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Some months since, a leading editorial appeared in a widely circulating eastern medical journal "on the medico-legal relations of chloroform," the purpose of which was to show the necessity for coroners to secure the services of “experts" to determine definitely whether death was due to chloroform in all suspected or known cases. The whole tenor of the article was so absurd, that within a few hours after the reception of the journal, a criticism was prepared, embodying the only possible definite conception of "how chloroform destroys life," consistent with the known facts of the anatomy, physiology and pathology of the human body, and sent to the editor. As the criticism had Do sugar-coating, but few expectations were indulged that it would be published. But it was published, including many typographical blunders), and elicited a short communication from a southern correspondent, commenting on it favorably, and asking for “more light” on the subject; and detailing a case of impending death from chloroform, rescued, apparently, by the depression of the patient's head and shoulders. Though considerable time has elapsed, it is no fault of mine that a reply has not been published before. "ACTION OF CHLOROFORM.

I amputated, at the junction of the upper and middle third, the right arm of a boy four years old, in consequence of a severe injury to the limb. It required a good deal of chloroform to produce anæsthesia. After I had ligated the vessel, it was discovered that the little fellow was rapidly sinking. Several teaspoonfuls of whisky were given, as long as he could swallow, water was thrown in his face, etc. By this time, the pulse had become almost imperceptible, and the movements of the thorax had almost ceased. Just at this juncture I thought of elevating the table, and as soon as the body was brought to about an angle of forty-five, the respiration and pulse almost immediately improved. This was even readily observed by unprofessional persons present.

"Now, will Dr. McElroy tell me how this was brought about? Of course I know the additional flow of blood to the head caused the train of more remote vital processes which ended in recovery; but the brain was not empty, and in what way does the additional amount cause the effect produced ? Does chloroform hare any tendency to decrease the amount of blood in the brain, thereby causing the heart to fail in its functions, or does the drug directly act upon the heart?

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“Hoping that Dr. M. will bring his erudition in the “Philosophy of Force" to bear on this subject, I remain very respectfully. J. C. MOBLEY, M. D.


To understand the whole matter from the beginning, it may be proper to state that when death occurs from chloroform, it is always due to paralysis of the heart or lungs, or both; further, that the paralysis is invariably owing to arrest of destructive metamorphosis in the nerve masses supplying their dynamics, viz: cerebellum and medulla oblongata; and that all possible lesions are confined to the distribution of the circulation, the points of congestion determined, to some extent, by the primary failure of the heart or lungs. If the lungs fail first, they would present accumulations of the circulatioa; if the heart, the greater vessels, organs, &c., and no two alike, for these reasons. Hence, a very slender amount of thought and study would qualify one man, quite as much as another with large experience, to determine by postmortem, whether death was due to chloroform. In replying, then, to Dr. Mobley, it may be proper to state certain fundamental propositions applicable alike to his case, and to the study of the phenomena of all organic life.

First-The hitherto regarded vital force or forces of organic life, seem to be confined entirely to the preservation of the types and forms of organs, tissues and textures, in the midst of constantly dissolving and renewing materials.

The so-called vital force, or forces, have hitherto been the great stumbling block in the pathway of investigation of the phenomena of organic life. As evidence of the truth of this first proposition, the whole of pathological anatomy, disease and death are offered, for, if the types and forms of organic life were constantly reproduced, in full dynamic integrity, all organized beings would be immortal. appropriate designation of the so-called vital force, or forces, and as expressive of its objects and purposes, form force or architect of organization is suggested—the preserver of form with changing material.

Second— The organizing force, that which builds up formless organic matter, as well as the various organs, tissues and textures of the human body, under the control of the form force, or architect of organization, is common to all organic nature, and is connected with the ordinary physical forces of the universe.

These two propositions, in the shape in which they are here given, are, to a great extent, original with myself, and as they are given almost for the first time in print, lack confirmation and acceptance by the

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scientific world. They are assumed to be true, because they account for and explain more satisfactorily than any previous formulation of force, all the varied phenomena of organic life.

ThirdThat the dynamics of the human body are due, in the main, to the destructive metamorphosis of its own nerve and other tissues.

That arrest of destructive metamorphosis is death. After death, putrefactive decomposition restores the elements of organic matter back to their states in the inorganic world.

Fourth-That fluids, in or out of the human body, obey the ordinary laws of gravity, when uncontrolled by superior forces or dynamics.

Chloroform, by suspending destructive metamorphosis, arrests the liberation of force, and with the decrease of organic force, the circulation comes under the control of the ordinary laws of gravitation, and settles to the most dependent parts of its circuit in the dying body. Some parts losing blood would appear pale and flabby, while others gaining it would present congestions, &c.

