The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum].
- Duncum, Barbara M.
- Date:
- 1947
Licence: In copyright
Credit: The development of inhalation anaesthesia : with special reference to the years 1846-1900... / [Barbara M. Duncum]. Source: Wellcome Collection.
450/664 page 430
![some comment. We learn that a commission f1] had been ap- pointed to investigate the action of chloroform, and that the result of the researches made upon pariah dogs was that these animals were killed from respiratory failure, and in no case did cardiac syncope occur directly. Unfortunately Mr. Lawrie contents himself with bare statements of results, adding that these results tally with his own experience, which he believes to be uniquely large. Mr. Lawrie, as a disciple of Simpson and Syme, arrives at conclusions consonant with the teaching of those great clinicians, but utterly at variance with the experience alike of experiment and practice as carried out in Europe. We should require more than the scanty statements of experiments per- formed upon dogs—notoriously non-susceptible to chloroform syncope—before we could accept the conclusions of the Hydera- bad Commission when they appear to go in the very teeth of those at which the Commission appointed by the Royal Medical and Chirurgical Society and by the British Medical Association [the Glasgow Committee] arrived, and, further, are opposed to the careful and painstaking experiments of such scientific observers as Snow, Claude Bernard, McKendrick, and others too numerous to mention. All those who are familiar with chloroform are well aware that syncope, when primary, as a rule supervenes in the initial stages of inhalation, while secondary syncope due to respiratory embarrassment is the result of accumu- lation of chloroform in the blood leading to paralysis of the medullary centres, and occurs in a late stage of the administra- tion. The primary syncope it is rarely, if ever, possible to induce in dogs, although, unfortunately, it is this form of chloroform heart failure which does occur in human beings, and which it is almost impossible to remedy. While welcoming the attention paid to the subject by the Hyderabad Commission, we cannot but feel that, should the Commission inculcate a disregard of the heart as a factor in chloroform dangers, it will do harm and provoke a slipshod carelessness in the use of that valuable anaesthetic, which must in the long-run do damage to the cause the Commission has espoused.' 2 Lawrie accepted the Lancet's challenge. In a letter to that journal, published on May n, 1889, he wrote : *. . . I hold . . . that there is no such thing as chloroform syncope. ' It is conceivable that syncope may occur in the initial stages of inhalation of chloroform, but in the course of a very large 1 This Commission, which was appointed by the Nizam of Hyderabad's Govern- ment during 1888 at the request of Lawrie, came to be known as the ' First Hydera- bad Commission '.](https://iiif.wellcomecollection.org/image/b20457200_0454.jp2/full/800%2C/0/default.jpg)
