RESEARCHES ON CHLOROFORM ANAESTHESIA 629 



substances as benzyl alcohol or salic3^1ic aldehyde undergo no 

 change within the blood-stream ; but that the substances are 

 easily oxidised to benzoic acid and salic3'lic acid when the 

 blood-flow passes among the cells of the kidney. 



The explanation which is advanced — that anaesthesia is due 

 to the abstraction of oxygen by chloroform — rests on no certain 

 basis, for it is quite easy to anaesthetise a frog when all its 

 blood is replaced by "65 per cent, sodium chloride. Moreover, 

 all animals, including man, who live at varying altitudes from 

 the sea-level to 10,000 ft., are luxuriously supplied with oxygen, 

 so that the amount available far exceeds the need. As will be 

 shown subsequently, the actual amount of chloroform in the 

 blood during anaesthesia is known, and assuming, which is not 

 the case, that it is easily oxidised, the amount of oxygen which 

 might be abstracted in this way would not produce any symptoms 

 at all, except in so far as the oxidation products could exert an 

 effect, and still less possible would it be for a state of anaesthesia 

 to be established by so small a diminution in the oxygen- 

 content of the blood. The destiny of the chloroform in the 

 blood is to be exhaled ; and if any amount of it is oxidised this 

 takes place, not in the blood, but in the tissues of the body. 

 Kast ^ and Zeller,^ also W. H. Thompson,^ have found an excess 

 of chlorides in the urine after chloroform narcosis ; while some 

 observers — Wagener,^ Thiem and Fischer® — state that chloro- 

 form as such can be recognised in the urine. An excess of 

 chlorides is not conclusive evidence that the drug is oxici^sed, 

 for these are increased, but not to the same extent, after 

 anaesthesia by ether. 



Experimental evidence that chloroform may be decomposed 

 within the organism has been furnished by Desgrez and 

 Nicloux,^ who found small quantities of a combustible gas 

 which might be hydrogen methane or carbonic oxide in normal 

 blood. 1000 cc. of this yielded i'2 cc. of a gas which was 

 apparentl}^ carbonic oxide. In the same quantity of blood from 

 animals deeply chloroformed larger amounts were found — in 

 one case 6"9 cc. of carbonic oxide. This increased amount was 



' Zeitschr.f.physiolog. C/ie>nie,\\. iS$7, a.nd/a/iresder. /. T/erc/ie;m'c,xv\u. 1888. 



* Zeitschrift f. physiolog. Cheinie^vm. 1883. 



' Proc. of Physiological Soc, January 21, 1905. 



* Jahresbericht f. Tie7-c/ie?nie, xx-s.. 1900. 



* C/ie7n. Ze7itralblatt^ i. 1890. 



® Arch, de Physiologic, No. 2, 1898. 



