612 SCIENCE PROGRESS 



all good faith by reason of a neglect of the most elementary 

 knowledge of the physical and physiological properties of 

 chloroform. 1 



I do not say that such neglect is universal, and that there 

 are not exceptional administrators of experience and natural 

 skill such as to entitle them to be considered " safe," but I do 

 say that the general practice of the overwhelming majority of 

 persons, whether medical or non-medical, who are necessarily 

 called upon to administer chloroform, is dangerous, and must 

 unavoidably kill a certain number of patients and endanger the 

 lives of many more, and produce an incalculable amount of 

 alarm and uncertainty in connection with anaesthesia. 



And I shall hope to show in the course of this article, so 

 as to be understood by any educated person, medical or non- 

 medical, that this heavy price is paid for lack of a little 



1 I do not think it necessary to enter here into any detailed discussion of 

 the value of these statistics. It has been urged in mitigation of the figures that 

 (i) they include many cases in which death has occurred not by, but only after, 

 chloroform ; and that (2) we should take into account the greatly increased number 

 of operations performed under anaesthesia. 



I think that the first error is far outweighed by the opposite error of attributing 

 to other causes deaths that have in reality been due to the anaesthetic. A large 

 proportion of cases of deaths undoubtedly due to chloroform are never published, 

 or are attributed to other causes. How many it is impossible to say. Some years 

 ago, when I went closely into the matter, I found in the case of one hospital, at 

 which two cases had been reported in the year, that nine cases had actually 

 occurred. The late Prof. Julliard, of Geneva, found that twenty cases of death by 

 chloroform had occurred at Geneva, of which three only were reported. And 

 only last January a London coroner, in opening an inquest, stated that "this is 



the thirty-ninth case of the kind from Hospital in the course of six and a 



half years." 



In The British Medical J our rial o>i January 25 (p. 202), a case of death during 

 anaesthesia is reported by an anaesthetist under the title " A Fatal Case of 

 St; tus Lymphaticus " ; and the previous pages of the same issue contain an 

 elaborate argument by another anaesthetist to the effect that death during 

 chloroform anaesthesia is so frequently associated with " status lymphaticus " 

 that it may be asked whether death under chloroform ever occurs apart from 

 that condition. 



Clearly the price of anaesthesia, as indicated in the returns of the Registrar- 

 General, must be below rather than above the mark. With regard to the probable 

 increased number of operations under anaesthetics during the last half-century, no 

 doubt it has had some influence on the increased number of deaths noted for the 

 later than for the earlier years, but it can hardly account for the figures of the 

 last two decades, in which, while the reported deaths have more than doubled — 

 533 and 1,269 — the number of operations can hardly have increased in the same 

 proportion. 



