THE PRICE OF ANAESTHESIA 61.7 



of chloroform. All the same, this loose talk in terms of per- 

 centage is a considerable step in advance of the state of matters 

 a few years ago, when anaesthetists were accustomed to scout 

 the possibility of any sort of measurement, and to judge of the 

 action of chloroform solely by its result upon the patient. 

 Obviously, under such conditions, the only safe anaesthetist was 

 the experienced anaesthetist, the man who had learned to 

 recognise danger as soon as danger became visible. No man 

 can be thus experienced from the outset, some men become 

 thus experienced more rapidly than others, others never 

 become thus experienced. Is it not, therefore, self-evident that 

 in every few thousand administrations there must be cases of 

 serious danger or death, and that in every single administration 

 there must be anxiety or alarm ? And may it not be expected 

 of science, which is measurement, that the heavy price of 

 anaesthesia should be reduced ? I assert again what I have 

 already asserted repeatedly in medical circles — at Montreal 

 before the British Medical Association, at the Society of 

 Anaesthetists in London in 1898, at Johannesburg to the Phy- 

 siological Section of the British Association in 1905, in many 

 communications to the British Medical Journal and Lancet — that 

 the price need not be paid, or, at least, may be greatly reduced, 

 by the application to medical practice of two or three simple 

 lessons of arithmetic learned in the physiological laboratory. 



It was estimated by Snow 1 that 18 minims of chloroform 

 in the blood of a patient will produce anaesthesia, and that 

 double the amount is fatal. 



Grehant estimated that the blood of animals killed by 

 chloroform inhalation contained about 50 milligrammes per 

 100 grammes. 2 This proportion would be about z\ grammes 

 in the blood of an average person. 



Buckmaster and Gardner 3 , by a more precise method, arrived 



at an almost identical result. The amount of chloroform in the 



blood of an animal killed by inhalation of strong vapour was 



from 40 to 60 milligrammes per 100 grammes; that in the blood 



1 Snow, On Chloroform and other Ancesthetics, 1858. 18 minims is approximately 

 1 c.c. of liquid chloroform, or 300 c.c. of chloroform vapour. I gramme of liquid 

 chloroform gives approximately 200 c.c. of vapour. 



2 Grehant et Quinquaud, " Dosage du Chloroforme dans le Sang d'un Animal 

 anesthesie," Comptes Rendus de PAcademie des Sciences, xcvii. 1883, p. 753. 



3 Buckmaster and Gardner, " The Estimation of Chloroform in the Blood of 

 Anaesthetised Animals," Proceedings of the Royal Society, vol. 79, 1907, p. 309. 



