158 POISONS : THEIR EFFECTS AND DETECTION. [§§ 188 , 189 . 
from a fatal dose of liquid chloroform mainly resolve themselves into 
redness of the mucous membrane of the stomach, though occasionally, 
as in Pomeroy’s case, there may be an ulceration. In a case recorded 
by Hoffman, 1 a woman, aged 30, drank 35 to 40 grms. of chloroform 
and died within the hour. Almost the whole of the chloroform taken 
was found in the stomach, as a heavy fluid, coloured green, through the 
bile. The epithelium of the pharynx, epiglottis, and gullet was of a 
dirty colour, partly detached, whitened, softened, and easily stripped off. 
The mucous membrane of the stomach was much altered in colour and 
consistence, and, with the duodenum, was covered with a tenacious grey 
slime. There was no ecchymosis. 
2 . THE VAPOUR OF CHLOROFORM. 
§ 188. Statistics. —Accidents occur far more frequently in the use 
of chloroform vapour for anaesthetic purposes than in the use of the 
liquid. 
Most of the cases of death through chloroform vapour are those caused 
accidentally in surgical and medical practice. A smaller number are 
suicidal, while for criminal purposes its use is extremely infrequent. 
The percentage of deaths caused by chloroform administered during 
operations is unaccountably different in different years, times, and places. 
The diversity of opinion on the subject is partly (though not entirely) 
explicable by the degrees of purity in the anaesthetic administered, the 
different modes of administration, the varying lengths of time of the 
anaesthesia, and the varying severity of the operations. 
During the Crimean war, according to Baudens and Quesnoy, 30,000 
operations were done under chloroform, but only one death occurred 
attributable to the anaesthetic. Sansom 2 puts the average mortality 
at -75 per 10,000, Nussbaum at 1-3, Richardson 3 at 2-8, Morgan 4 at 3*4. 
In the American war of secession, in 11,000 operations, there were 7 
deaths—that is, 6-3 per 10,000, the highest number on a large scale which 
appears to be on record. In the five years ending 1916, 16 deaths are 
attributed to chloroform in England and Wales—viz., 6 males, 1 female, 
from use as a general anaesthetic ; 9 (7 males’ 2 females) from suicide. 
§ 189. Suicidal and Criminal Poisoning by Chloroform. —Suicidal 
poisoning by chloroform will generally be indicated by the surrounding 
circumstances ; and in no case hitherto reported has there been any 
difficulty or obscurity as to whether the narcosis was self-induced or 
not. An interesting case is related by Schauenstein, 6 in which a 
physician resolved to commit suicide by chloroform, a commencing 
1 Lehrbuth der ger. Med., 2 te Aufl. 
Chloroform: its Action, etc., London, 1865. 
Med. limes and Gazette, 1870. 4 Med. Soc. of Virginia , 1872. 
5 Maschka, Handbuch der gerichllich. Medicin, p. 787, Tubingen, 1882. 
