54 ANESTHESIA BY CHLORAL. 



solution obtain 'entrance to the perivenous tissue, grave results 

 almost always follow. The majority of those who have tried 

 this method have had at least some cases of phlebitis, and, in 

 consequence, have abandoned it. Phlebitis usually appears between 

 the second and fourth days : a swelling, sometimes circumscribed, 

 sometimes diffused, occurs in the jugular furrow. {Suppuration 

 follows ; frequently a portion of tissue becomes necrotic. In one 

 case mentioned by Cadiot the vein was destroyed throughout almost 

 the entire length of the neck. Furthermore, chloral acts as a vaso- 

 dilator, increasing haemorrhage during operation. Finally, although 

 it has been little used, chloral is responsible for a considerable number 

 of deaths. Moller killed a number of horses by injecting twelve 

 and a half drachms in solution. As the horses were not weighed, 

 it might be said that this dose was too large, but Cadiot has had a 

 death with the prescribed dose, where the quantity administered 

 did not exceed one and a half drachms per hundred pounds of body- 

 weight. Fifteen to twenty minutes after administration, when the 

 operation Mas almost complete, respiration ceased, and a few seconds 

 later death resulted, despite efforts made to establish artificial 

 respiration. 



Intra-peritoneal injections of chloral are made through the flank. 

 A ten per cent, solution in physiological saline is used. The operation 

 is without danger, and is simpler and more convenient than intra- 

 venous injection. Anesthesia is produced in ten to fifteen mmutes 

 and lasts a long time. Recovery can be hastened by a subcutaneous 

 injection of pilocarpine. 



Administered by the mouth in doses of ten to twenty drachms 

 diluted solutions of chloral produce drowsiness, loss of co-ordination 

 of movement, but not complete anaesthesia. The method, however, 

 is of value in practice. 



Chloral and Morphine. To avoid the accidents resulting from 

 intra- venous injection of chloral Cadeac and Malet associated chloral 

 with morphine. They claim to produce complete anaesthesia by 

 subcutaneously injecting a solution of fifteen grams of hydrochloride 

 of morphine, and at the end of ten minutes giving an enema 

 containing twenty to twenty-five drachms of chloral. 



Anaesthesia is not always produced. It appears slowly, and 

 sometimes only after prolonged excitement. Esser recommends 

 this method where chloroform is contra-indicated. 



Morphine, in the form of subcutaneous injection, has been recom- 

 mended to quiet small animals, and in the horse to produce slight 

 anaesthesia for trifling operations in the standing position. According 



