CHLOEOFOEM 297 



and muscular tissue, relieves spasm, pain and flatulence iix 

 the stomach and small intestines. 



Circulation. — Chloroform exerts an ever increasing de- 

 pressing influence upon the heart muscle, its ganglia, and 

 the vasomotor centres. 



Vasomotor depression leads to dilatation of the arte- 

 rioles and leaking of blood into the veins, vs^ith consequent 

 venous engorgement (particularly of the abdomen), and 

 arterial antemia. Failure of respiration in chloroformiza- 

 tion is secondary to cerebral an8?mia, and chloroform kills, 

 primarily by vasomotor depression. (Leonard Hill and 

 Hare.) 



The ventricles dilate and all cardiac muscular contrac- 

 tility is lost in fatal poisoning. Death, hov^ever, occurs' 

 almost invariably in healthy animals during chloroform in- 

 halation from respiratory failure associated with circula- 

 tory depression. The heart usually continues to beat after 

 cessation of breathing. Death from syncope occurs occa- 

 sionally, and circulatory depression is greater and occurs- 

 more suddenly than with ether. Rarely sudden death occurs- 

 in the beginning of ansesthesia from reflex inhibitory arrest 

 of the heart produced by the inhalation of concentrated- 

 chloroform vapor. The degree of concentration is of the ut- 

 m.ost importance. A great deal of chloroform may be given 

 for a long period if it is greatly diluted with air. It is- 

 not the amount but the rapid absorption of concentrated, 

 vapor which kills. 



With ether the vapor may be greatly concentrated with- 

 out danger ; with chloroform the difference between the neces- 

 sary concentration for anassthesia and that which means 

 danger is slight As chloroform anesthesia proceeds, the 

 pulse becomes rapid from the depressing effect of chloro- 

 form upon the vagus centre. 



Respiration. — Chloroform does not markedly affect the 

 respiration, when inhaled in proper dilution for an ordinary 

 period, or when ingested in small doses, but after long con- 

 tinued inhalation, or when- large quantities have been swal- 

 lowed, depression and paralysis of the respiratory centre 

 ensues. Since asphyxia leads to inhibition and heart fail- 

 ■ure — besides being dangerous in itself — the respiration should 



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