ONT ANAESTHETICS 149 
if properly used, the following being the rules for its safe administration. 
A drachm or two of the liquid having been sprinkled upon the middle of a 
folded towel, hold it near the face, taking care that free space is afforded for 
the access of air beneath its edges, till the eyelids cease to move when the 
conjunctiva is touched with the finger. Meanwhile watch the breathing care- 
fully ; and if at any time it should become obstructed or strongly stertorous, 
suspend the administration and draw the tip of the tongue firmly forwards till 
the tendency to obstruction has disappeared. 
These simple instructions may be acted on without difficulty by any intel- 
ligent medical man. The notion that extensive experience is required for the 
administration of chloroform is quite erroneous, and does great harm by weaken- 
ing the confidence of the profession in this valuable agent, and limiting the 
diffusion of its benefits. 
ParT II. WRITTEN 1870 
The nine years which have passed since the above article was written have 
tended to confirm its main doctrines. 
The safety of chloroform when administered according to the rules laid 
down in the preceding pages has hitherto been verified without exception in 
my own personal experience ; and I may add that Mr. Syme, though he con- 
tinued to within the last two years in the full activity of his career as an operator, 
never lost a patient through its use, either in public or private practice. Further, 
I believe I am correct in stating that no case of death from chloroform has 
occurred during these nine years in the operating theatre of either the Edin- 
burgh or the Glasgow Infirmary, two of the largest surgical hospitals in Great 
Britain. Yet in both these institutions a folded towel on which the anaesthetic 
liquid is poured, unmeasured and unstinted, is still the only apparatus employed 
in the administration ; preliminary examination of the heart is never thought 
of, and during the inhalation the pulse is entirely disregarded; but vigilant 
attention is kept upon the respiration, and, in case of its obstruction, firm traction 
upon the tongue is promptly resorted to. And it is worthy of special notice, 
as showing that success is due to soundness of the principles acted on, rather 
than any particular skill, that the giving of the chloroform, instead of being 
restricted to a medical man appointed for the function, as is elsewhere often 
thought essential, is entrusted to the junior officers of the hospital. In Edin- 
burgh each of the five surgeons has two ‘clerks’, intermediate in position 
between the house surgeon and the dressers. They, besides other duties, take 
it in turn to administer the anaesthetic ; and if I had to be placed under its 
