320 Mr. J. A. MacWilliam. The Mechanism and 



intia-cardiac or intra-vascular injections. Hypodermic doses of 0*5 grm. per 

 kilogramme and upwards (given in 25-per-cent. solution, etc.) have a 

 pronounced influence in protecting against fibrillation in light chloroform 

 anaesthesia and in diminishing, though not always obviating, the danger of 

 adrenaline fibrillation in the same grade of anaesthesia. Sufficient time has to 

 be allowed for absorption before the effects are tested. Smaller doses suffice 

 for this purpose when given by intra-vascular {e.g., saphenous vein) injection. 



Strontium Chloride was given in doses of 0"01 — 0'06 grm., a 1-per-cent. 

 solution in dilute Einger's fluid being usually employed.* Especially when 

 applied at an early phase of the fibrillation this remedy often succeeded very 

 well, and the condition of the heart and circulation were excellent afterwards 

 (fig. 11). In other cases after fibrillation had lasted for a long time and other 



Fig. 11. — A, fibrillation, preceded by period of tachycardia and pseudo-fibrillation, from 

 faradising with 500 units. Injection of 0"06 grm. strontium chloride was followed 

 in 30 seconds by restoration of the normal action, shown in B, taken shortly after 

 recovery. Soon afterwards faradisation with 1000 units again caused fibrillation ; 

 recovery followed injection of 0"03 grm., with the usual massage. 



measures had been unsuccessful, this salt sometimes speedily induced 

 recovery. Fibrillation, in its various phases, caused by potassium salts is, as 

 might be expected, specially amenable to treatment with strontium in doses 

 varying according to the toxic dose of potassium. 



Adrenalin. — Solutions of 1 in 10,000 or 1 in 5,000 were commonly used ; 

 sometimes as strong as 1 in 1,000 ; in Einger's fluid in each case. The dose 

 varied from O'l to 1 mgrm. Successful results were very fiequent in fibrilla- 

 tion which had been induced in various way — by electrical stimulation, 

 chloroform, adrenalin injection during light chloroform anaesthesia (the 



* The amounts here stated are of strontium chloride crystals (SrClj + 6H2O). The 

 doses of the anhydrous salt would be represented by about 60 per cent, of the above 

 amounts. 



