VI. The use of Chloroform in the Crimea Primary and Secondary Hemorrhage from Tetanus Gangrene Erysipelas Frost-U to. TIM: advantages derived t'nnn use of ana'sthrtics are perhaps limn- evident and more appreciated in the field than in civil practice. The many divadf'ul inj; which an to us in war, and the severe suffering which so often results t'nnn them, soon cause u> fully to appreeiate the benefits bestowed by such -painsoothers." -t majority of the surgeons of the Eastern army were most enthusiastic in their anticipations of what chloroform was to accomplish. It was cxj cctcd to revothe whole art of surgery. Many operations, hitherto discarded. to le performed; and many, of the Peninsula said were necessary, wciv heneciorth ilh.
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The only case in which, with any show of fairness, fatal consequences could be said to have followed its use, occurred in the division referred to. The patient, a man of thirty-two years of age, belonged to the 62nd regiment, and was about to have a finger removed. The chloroform was administered on a handkerchief, as he sat in a chair. Death was sudden; and artificial respiration, which was the means of resuscitation employed, failed to restore him. No pathological condition sufficient to account for death was found post-mortem. Some five or six other cases were brought forward by the small body of surgeons who were suspicious of the action of chloroform, as having ended fatally from its effects; but in none of these could, I think, the least pretext be found for the imputation, further than that the anaesthetic had been administered at some period previous to death.
A man who had been dreadfully mutilated, and who had lost much blood, died shortly after having his thigh removed high up. Chloroform had been used, and to it was ascribed the fatal issue. Death, twenty or thirty hours after a capital operation, rendered necessary by the most dreadful injuries, must be attributed to the chloroform, and so on, and no note taken of the effects of severe injury, plus a capital operation, in shattering the already enfeebled powers Death occurring under such rsi: or rm. demand any special explanation, nor tinfact injury was occasioned by a round shot introduce any new element into tin' calculation.
The objections made to the use of chloroform were restricted to two classes of cases trivial accidents, in which it was thought unnecessary to run the risk of Lfivinu' it. and amputations of the thigh, in which a fatal -sion of shock was feared. Jlowcver this may he, it certainly sh >ws the little practical force of these objections, that, while with every indulgence in the interpretation of the law "post hoc," only some half-dozen cases could be obtained throughout the whole army to illustrate the pernicious effects of this agent, and that, too, when thousands upon thousands had been submitted to its action, and hundreds of surgeons of equal experience to the objectors were ready to record their unqualified opinion in as their gratitude for its benefits.
K.r my own part, I never had reason, for one moment, to doubt the unfailing good and universal applicability of.form in injuries, ifproperly usly belirve that its use in our army 9ATed very many lives -that many operations necessary for this end were performed by its assistance. which could not otherwise have been attemptedthat ons were more successfully, because more 'ully. executed that lite was cd even the of pain tli' of the wounded bettex 1. and the murage and comfort of the sur i-ed. I think I have seen of its conclude, that, if its action is not carried lu-yond the Stage it d06f QOt increase the depression which results from injury, but that, on the contrary, it in many instances supports the strength under operation.
Its usefulness is seen in nothing more than when, by its employment, we perform operations close upon the receipt of injury, and thereby, if not entirely, at least in a great degree, are able to ward off that " embranlement " of the nervous system which is otherwise sure to follow, and whose nature we know only by its dire effects. To men who had lost much blood, it had, of course, to be administered with great care, from the rapidity of its absorption in such persons; but if we do not act on broader principles in its exhibition than reckoning the number of drops which have been employed, or the part of the nervous system which we may presume to be at the time engaged, then we must expect disastrous results.