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CHAPTER XL 



IMMEDIATE AND REMOTE POISONING 

 BY CHLOROFORM. 



Sudden death under chloroform — The fatal adrenalin-chloroform 

 combination — Delayed chloroform poisoning. 



ENTHUSIASTIC advocates of chloroform as the 

 ideal anaesthetic (usually hailing from the 

 north) used to say, " Chloroform kills your patient 

 to-day, and ether kills him to-morrow." They 

 referred of course to the pulmonary complications 

 which used to follow the use of the latter drug in the 

 days when it was given by a Clover's inhaler through- 

 out the operation, instead of by the open methods 

 We are now finding out that chloroform too may not 

 claim its victims until to-morrow. 



Chloroform may cause a fatality in three distinct 

 ways : first, by sudden arrest of the heart ; secondly, 

 by poisoning the heart and vital centres in the 

 medulla of the brain ; and thirdly, by inducing acute 

 fatty degeneration of the viscera, and acidosis. We 

 shall here only consider the first and third. 



SUDDEN ARREST OF THE HEART, 



Some of the most tragic calamities of surgical 

 practice are due to sudden death from chloroform, 

 and few and happy are the surgeons who have never 

 seen it. Here we must place those cases where the 



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