116 IMMEDIATE AND REMOTE 



would take up a far larger quantity of the drug than 

 aqueous substances such as the protoplasm of the 

 muscles, heart, and glands. Hence the principal 

 action should be upon the nervous system. The 

 rapidity and evanescence of that action depend on 

 the volatility of the drug. Ethyl chloride, ether, and 

 chloroform would act rapidly, the solid drugs more 

 slowly. Meyer supports his hypothesis by arranging 

 a series starting with trional, which is relatively 

 least soluble in water but most soluble in fat, and 

 passing through butyl chloral to sulphonal, next 

 chloral, and finally to urethane, which of the five is 

 most soluble in water, but least soluble, relatively, 

 in fat. He finds that the narcotic power of these 

 drugs for tadpoles is greatest with trional, and 

 passes in the same order to the least toxic, urethane. 

 The hypothesis has scarcely yet passed out of 

 the realm of suggestion, and in any case would 

 be of greater theoretical interest than practical 

 importance. 



Chloroform may cause a fatality in three distinct 

 ways : first, by vagus inhibition ; 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. 



VAGUS INHIBITION. 



Some of the most tragic calamities of surgical 

 practice are due to vagus inhibition by chloroform, 

 and few and happy are the surgeons who have never 

 seen it. Here we must place those cases where the 

 patient is far from under, perhaps struggling and 



