POISONING BY CHLOROFORM 119 



Its value in overcoming chloroform inhibition has. 

 been abundantly proved by Dixon and others in 

 dogs, and though its use in such cases in man is 

 but recent, successes are already recorded. That 

 there have been failures is admitted, but there is 

 good reason to hope for recovery with immediate 

 injection into the heart itself. There is ground for 

 hoping, also, that a preliminary injection of scopola- 

 min, now becoming popular for employment before 

 the administration of a general anaesthetic, may 

 help to eliminate these terribly sad occurrences. 



Several patients apparently passed beyond the 

 shadowy Rubicon which separates the living from 

 the dead have been brought back to life by rapidly 

 opening the upper abdomen and rhythmically 

 squeezing the heart against the chest wall through 

 the diaphragm. 



POISONING OF THE VITAL CENTRES. 



Turning to the second danger, we must realize 

 another outstanding difference between chloroform 

 and ether. The latter stimulates the circulation, and 

 death from an overdose of ether will be death from 

 paralysis of respiration. During the prolonged 

 administration of chloroform, on the other hand, the 

 circulation is depressed, the heart dilates, and the 

 blood-pressure, as measured by the Riva-Rocci 

 instrument, falls steadily. It is well known that 

 when the operator complains of haemorrhage obscu- 

 ring his view, the substitution of chloroform for 

 ether will usually diminish the bleeding. In very 

 prolonged operations, or in surgical procedures 



