CHLOROFORM IN USE 



By N. H. ALCOCK, M.D. 



Lecturer in Physiology to the St. Mary's Hospital Medical School 



PAGE 



Introduction 558 



Apparatus 559 



The Chloroform Curve 563 



Four-fifths of Mankind 565 



The Exceptions 568 



Conclusions 571 



Introduction 



Exactly twelve months ago two important papers appeared in 

 this journal. In the first, Waller (6 a) pointed out the much 

 greater safety of anaesthesia when the percentage of CHCI3 in 

 the inspired air was known, and the need for the adoption of 

 some such system in the case of the human subject. In the 

 second, Buckmaster (8 a) gave a resume of the recent physio- 

 logical work on the action of chloroform in the body and the 

 amount actually present in the blood in different stages of 

 anaesthesia. It was plain that the time had come to apply 

 the knowledge so acquired to the more difficult problem of 

 anaesthesia in man. It is by no means the first time that this 

 problem has been attacked. To mention only the more pro- 

 minent names, Snow (1), Cushny (2), Dubois (3), Vernon- 

 Harcourt (4), Levy (5), Waller (6a, b), Roth, Hagen (13), and 

 Kionka and Kronig (7 b) have all made observations on the 

 percentage necessary for anaesthesia in the human subject, 

 using apparatus giving a measured amount of the anaesthetic ; 

 and Victor Horsley (9) has published a curve, constructed on 

 lines similar to those considered later, showing the percentages 

 used in operations on the central nervous system. But if we 

 bear in mind the recent advances in our knowledge of the 

 subject, particularly the rapid and accurate methods introduced 

 by Waller (b, c) for the estimation of chloroform vapour in air, 

 it can easily be seen that the conditions at the present time 

 are much more favourable for the construction and employ- 



558 



