On the discussion respecting chloroform, in the Académie de Médecine of Paris ... / [John Snow].

  • Snow, John, 1813-1858
Date:
[1849]
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Licence: Public Domain Mark

Credit: On the discussion respecting chloroform, in the Académie de Médecine of Paris ... / [John Snow]. Source: Wellcome Collection.

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    i V. a 2 tHE DISCUSSION RESPECTING CHLOROFORM. than one-sixth part of the air was displaced by the vapour diffused through the remainder. The vapour of chloroform never acts, as sup¬ posed by the Commission, by excluding the air, and so producing as¬ phyxia. This is physically impossible. The same quantity of vapour of ether in the air causes a much slighter effect; and, of some vapours, a scarcely appreciable influence, even when the air is quite saturated with them. Chloroform acts by its narcotic properties alone; and when inhaled of the strength employed in the above experiments, it paralyzes the action of the heart at the same time as the respiratory movements. In two experiments of this nature previously related,’ I found the blood in the lungs still florid, immediately after death. In the case at Boulogne, artificial respiration was performed for up¬ wards of an hour after death, and with force enough to cause perma¬ nent dilatation of the air cells. At the subsequent inspection of the body, air was found in the pulmonary veins, in the heart, in the right carotid artery, and in the veins generally; a little frothy blood being found at the orifice of the vena cava. The conclusion of the report which has been adapted by the Academy, is, that death was probably caused by this mixture of gas with the blood. The report does just notice the idea that the air might have entered during the artificial respiration, but adds that this would not explain the cause of death, having prejudged, that it was not the narcotic action of the chloroform ; and goes on to state that the froth at the orifice of the vena cava proves that the air entered during life, entirely overlooking the fact (and I do not see it alluded to by any of the speakers), that the froth would be produced by the churning of the blood backwards and forwards in the large vessels, during the artificial respiration which had introduced the air. The Commission suppose that the air or gas was suddenly deve¬ loped in the vessels by some unknown cause, and curiously the speakers who oppose their conclusion, admit this sudden evolution of gas, but attribute it to the chloroform—to a peculiar action of ether on the blood. This is the weak point in their argument, for M. Malgaigne justly replies that this is only hypothesis. One fact of importance has been brought to light by this inquiry. In the report previously published, it was stated that not more than from fifteen to twenty drops of chloroform had been employed; but by a judicial examination of what was left in the bottle, it was found that from five to eight grammes had been used—from 77 to 123 grains, or from one to two tea-spoonfuls, a quantity amply sufficient to cause death. After thus treating the special case submitted to them, it is not sur- 1 Medical Gazette, October 13,1848.