CHLOROFORM A POISON 



By B. J. COLLINGWOOD, M.D. (Cantab.) 



Demonstrator of Physiology, St. Mary s Hospital Medical School 



Chloroform has been rightly regarded as the most dangerous 

 of anaesthetics, for it undoubtedly has been accompanied by a 

 greater number of fatalities than any other narcotic. Neverthe- 

 less, the light which has recently been thrown on the causes of 

 its danger has done much to render it possible to reduce its 

 risks to a minimum. The growth of knowledge has been at once 

 followed by increased safety in administration. It is of the very 

 nature of anaesthetics that they should be poisons, for their name 

 implies the power to abrogate one of the functions of the central 

 nervous system — namely, the function of sensation. They are 

 thus in their very essence toxic to the nervous system ; it is only 

 in a secondary sense that they are poisons of other systems, 

 such as the respiratory or vascular. It is because of its 

 extremely potent influence on these latter two systems that 

 chloroform is the most poisonous of these drugs. 



To administer a poison in unknown doses is to court disaster, 

 with every chance of attaining it ; and to judge of the amount 

 administered solely by its effects must ultimately lead to an 

 unjustifiable study of the phenomenon of death. The skilled 

 anaesthetist who is acquainted with the earliest signs of an 

 overdose of chloroform may legitimately use a rough method 

 of administration ; but the drug is frequently given in a similar 

 manner by those who make no claim to be regarded as specialists 

 in anaesthetics. It is therefore no matter for wonder that the 

 number of deaths from chloroform is at a high level. To drop 

 chloroform on a Skinner's mask may be the most convenient and 

 the safest method for the specialist, but one can only protest 

 against such a procedure when employed by unskilled hands. 



Much has recently been said in favour of some mechanical 

 device for supplying graduated percentages of chloroform and 

 air ; and it appears to the writer that an apparatus of such a 

 nature, if in truth reliable as to its accuracy, would do more 



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