With these fundamental principles for our guidance, Dr. Mobley's inquiries can be satisfactorily answered.

The facts of the boy's case, so far as they concern the present investigation, may be summed up as follows:

First—That he must have been severely shocked by the accident to the limb, rendering amputation necessary.

By shock must be understood a more or less complete suspension of nutrition, or constructive metamorphosis, as well as of oxidation, or destructive metamorphosis. These organic processes of life at the time of deepest depression, are nearly brought to a stand-still. What is called reaction, is a practical resumption of nutrition, with a largely increased waste, or oxidation, the increased waste being more generally manifested by increased temperature of the body, though occasionally by mechanical results in addition, as spasms, convulsions and tetanus.

Second-Chloroform has to be given largely and for a considerable time, to obtain the desired anæsthesia.

ThirdThat in obtaining the requisite degree of anæsthesia, the motor power of the heart and lungs was nearly, if not quite, suspended.

Fourth-That he was resuscitated from impending death, apparently, by placing his head and chest in a dependent position-angle of forty-five degrees, though other means were used.

A careful study of these facts, guided by the propositions hereto

fore laid down, will, it is believed, point to and justify the following conclusions :

First-That from the shock of the accident to the patient, nutrition in his system was very nearly, if not wholly arrrested.

SecondThat oxidation, waste, or destructive metamorphosis, if reaction had been established, was largely increased.

What are called stimulants, as alcohol and malt liquors, opium, &c., simply serve to hold this waste in partial check, while they are used. They do not add anything to the sum of the forces of life, they simply supply conditions to limit molecular transformations, both of nutrition and oxidation, but more notably of oxidation or destructive metamorphosis. Dr. M. does not say anything about his temperature either before, during, or after the operation, but it is well nigh certain that it must have been several degrees above natural, at the time the chlo. roform was given.

With nutrition arrested, and the waste of the body more or less increased, as would have been shown by an increase of temperature, though the waste was probably less in the nerve masses than elsewhere, as would have been shown by the state of the pupil, and the absence of mechanical phenomena, as spasms, and convulsions, the correlation of the waste, was, most likely, increased heat, which always indicates increased waste of tissue.

Third—That the chloroform, did, in fact, suspend the molecular transformations in the nerve masses furnishing the force or dynamics for the working of the heart and lungs.

Though it may never be vouchsafed to material vision to watch with the naked eye, each little molecule or particle of organic matter, break away from its highest state of organization, combining with its beloved oxygen, forming new and simple compounds, simultaneously liberating the dynamics or forces of organic life; yet, as the antecedent and consequent are definitely known, definite conceptions of the mode or modes by which the ends are accomplished, are best obtained by studying matter and force in more elementary states. Conclusions arrived at in this way, have probabilities of truth, and if they explain and harmonize all the facts, conditions and circumstances present, must be so accepted. Mental vision, however, can alone comprehend them.

Fourth-That the diminished motor power of the heart and lungs, owing to the nearly total arrest of oxidation, placed the circulation more and more under the control of the ordinary force of gravitation than it was before the chloroform was given, and as a consequence,

blood arrived at and departed from the brain and nerve masses much more slowly and imperfectly, with less of the destructive as well as life giving oxygen than was necessary to carry on destructive metamorphosis to furnish the requisite force for their functions. Diminished respiration supplied less oxygen, diminished volume of circulation less blood, than was needful for the purposes of life.

Fifth-That by depressing the head and chest of the patient, the blood, obeying the law of gravity, passed to the brain and nerve masses, the then lowest portions of the body, in fuller quantity; and with the increased volume of blood, increased quantity of destructive oxygen: the conditions being supplied, destructive metamorphosis was resumed in the nerve masses, with the result of liberating more force, and with increasing force, the lungs and heart slowly resumed their functions. Dr. Mobley then and there transmuted gravity into organic forcegravity disappearing—organic force reappearing—the correlation of one mode of force into another-with the result of saving his patient's life, for the other means employed, in the absence of the conversion of gravity into organic force, must have surely failed.

This, it seems to me, presents an understandable, and to my mental vision, a most practical explanation of the phenomena attending Dr. Mobley's case of impending death from the inhalation of chloroform, and the rescue of his patient by the depression of his head and chest.




In former times, when the parts played by nature and art in the cure of disease were less definitely known than now, theory led to the administration of many and various drugs in cases of disease, and the post hoc, ergo propter hoc mode of reasoning, so common among physicians, decided upon their curative or non-curative influence, while the respect that attaches to the dicta of the fathers of medicine, lead, in many instances, to an almost universal belief in the remedial action of agents, that are now known to be either without influence, or decidedly harmful, in the conditions in which they were administered.

*Read before the Wayne County Medical Society, April 1, 1869.

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