igoo-i.] Observations on Blood Pressure. 219 



short time by respiration alone. Thus, whether one believe that chloro- 

 form kills by respiratory paralysis or by heart failure, or by vaso-motor 

 paralysis, artificial respiration should be resorted to at once, and should 

 rank, in my opinion, above all other remedies which may afterwards or 

 along with it be attempted. 



Fourth, forcible pulling out of the tongue, the placing of the finger 

 in the rima glottidis, and the performance of tracheotomy all seem to 

 stimulate respiration. 



Fifth, the horizontal position is advisable when chloroform is being 

 administered, not because respiratory failure is less likely to occur in 

 that position, but because the risk of syncope is thus greatly lessened. 

 Syncope is in my opinion the cause of death in most cases reported, and 

 in many at least is not due to chloroform poisoning at all, but to the 

 shock of pain or emotion before the patient is fully under or when he is 

 coming out. 



The actions of three drugs were investigated in regard to choroform 

 poisoning. These were. Nitrite of Amyl, Hydrocyanic Acid, and 

 Atropine. 



Nitrite of Aniyl. — This drug was given in several cases where the 

 respiration had ceased as a result of chloroform poisoning, but no 

 beneficial results were obtained. In each case one or more capsules 

 containing the drug were crushed in the fauces while artificial respiration 

 was being maintained. 



Hydrocyanic Acid. — On the first of January, 1898, an article 

 appeared in the Lancet by Professor Hobday, of the Royal Veterinary 

 College of London. In it he suggested the use of hydrocyanic acid as 

 an antidote in cases of chloroform poisoning. The dose recommended 

 was I minim of Scheele's acid by the mouth for every seven or eight 

 pounds of body weight. He stated that he had found it invariably 

 useful in animals in which, as a sequence to chloroform poisoning, the 

 respiration had stopped. He had already published^ a list of forty-three 

 observations on various animals, including dogs, cats, horses, sheep and 

 calves, showing the results obtained by this method of resuscitation. In 

 the last paper he refers to a series of fifteen additional consecutive 

 cases in which H.C.N, had been successfully used in dogs after the 

 respiration had actually ceased. Dr. A. Wilson, of Manchester, in the 

 next number of the Lancet'^ opposed this view very strongly, arguing 

 on theoretical grounds that as H.C.N, is the most powerful of all respira- 



1 Journal of Comparative Pathology and Therapeutics, June 1896. 



2 Lancet, Jan 8th, 1898. 



