150 ON ANAESTHETICS 
influence I would rather trust myself to one of these young gentlemen than to 
the great majority of ‘ qualified practitioners ’. 
The appointment of a special chloroform-giver to a hospital is not only 
entirely unnecessary, but has the great disadvantage of investing the adminis- 
tration of chloroform with an air of needless mystery, and withholding from 
the students the opportunity of being trained in an important duty, which any 
one of them may be at once called upon to discharge on commencing practice, 
and which, though certainly simple, is better performed after some practical 
initiation. I well remember the anxiety I felt on entering upon office as Mr. 
Syme’s house surgeon, though I had before held a similar position in London, 
lest his first fatal case should occur in my hands; but this feeling soon gave 
place to perfect confidence, more especially after I had seen symptoms, which 
would before have alarmed me, dispelled at once by traction on the tongue, 
which was then a novelty to me, and which is, I fear, even yet not duly appre- 
ciated by the profession generally. 
An incident which occurred during my Glasgow incumbency illustrates so 
strikingly both the value of drawing forward the tongue, and the relations of 
the circulation and the respiration to chloroform, that 1t seems right to place 
it on record. One of my colleagues in the Infirmary had been making an 
attempt to reduce a dislocation by means of the pulleys, chloroform having 
been given very fully by the house surgeon, who, at the close of the perfor- 
mance, removed the cloth from the patient’s face, and proceeded to attend to 
other matters. Happening to be present, and observing that the respiration 
was deeply stertorous, I watched it carefully, and noticed that it passed almost 
immediately into the state of complete obstruction, though still accompanied 
by the movements of the thorax, the face meanwhile becoming markedly livid. 
Unwilling to interfere, and seeing the carotid pulsation conspicuous in the neck, 
I waited awhile, hoping that the obstacle to the breathing would disappear 
spontaneously. But instead of this I soon saw to my horror the lividity give 
place to what I knew was physiologically identical with post mortem pallor. 
I now rushed forward and drew the tongue out firmly with the artery forceps ; 
air at once passed into the chest, and the man was rescued. 
This case seems to me fraught with the deepest instruction. 
There can be no doubt that the patient was on the very verge of death ; 
that if the laryngeal obstruction had lasted a very short time longer, the respira- 
tory and cardiac ganglia would have failed in their functions. Supposing the 
administrator to have continued the chloroform with his attention devoted to 
the circulation, the first thing that would have alarmed him would have been 
the failure of the pulse at the wrist. On removing the cloth from the face, 
he would have seen the deadly pallor, and, ignorant of the asphyxial lividity 
which had preceded, he would have taken it as positive evidence of primary 
