one, the ether in a separate inhaler, which restores a flagging pulse better than anything else one is acquainted with. Twenty or thirty drops of sal volatile in a little water immediately before operation is also better than brandy. An aloetic purgative the night before an operation helps to prevent vomiting. Bichât tells us that the carbonic acid of venous blood is the proper stimulus of the lung; so that it is to be feared oxygen gas as proposed for inhalation will not prevent death from chloroform. Transfusion of warm water with ammonia would be better worth trial, and electricity. The explosive, or rather expansive, power of the condensed nitrous oxide-something at one time compared to a soda-water bottle, then to a pocket pistol-has been partially got over by farther condensation of the gas into a liquid, as already stated. Respiration is perhaps more important to watch during inhalation than the pulse; they are, shall we say, rather opposite swings of the pendulum that regulates the circulation. This is applicable to the administration of the gas as well as to the administration of ether or of chloroform. The public, in fact, with average care, need not be at all afraid of chloroform. The nitrous oxide must be used pure, and undiluted with air, to secure insensibility. Of this gas five thousand gallons were despatched to the seat of war in Paris. The public are perhaps unnecessarily afraid of the danger of chloroform administration, and will welcome 'laughing-gas.' The 'gas' realises for us very notably a curious reform, as it is actually safer than chloroform-safer than all other anæsthetics; very alarming, no doubt, to watch in its asphyxiating effect, as says Cymbeline : No danger in what show of death it makes, More than the locking up the spirits a time A different thing altogether as now manipulated from what once on a time, as Sir H. Davy tells us, was inhaled by his friends Coleridge and Wordsworth, when the former burst out into an aphorism, that sensation was our only world-no world else. But if we still pursue the theme of our philosopher who, in the age of Queen Elizabeth or the Armada, could not stand the pain of 'odontalgia,' as our better sort of dentists are supposed to style toothache still pursue this activity which realises a happy life, for with Horace we believe our philosopher of Samos and the Epicureans very much misrepresented men; if we believe there is no danger in what show of death these anesthetics make, as recovery is so quick, and freedom from pain is already a pleasure, man always plotting in his heart not to suffer or to fear pain,-a wise and healing instinct, -if chloroform be so safe with average skill, it is well to do away with popular errors as to its danger. Lord Palmerston, following Horse - Guards authorities, poohpoohed the surgeons of the Crimea and their new-fangled notions as to removing pain. Soldiers, it was said in general orders,' were too brave to require chloroform. How different the great epic of Homer! There Idomeneus addresses Hector: Haste to your chariots! Let Machaon ride by your side: his life is precious; for one good physician (and such is Machaon) is worth a whole army.' What a coronal would Homer have placed on the brow of the now forgotten and despised American who in our day revolutionised surgery for the better, and blessed humanity with ether and its adjuncts, which not only help to save human life, but for ever to abolish surgical pain in operations! Accidents from chloroform, in one word, are not as numerous as railway accidents. The latter do not prevent us from travelling by rail. Let us secure the same equanimity on the part of the patient as to chloroform, and we shall hear of no more accidents from its effects. But our patient is again awake that we placed under chloroform; the operation is done while we have been reading or writing of its effects. He remembers nothing save as of his ordinary sleep at night-no pain; and his convalescence is now assured to be quicker than if he had not had the anaesthetic. The poetic dittany is the beau-ideal of medicine in Homer; for it not only takes away pain, but also helps the cure. No needleguns then, no doubt, with their direful egg-shaped bullets, tearing each poor wretch's bones who happened to be wounded; but this should make us in a civilised age popularise more than we do the blessings of anesthetics. It is wise and well to know that there is really no danger in this modern boon of chloroform that may not be averted with as great certainty as smallpox danger by vaccination, or ague by quinine; and yet it is a sorrowful page in popular delusion that from various causes, chiefly from want of popular knowledge of its vast importance, chloroform was denied the wounded in the Crimea, and was the one thing not forthcoming in the later disastrous Franco-German war at the proper time! It is a sad and sometimes disheartening thing that for any improvement in rifled cannon or hellish explosive bullet there is honour or promotion, but for what takes away pain and saves life only neglect and carelessness! CHARLES KIDD, M.D. REMEMBER ME Suggested by Alfred de Musset REMEMBER me, what time the timid morn And o'er thy soul its starry mantle falls. A voice which still shall say, Remember me, when cruel destiny Hath forced for ever thee and me to part; Have done their worst upon my lonely heart. Remember me, when in the grave's cold gloom Remember me, when on my lonely tomb A solitary flower its watch shall keep. The same sad solemn sound, MAURICE DAVIES. ROBSON AND SONS, PRINTERS, PANCRAS ROAD, N.W. Provide against the losses that follow by taking a Policy AGAINST ACCIDENTS OF ALL KINDS, OF THE RAILWAY PASSENCERS ASSURANCE COMPANY, THE OLDEST AND LARGEST ACCIDENTAL ASSURANCE COMPANY. Hon. A. KINNAIRD, M.P., Chairman. Paid-up Capital and Reserve Fund, £160,000. ANNUAL INCOME, £180,000. COMPENSATION PAID, £915,000. BONUS ALLOWED TO INSURERS OF FIVE YEARS' STANDING. Apply to the Clerks at the Railway Stations, the Local Agents, or 64, CORNHILL, & 10, REGENT STREET, LONDON. WILLIAM J. VIAN, Secretary. |