A RESEARCH UPON ANÆSTHESIA

The conclusions which have been reached by the series of experiments recorded in the present memoir are: First. Lowered arterial pressure has a comparatively feeble effect upon the respiration, but when the pressure falls sufficiently, respiratory depression does occur. Second. Even excessive lowering of blood pressure primarily stimulates the vaso-motor centre, the sensibility of the centre being evidently necessary to the automatic regulation of the circulation. Third. The circulation recovers itself more slowly after profound etherization than after a like chloroform narcosis. Fourth. It is possible for ether as well as chloroform to produce death some hours after the cessation of its administration, at a time when the cerebrum has long freed itself from distinct evidences of the narcotic, so that consciousness and intellectual action have been restored. In applying these conclusions to the subject of practical anæsthesia it is evident that the depression of the circulation produced by chloroform has effect upon the respiratory centres only when the pressure has fallen very low, and whilst it may be a factor in the production of respiratory failure during chloroformization, the failure must be chiefly due to the direct influence exercised by the drug upon the respiratory centres. Clinical experience shows that nausea and general depression are more pronounced after the use of ether than after the use of chloroform, a difference which is strongly insisted upon by the advocates of chloroform as an important agent in favor of that anæsthetic. Our research confirms clinical observation, and experimentally shows that the depression of the circulation produced by ether is more permanent than that caused by chloroform; the reason probably being the large amount of ether which is necessary to produce profound narcosis, with lowering of the arterial pressure; an amount so large that it can neither be burned up in the system nor yet eliminated in the time which would be necessary for the much smaller amount of chloroform to be gotten rid of after chloroformization.