162 DEPRESSANTS TO CENTRAL NERVOUS SYSTEM 



External and Local Action. If allowed to evaporate upon the 

 skin, chloroform produces cold with constriction of the blood ves- 

 sels together with local anesthesia, but if the vapor is confined or the 

 drug is rubbed into the skin it is an irritant, causing redness and 

 vesiccation. Chloroform is also antiseptic; even in dilute solutions 

 (the aqua) it will prevent or retard putrefaction and fermentation as 

 in urine. 



Digestive System. If administered per os in strong solution, 

 chloroform is irritant to the mouth, throat, and stomach. Dilute 

 solutions produce a sensation of warmth to the stomach, increase 

 the saliva, gastic and intestinal secretions, stimulate peristalsis and 

 aid in the expulsion of gas. In other words, it is a carminative. It 

 may also be soothing to the stomach and antemetic in weak solution. 



Circulatory System. Blood pressure is always lowered by 

 anesthesia with chloroform. This may be somewhat accounted for 

 by depression of the heart and to some extent by the dilatation of the 

 blood vessels from depression of the vasomotor center. Occasionally 

 death occurs early in chloroform anesthesia from reflex stimulation 

 of the vagus and consequent stopping of the heart. A strong concen- 

 tration of the vapor is more dangerous in this respect than a weak 

 one. 



Respiratory System. There is a decided depression of the 

 respiratory center preceded by a very short period of stimulation. 

 In some cases respiratory paralysis is the cause of death, and in ex- 

 periments with miich diluted vapor the respiration regularly ceases 

 before the heart; but the heart is too weak to permit of resuscita- 

 tion. 



Absorption. Chloroform is rapidly absorbed from the gastro- 

 intestinal tract and from the lungs when inhaled. The changes 

 which it undergoes in the body are not well knovwi. It is mostly 

 excreted by the lungs, some by the kidneys and a small amount seems 

 to be oxidized in the tissues. 



Metabolism. The prolonged administration of chloroform in- 

 creases the amount of urea, phosphates and sulphates in the urine 

 and has a tendency to cause fatty degeneration in the internal organs, 

 in the following order of extent and frequency: Liver, kidneys, 

 spleen, heart, arteries, and cardiac ganglia and, perhaps, the lungs. 

 The main effects upon metabolism are due to the marked destructive 

 changes in the liver. There is a decrease in the storage of glycogen 

 and, as a consequence, an increase of sugar in the blood. In the 

 urine there is an increase in phosphates, chlorides, sulphates and 

 total nitrogen, the ammonia nitrogen being increased while the urea 

 is decreased. The urine sometimes contains sugar, acetone and 

 allied bodies, and cystin, leucin or tyrosin. These effects are evi- 

 dences of increased destructive metabolism with incomplete oxida- 

 tion. 



