A COMPARATIVE STUDY OF ANAESTHETICS. 
235 
inculcate more cases of heart failure under ether than chloro¬ 
form, since the former is more irritating to the upper air pas¬ 
sages. 
Again, Dr. Lawrie’s assertion that no death has occurred in 
Great Britain through chloroform when the respiration alone 
was attended to, is not borne out by facts. A notable case is 
recorded in the British Medical Journal for [884,* and Dr. 
Wilson (just quoted) declares f “ there are several cases where 
the respiration only was attended to, and there are many 
more in which respiration was attended to as fully as possi¬ 
ble.” Equally untrue is the comparison of chloroform anaes¬ 
thesia in Scotland and England, for while fewer people die in 
the former country, fewer people inhale it. The population 
of Scotland is less than four millions, while that of England is 
more than twenty-nine millions, and careful examination of 
medical literature from 1878 to 1885 shows there were four¬ 
teen deaths north of the Tweed against one hundred and ten 
in the south ; or in other words the death rate in Scotland is 
one in 285,714 against in England one in 263,636, a difference 
practically inappreciable. 
Again, even supposing the claims of the Commission 
could be unreservedly accepted as regards the experiments 
conducted, those made for their teachings, that: “ It has now 
been demonstrated that this anaesthetic may be given in any 
case requiring operation in perfect safety,” and “ deaths from 
chloroform are not inevitable, therefore they are preventible 
and by due care in administration may be avoided”:};—cannot 
be. The Commission seem to have forgotten that their own 
showing reveals another danger,even more serious than cardiac 
syncope, viz. paralysis of the vaso-motor centre. This may 
set in suddenly, without warning, and is as far beyond treat¬ 
ment, and as fatal, as cardiac paralysis; and when death oc¬ 
curs from this cause, it is clearly imaginable that the vaso¬ 
motor centre may be hopelessly damaged or rapidly reaching 
that stage, while the pulse is still present and the heart at- 
*Vol. ii. p. 811. 
t Medical Chronicle, vol. xii. p. 9. 
X Lancet , London, January 18, 1890. 
