REPORT ON CHLOROFORM. 
101 
the agent be administered, the results produced are nearly uniform. The first effect of 
chloroform-vapour is to increase the force of the heart’s action; but this effect is slight 
and transient, for when complete anaesthesia is produced, the heart in all cases acts with 
less than its natural force. The strongest doses of chloroform-vapour, when admitted 
freely into the lungs, destroy animal life by arresting the action of the heart; whilst by 
moderate doses the heart’s action is much weakened for some time before death ensues, 
respiration generally, but not invariably, ceasing before the action of the heart, death 
being due both to the failure of the heart’s action and to that of the respiratory function. 
The danger attending the use of chloroform increases with the degree of stupor it induces; 
the apparent irregularities in the action of the anaesthetic mainly depending on the 
varying strength of the vapour employed, on the quality of the chloroform, and on the 
constitution of the patient. In order that it may be administered with comparative 
safety, it is necessary that the proportion of vapour should not exceed per cent.; that 
its effects should be carefully watched, and the inhalation suspended when the required 
anaesthesia is induced. 
In many respects the action of ether is similar to that of dilute chloroform. At first 
its vapour increases the force of the heart’s action,—an effect which is both greater and 
of longer duration than that observed with chloroform. The stimulation is followed by 
a depression of the force of the heart’s action, but at the same degree of insensibility 
ether does not depress the action of the heart to the same extent as chloroform. Even¬ 
tually ether kills, partly by enfeebling the action of the heart, but chiefly by arresting 
the movements of respiration. Thus the energy with which chloroform acts, and the 
extent to which it depresses the force of the heart’s action, render it necessary to exercise 
great caution in its administration, and suggest the expediency of searching for other 
less objectionable anaesthetics. Ether is slow and uncertain in its action, though it 
is capable of producing the requisite insensibility, and is less dangerous in its operation 
than chloroform. On the whole, however, the Committee concur in the general opinion 
which in this country has led to the disuse of ether as an inconvenient anaesthetic. 
A mixture of ether and chloroform is as effective as pure chloroform, and a safer agent 
when deep and prolonged anaesthesia is to be induced; though slow in its action, it is 
sufficiently rapid in its operation to be convenient for general use. A mixture composed 
of three parts of ether, two parts of chloroform, and one part of alcohol (by measure), is 
to be preferred, on account of the uniform blending of the ether and chloroform when 
combined with alcohol, and the equable escape of the constituents in vapour; and 
the Committee suggest that it should be more extensively tried than it has hitherto been 
in this country. 
Effects of chloroform on the fauces. —The sudden administration by the mouth of 
concentrated chloroform-vapour induces a spasm of the fauces, which lasts for some se¬ 
conds ; afterwards, when the animal has inspired, the phenomena of asphyxia are for a 
time associated with those of chloroform poisoning, and death is finally induced as by di¬ 
lute chloroform. If, however, partial insensibility is first induced by weaker chloroform, 
no spasm of the fauces eusues upon the sudden administration of the concentrated form 
of the agent. 
Post-mortem appearances. —Judging from the observations on animals,—the appear¬ 
ances in the human subject having been noticed in but few cases, and being insufficient 
for yielding satisfactory conclusions,—it appears that though there may in certain cases 
be an impediment to the free circulation of the blood through the lungs, yet the 
appearances are very different after death has been caused by chloroform from those ob¬ 
served when life has been destroyed by asphyxia. In death from chloroform, all the ca¬ 
vities of the heart are distended, and the cases are only exceptional in which the left side 
is empty. The rule, however, is alike in both,—that the cavities of the right side contain 
more blood than those of the left. 
Resuscitation —The most certain means of restoring life after poisoning with anaesthetics 
is by artificial respiration. By this means resuscitation may generally be accomplished 
after natural respiration has ceased, provided the heart continues to act, and it. may 
sometimes be effected even after the cessation of the heart’s action ; but this result is ex¬ 
ceptional. Galvanism resuscitates within the same limits as artificial respiration; it is, 
however, far less to be relied on than artifical respiration in equal cases. With either 
remedy it is found that animals quickly rendered insensible by a strong dose are more 
easily recovered than those which have been gradually narcotized even by a small per¬ 
centage of the anaesthetic. 
