THE PRICE OF ANESTHESIA 613 



elementary science — not science expressed in Graeco-Latin 

 neologisms, but science of the ABC character, consisting of 

 simple arithmetical measurements, far less complex and learned- 

 sounding than much of the science that is dispensed by board- 

 school teachers and extension lecturers, but for lack of which 

 even a doctor of medicine is not qualified to administer 

 chloroform. 



Let me premise in the first place that it is totally futile 

 in the case of any poison, whether it be called strychnine 

 or alcohol or aconite or morphia or chloroform, to discuss 

 sources of danger, antidotes, diathesis, idiosyncrasy, etc., etc., 

 without knowing how much strychnine or alcohol or chloro- 

 form has been put into the body. It is comparatively easy 

 to learn how much strychnine will kill, rather less easy to 

 know how much alcohol will intoxicate, comparativel}^ difficult 

 to determine how much chloroform will anaesthetise. 



Alcohol is more or less measured out, by glass or bottle, 

 and we know that the subject gets more or less drunk after 

 more or less drink ; knowing this we are justified in observing 

 that subjects differ, and that qualities of liquor vary ; and if 

 necessary we can go on to consider effects of adulterations 

 and effects of idiosyncras}^ But obviously we could do 

 nothing of the sort unless we could measure quantities of 

 poison swallowed. 



But in the case of chloroform, which is administered by 

 inhalation through the lungs, the effects of adulteration and 

 the effects of idiosyncrasy have been discussed in the absence 

 of any approach to such a measurement. The patient has as 

 a rule inhaled an unknown quantity of chloroform. As 

 a rule the administrator has not the slightest idea what 

 the quantity has been, and a fatal accident that has in all 

 probability been caused by overdose is put down to idiosyncrasy 

 of patient or impurity of chloroform. 



Is it not clear that the first necessary step to take, previous 

 to any possible rational discussion of idiosyncrasies and im- 

 purities, is to find means of measuring the quantity of chloro- 

 form absorbed, or at any rate, of measuring the quantity of 

 chloroform in the air inspired ? 



My attention was forcibly directed to this question in 1890, 

 in connection with physiological experiments. Whereas in my 

 previous clinical experience I had had occasion to administer 



