213 



clearly resulting from the inhalation of ether, until the very recent 

 one at Auxerre, apparently resulting in part from convulsions im- 

 properly treated, and in part from a neglect of the indications which 

 the pulse affords. Of this case the details are imperfect. Deaths, 

 like those reported by Nunn and Robb, occurring at an interval of 

 twenty-four hours or more after the operation, may or may not have 

 been accelerated by ether ; which does not prevent, nor is to be con- 

 sidered responsible for, the ordinary collapse resulting in certain 

 states of the system, after certain injuries and certain operations. 

 The strong argument in behalf of ether is, that so few opportunities 

 have occurred in which it could be even suspected of agency in 

 fatal results. 



With chloroform the evidence is a little different. Two some- 

 what remarkable cases of death, occurring during the brief admin- 

 istration of this agent for surgical purposes at once present them- 

 selves. The Cincinnati case and that of Mr. Meggison at Winlaton. 

 In these cases death occurred in about five minutes from the begin- 

 ning of the inhalation. In the Cincinnati case the quantity inhaled 

 must have been considerable, from a saturated sponge in a four inch 

 glass globe; yet in Meggison's case a drachm only was applied upon 

 a handkerchief. It is quite possible that death resulted in the latter 

 case, as Mr. Simpson avers, from asphyxia produced by the admin- 

 istration of brandy and other liquids before the patient was able to 

 swallow. Such error would be easily avoided. Yet these instances 

 suggest a specific cause of danger. This is the sudden impression 

 upon the system of a powerful inebriating agent. Abundant alco- 

 holic stimulus has often produced immediate death; and analogy would 

 suggest that inebriating vapour in the lungs may be the equivalent 

 of similar fluid in the stomach; and that in one or both the cases 

 alluded to, chloroform may have produced a sudden and overwhelm- 

 ing shock upon the system. 



Apart from the somewhat obscure case, before alluded to, there 

 is no authentic evidence that sulphuric ether has been a cause of 

 sudden death; and there is little doubt that this immunity from 

 danger in its use is due in part to the comparatively moderate de- 

 gree of its inebriating property, and in part to its volatility. Chlo- 

 roform is much stronger than ether, while it is less volatile ; so that 

 although the vapour of a few drops may only give rise to moderate 

 symptoms, and then escape by exhalation, that of a large quantity 

 whose volume the lungs might easily contain, might powerfully im- 

 press the system, while the delay of its evaporation would materially 



