The Wanganui Chronicle "NULLA DIES SINE LINEA." FRIDAY, OCTOBER 3, 1902. THE CAUSE OF DEATH UNDER CHLOROFORM.

Wanganui Chronicle, Volume XXXXVII, Issue 11754, 3 October 1902, Page 4

The Wanganui Chronicle "NULLA DIES SINE LINEA." FRIDAY, OCTOBER 3, 1902. THE CAUSE OF DEATH UNDER CHLOROFORM.

Every now and then the community receives a shock by a run of accidental deaths under ohlciroform, and gets some conception of the tension of responsibility under which the medical profession uses this blessing in the interests of suffering humanity. A knowledge of the cause of these accidents is thus a. matter of prime practical and theoretical importance to medical men and to the public. Much good experimental work has been carried out to discover this cause, but the people of Melbourne have just learned the gratifying intelligence that what is regarded by those qualified to judge; asi by far the most mastexiy single x>iece of work on this important subject has heeni carried out :n Melbourne by Dr. E. H. -Embley, an honorary anaesthetist at the Melbourne Hospital. To turn from the account, of Dr. 'Embley's experiments in the "British Medical Journal" to that of the trial by which Dr. James Simpson, of Edinburgh, 54 years ago established the anaesthetic properties of chloroform is to get a vivid impression of the distance medicine has travelled towards becoming an exact science during th© last half century. Simpson and some medical friends sat round a table inhaling the vapour, which at first made them exceedingly jolly. According to Simpsons subsequenti account of his. sensations, he suddenly began to hear a portentous noise, and then with a crash became unconscious. His first sensation on coming to himself was that the new drug w.a#i far better and stronger than ■ether, but when foe (looked around he sa.w his friend, Dr. Duncan, under a chair with his jaw dropped, his eyes staring, his head half beat under him, quite uncowsoious, a>nd snoring horribly. Another friend', Dr. Keith, was stretched on the floor engaged in an unconscious attempt to kick the mppev table to pieces. Such was the initiation) of chloroform into its mi-salon of beneficence. For many years medical opinion has been divided into two camps on the cause of death in chloroform accidents, the one claiming to find it'in the stoppage of breathing, and the other in the arrest of the heart's action. A commission of Indian medical experts declared definitely that paralysis of. the breathing is the main source of danger with chloroform. On the other hand, a prominent French investigator declares that death under chloroform never occurs

by failure of respiration. Dr. Embley, by a thorough analysis of the complicated mechanism of the dhjloroform sleep by meana of hie hunidiieds of experiments on dogs ia able to show how the conflicting conclusions of his predecessors *^ can be traced td their only investigating part® of the whole subject. For example, lie finds that a dag in the later stages of the chloroform sleeU; is quite a different animal from what he is in the earlier, because the earlier stages have exhausted an im-, portant ixirt of his nervous excitability. This has a valuable practical bearing on the strange fact that most of the really tragic deaths through chloroform' occur in the eairSy stage, often before the operation for which it was given has commenced. It is said, too, that accidental deaths under chloroform occur more frequently in cases of ligiht chloroforming for minor operations than in the heavy anaesthetising for serious ones. For the present, Dr. Embley urges on medical men the one practical moral of his experiments, that only weak vapour of oliloa-oform should be used is the early stages, so as to give the nerves time to quieten down gradually to their safer second1 state. It may be a littile more tedious and! unpleasant to the patient. to be cli/'orofomned slowly, but it is less risky. Dr. Ermbley thus seems to endorse the old recommendations of Drsi. Siimipson and Syme, that chloroform should always be given with plenty of air; but his exact experimental methods give him this advantage, that he recommends this for the early stages and allows the strength to be increased later on if need be. In the published account of his experiments, which were earned out in the physiological laboratory of the University of Melbourne, Dr. Embley pays' tribute to the generous way in. wlrich Professor Martin has forwardied the investigation by the aid of his. experimental skill and resource. It should be remembered that only high (scientific devotion could enable a practitioner to spend lids leisure in prosecuting so extensive and difficult a research as this otf Dr. Embley. ,