CHLOROFORM. — This well-known anmsthetic was simultaneously discov I eyed, in 1331., by- Guthrie, of the United States; Soubeiran, of France; and Lie big, of Germany. Dumas later on gave it its present name, and Sir James Y. Simpson, of Edinburgh, first used it as an amesthetic.
Chloroform (ChC13; specific gravity, 1.497 at 62.5° F.) is a terchloride of formyl, obtained by the action of chlo rine upon alcohol, the methods usually employed being either the addition of chloral-hydrate to an alkaline solution or of chlorinated lime to ethyl-oxide. This is distilled and subsequently puri fied by the addition of sulphuric acid, sodium carbonate, and lime, and redis tillation is then resorted to.
Chloroform appears as a neutral, color less fluid, possessing a sweetish and hot taste, and giving off a fragrant and char acteristic odor. It possesses marked solvent powers, rapidly dissolving alka loids, iodine, bromine, volatile oils, etc.; but is itself only sparingly soluble in water. It is distinctly so, however, in alcohol and ether.
Chloroform is not inflammable under ordinary circumstances, except when mixed with alcohol. When used, how ever, in the presence of a gas-flame, it is likely to become decomposed, and the product may prove noxious to the per sons inhaling it.
Chloroform-vapors are broken up into chlorine and earbonic oxide by gaslight, cansing bronchial irritatio» in those present, asphyxia in the patient, and even death. nerson-Leidon (Deutsche med. Woch., Apr. 3, '90).
Hydrochloric acid and earbon dioxide, and not monoxide, are the toxic agents. Kunkel (11 finch. med. 'Woch., Apr. 4, '00).
A eoal-gris flame in an ill-ventilated room and a somewhat prolonged exhibi tion of chloroform may, by forming a. compound with the latter, induce serious symptoms in patient, surgeon, and assist ants. Illustrative instances. Charles G.
Lee (Liverpool AIetlico-Chir. Jour., July, '95).
Identical effects observed. Irritating agent, a carbon-oxychloride, or phosgene, discovered by Sir 1-fumpliry Davy. Pat erson (Practitioner, vol. xlii).
Warning against Ilse of chloroform near it gaslight, ethylene-chloride being thereby formed. In tabetic patients fatal coma may be induced. Helm (Le Bull. 1Ied., May 12, '113).
C'ase of a man shot in the abdomen, who was brought to the hospital at night and immediately operated upon by gas light. As a result of the chloroform
narcosis, which had to be kept tip for four hours, powerful chlorinated vapors were produced. Two of the surgeons and several of the Sisters of _Mercy were overcome and one of the latter has since died. (Inter. 31ed. 3Iag., Apr., '98.) The administration of chloroform while artificial lights art. burning is likely to produce broncho-pneumonia and cedema of the lungs, with marked passive con gestion of the liver and kidneys. This variety of poisoning also occurs with some frequency in druggists and chemists who use chloroform in the presence of gas-flames. Kenelm Winslow (Boston Med. and Slug. Jour., May 11, '09).
Even under ordinary conditions the chloroform usually employed for anws thetic purposes tends to decompose and to form hydrochloric acid and carbonyl chloride. According to Newman and Ramsay, this latter substance is the cause of the majority of cases of after-sickness.
This can be overcome by keeping a little slack lime in the bottles and filtering in the supernatant liquid as required.
The deleterious effects of chloroform become especially manifest when kept in a. bottle containing air and exposed to light.
Physiological Effects and dications.—The conclusions of Lawrie and of the Hyderabad Commission, the principal of which is that failure of respiration is the only possible way- by which death is produced by chloroform, has now run the gauntlet of several years' criticism and may be said to no longer be accepted by the profession, and espe cially by experienced anmsthetists. In deed, many competent observers have reported cases in which the heart ceased before the respiration, and Mr. Leonard Hill has recently expressed the view that the cause of chloroform collapse was in all cases a primary failure on the circulatory mechanism, the respiration failing secondarily on account of the amemia of the bulbar centres. He had examined all the tracings taken by the Hyderabad Commission, and found that in them (although it was not so inter preted by the experimenters) the same typical fall of arterial pressure actually occurring before the cessation of respira tion observed by him elsewhere. Thus their own experimental evidence contra dicts the conclusions arrived at by the workers on the said commission.