TRANSACTIONS OF THE SECTIONS. 117 
of chloroform accidents is of singular importance, as it bears in a marked manner 
on the entire physiology of apnoea, viz. the apnoea and treatment of persons drowned, 
the resuscitation of still-born children, the recovery to life of patients suffocated in 
coal-mines, or individuals dug in a state of apnoea out of the ruins of tumbled-down 
houses, or even the restoration to life of persons “found dead” in bed at night 
from the effects of an overloaded stomach (from indigestion) pressing on the dia- 
phragm, but oftener ascribed to a mythical disease, “fatty heart.” 
Reasoning deeply on various groups of facts, partly practical in hospitals, partly 
pathological, partly experimental on animals, as seen in the dead-house, partly em- 
pirical from observations now of some ten thousand administrations of these agents, 
the author leans to the belief that, under chloroform or ether, the heart is never 
attacked by the sudden paralysis which popular fancy as also some writers have 
sought to convey by the words cardiac syncope : we have had an erroneous or wrong 
interpretation of the facts. 
He contends, as a matter of reasoning, that if in one hundred experiments on 
dogs, rabbits, &c., poisoned by chloroform, the most marked or only marked post- 
mortem appearances be gorging of the right cavities of the heart, if in the human 
subject the same condition of the pulmonic or right heart be found, as it is, 
the previous statistical or bare induction from the facts that this gorging of the 
heart is the result of paralysis from chloroform (cardiac syncope), and the imme- 
diate cause of death, is not true, as there has been an anterior condition more im- 
portant overlooked, viz. that this gorging of the right heart is merely the result of 
(apnoea or) the lungs not receiving the blood from the heart thus vainly striving 
to push it forward ; it is the function of the lungs and diaphragm, in a word, that 
is at fault, and what has been overlooked by mere experimenters of a vivisectional 
kind on animals; that, in hospital, the patients under chloroform usually struggle 
very violently, as if suffocating; and also when alarm of accidents arises, the pa- 
tient’s limbs are actively rubbed in the course of the veins, all which tends power- 
fully to engorge or fill the right side of the heart: the heart, in fine, strives ac- 
tively to push forward this blood; but the lungs are in a state of paralysis, and do 
not receive it. 
Electricity to the heart is useless in all these cases; but electricity to the dia- 
phragm and respiratory muséles, as causing full artificial respiration, unloading 
the lungs and heart-cavities, &c., acts like magic. To support his view, other 
logical deductions were quoted by the author. It is against the analogy of the 
action of chloroform, so peculiarly confined to muscles of the voluntary kind, that it 
should act on the heart. It is contrary to all clinical observation of the pulse and 
action of the heart in thousands of hospital cases deeply narcotized, the pulse 
being almost always increased in volume and strength, even so much so that 
some good observers can see no explanation of the deaths but by over-stimulation 
and over-action which induce this gorging of its cavities: the heart, in experi- 
ments under chloroform, is, in fact, wltimewm moriens. Again, it often occurs that 
the pulse, before taking chloroform, may, in patients, be almost imperceptible 
and very slow, with a heart equally feeble, but both improve in force and number 
of beats as the narcotism of the chloroform becomes more and more advanced: 
even Dr. Snow describes the pulse as thus usually increased in foree by chloro- 
form—a paradox he admits he cannot explain. Again, the deaths from chloroform 
do not usually occur from or in deep narcotism or coma, but generally in the stage 
of excitement or half-narcotism, and want of proper relation of the capacity of 
the lung (diminished perhaps) to the supply of blood in excess crowded into or 
engorging the large veins and right auricle and ventricle: a form of tetanic rigi- 
dity, with spasm of the glottis, explains the condition. 
omparing thus one group of facts with another group, the best form of deduc- 
tive reasoning, the error in the earlier hasty generalization is corrected; and when 
we remember that there have been now nearly 200 deaths in surgical operations from 
this mistake or generalization, its correction becomes a matter of grave importance. 
The remedy which promises such good effects, which was used in the case of the 
poor lady dead from chloroform, the subject of the present communication (and has 
since been referred to in the leading medical journals in three other instances of 
apnoea from chloroform accident or drowning, with the same admirable good re- 
