684 
USE OF CHLOROFORM IN SURGERY. 
All these advantages of anaesthetics in surgery must be obvious 
to you. I wish we could stop here, but there is always some 
little drawback, something to mar the perfection of our dis- 
coveries. What’s this we read ? Surgit amari aliquid, medio 
de fonte , 8fc. ; some one drop of bitterness behind, something 
unfortunately which shakes our confidence in this great dis- 
covery, of which we had a too striking instance lately in this 
hospital. Accidents of a painful and serious nature will 
occur ever and again. We are not, however, at all to give up 
chloroform, we must rather strive and eliminate those cases 
and causes of danger, and for the future use more precaution. 
These cases of death are sobering lessons, which we should 
all strive to understand. 
“ I would wish at present to say a few words as to the 
mode of administering chloroform. This is a thing which 
every one should learn, for I am satisfied a very great deal 
depends on it. You may give your patient an over-dose of 
chloroform when you least expect it, and an over-dose in 
some patients will be another word for death. And first, as 
to the relative value or safety of the inhalers or the advantage 
of a common piece of lint and oiled silk. I do not think this 
signifies very much, the chief advantage of the tubular inhaler 
I here show you is, that you know the quantity used, which 
should always be measured, while, when you use lint there 
is more or less wasted. Yet I think this is counterbalanced 
in the use of lint, by the gradual and safe mode in which you 
bring your patient under chloroform, while in the instrument 
or apparatus it may be that the vapour is too concentrated. 
You will find a great deal written, from time to time, on this 
point ; it is, after all, not one of much moment, and as you 
may be obliged to use chloroform where there is no apparatus, 
a preference may be given to the lint. You pour a drachm 
of chloroform over a piece of lint the size of the hand, do not 
over-saturate it, place this over the patient’s nose and mouth, 
and then throw a towel loosely over your hand while apply- 
ing it. You may find it necessary now to replenish the 
chloroform after a little, as the lint gets dry, and here I would 
impress on you the necessity of remembering the second 
quantity is much more dangerous than the first, the patient, 
for what you may see to the contrary, may be on the verge 
of a precipice, in the balance between life and death. The 
great point to be attended to is, watch the pulse , as, when 
danger threatens, it becomes perceptibly feeble, and smaller. 
The effect of chloroform on the heart is peculiar : at first it 
quickens the pulse, indeed the general effects on the brain 
and nervous system at first, so intimately connected with the 
