144 MATERIA MEDIC A AND THERAPEUTICS. 



in pharmacy to cover the nauseous, hitter, and astringent 

 characters of many drugs. It may also he used to relieve 

 toothache. Like alcohol, it causes reflex salivation, and in this 

 way, as well as hy a carminative action on the stomach, the 

 compound tincture, spirit, and aqua are useful adjuvants to 

 stomachic and tonic mixtures, relieving pain, vomiting, and 

 flatulency. In full doses it may give rise to vomiting, as is 

 frequently seen after anaesthesia. A few drops of chloroform 

 inhaled from a sponge or piece of lint (quite apart from its 

 action and use as a general anaesthetic), rapidly soothe the 

 respiratory nerves, and may he employed to arrest spasm of 

 the glottis, asthma, and spasmodic or dry useless cough attend- 

 ing irritation of the air passages. 



2. ACTION IN THE BLOOD. 



Chloroform enters the circulation hy the respiratory organs, 

 stomach, and the unbroken skin, as well as subcutaneously. 

 Chiefly as chloroform, partly as various products, it mixes with 

 the blood ; but its action on the living circulating blood is 

 still obscure. 



3. SPECIFIC ACTION AND USES. 



Chloroform reaches the tissues very rapidly, especially if 

 administered in the form of vapour freely mixed with air, as 

 it always is when given as a general anaesthetic. Its most im- 

 portant action is exerted upon the central nervous system, and 

 demands detailed description. The phenomena which it pro- 

 duces will first be noted ; secondly, an analysis will be made of 

 these ; thirdly, the uses of chloroform will be enumerated ; and 

 fourthly, the method of administering the anaesthetic, and 

 certain necessary precautions will be briefly indicated. 



1. Phenomena of chloroform anaesthesia. a. First stage. 

 The first effect of the inhalation of chloroform on the nervous 

 system is powerful stimulation, but almost from the com- 

 mencement this is accompanied by a certain amount of dis- 

 order. The first few inspirations seem to rouse the cerebrum 

 to increased activity, an eifect due to the direct action of the 

 anaesthetic on the nerve-cells of the convolutions and partly, per- 

 haps, to vascular disturbance. The highest centres are first and 

 chiefly excited so that the imagination and f eelings immediately 

 become exalted, always, however, with some confusion. For 

 a moment the senses may be quickened, but they are quickly 

 disordered and depressed : vision, hearing, and touch become 

 dulled or blurred, and a strange feeling of lightness, freedom, 

 tingling, or numbness pervades the surface and the extremities. 

 All these sensations are strictly central, probably convolutional 

 in origin. 



