidents that resulted from the use of chloroform were the result of careless administration. He found that an epidemic injection of strychnine was a safeguard in many cises. Dr Will was inclined to the view that many deaths attributed to chloroform were traceable to otht^r causes, and he deprecated the offici ous interference of by standt rs ia cases where chloroform was admin is tered. Death occurred sometimes as a result of a shock from 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 Maud preferred the combination of chloroform and ether in bis practice, and he tried as far as possible to drop chloroform and adopt ether.

Dr. Thomas remarked that this subject had a special interest for him, as only recently in Chri3tchurch a number of letters appeared in the newspapers condemnatory of chloroform. One correspondent went the length af stating that where a medical practitioner administered chloroform and death resulted, he was guilty of an act of murder. The only two anesthetics they had in thy present condition of medical science was chloroform and ether. Out of between 3000 and 4000 cas s, he only remembered six deaths — three while he was student, and three since he had been in practice. Speaking from his own experience, he had doubts as to whether chloroform or ether were responsible for most accidents His practice, when using chloroform, was the open air method. He did not like administering chloro form in dentistry operations. A patient was not always in a suitable position owing to the operation to be performed for administration of an anaesthetic. He thought that the public should be assured tbat chloroform being stronger than ether was a safer anresthetic, if administerd with care.

Dr. Mullins remarked that a chronic invalid was the best subject for chloroform, and in such cases there was the presence of tbat philo3ophio calm so desirable where important operations had to be performed. He recommended the administration of morphine in conjunction with chloroform to ensure safety.

Dr. Cleghorn thought a very safe guide to a 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.

Dr. Brown said his rule was to always have a sense of responsibility. To administer slowly, and give no more than was actually necessary was a safe one to follow. He deprecated the public writing letters to the press condemning the use of chloroform, and attributed this class of corres ppndenee to the intemperate laudation of fth^r by its votaries, and pos sibly the injudicious actions of some ra fiical men were responsible for what appeared. He deprecated smoking for at J.enst twenty-four hours before taking1 chloroform, and condemned the hysterical attacks that had been made upon the anassthetic.

Dr. Fulton said it was a common error on the part of the people that persons suffering from he rt disease could not with safety undergo cbloro form. He administered it in two cases himself with good results.