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an occasional exception, be selected without in the slightest degree interfering with the military plans of a commandant; tents and their necessary furniture may be preserved, as a general thing, if proper care is exercised. A disregard of camp police and personal cleanliness is an unjustifiable neglect of the plainest laws of health. In the matter of the supply of food, a system could be adopted which would bring to the camp the best article in market. Cooks should be sent with the army, whose whole duty is to attend to the care and preparation of the food. Finally, the advice of the medical officers should not only be sought on all questions relating to the camp, the food, the clothing, etc., but equally in all movements of the army. If a campaign is to be undertaken the most perfectly projected plans must have the sanction of the chief of the medical staff to insure success. the late war this fact was repeatedly demonstrated. Important campaigns were elaborately arranged by commanding officers, but the medical staff was only consulted as to supplies; the result was failure owing to excessive sickness. To the General medical counsels are as essential to success in planning and executing campaigns as are the maps of the coast survey to the Admiral who is about to attack a hostile seaport town. The former, like the latter, deliberately invites disaster and defeat, when he ignores the guide to success.

In

LVI,

RESPONSIBILITY OF PHYSICIANS.

T

HE question of the responsibility of the physician in the administration of chloroform, or for alleged injuries resulting therefrom, has at length been decided in a Court of Law. The case was tried at Philadelphia before Judge Hare, and a jury, and among the witnesses we notice the names of Professors Gross and Goddard. The evidence in this case and the charge of the Judge have an important bearing upon practice. The plaintiff, Mr. Bogle, was a driver on the horse-cars, and was thrown from his car, striking his head against a tree-box. He was taken up insensible, but so far recovered as to resume his work on the following day. Some three months after the accident, Mr. B. called on Dr. Winslow, a dentist, to have several teeth extracted. Chloroform was administered, and it was found necessary to give it in large quantities, and for three-quarters of an hour, and in the intervals between the drawing of the different teeth, as signs of returning consciousness appeared. The operation completed, Mr. B. left in company with a lady friend, but he staggered like a drunken man, and was obliged to lean on

his companion for assistance. He grew worse after that; his tongue thickened so that his articulation became indistinct, and finally, on the fourth day, he had paralysis of the left side. Dr. Winslow was called, and treated him for this sickness for four weeks, at the end of which time no perceptible relief having been afforded, another physician, Dr. Longshore was employed, under whose treatment he remained until he was able partially to resume his employment. For the loss sustained by him by reason of his sickness and continued inability to attend to his duties the suit was instituted. Dr. Longshore, the principal witness on the part of the prosecution, testified that, after hearing the evidence in the case, he inferred that the chloroform was the cause of the paralysis; never knew chloroform to be given without producing paralysis; that is its purpose; it is not permanent, however; there are cases reported in the books of paralysis of the tongue resulting from the use of chloroform; never heard of a case of paralysis of the side; chloroform might produce paralysis of the side by reason of its effect upon the brain; cerebral hæmorrhage produces paralysis; never heard of a case of cerebral hemorrhage produced by chloroform; the kick of a horse will produce it; does not think it resulted from such a cause in this case; there is no standard for a dose of chloroform; the operator must be governed by the action of the patient; if the effect was not

produced in three-quarters of an hour I would stop the use of the chloroform, as I would be afraid of the consequence; there might have been an injury to the brain, brought into action by the use of chloroform, but if it resulted from injuries received two months before, there would be complaints on the part of the patient. Dr. Harbeson testified that he knew of a case where paralysis was caused by the use of chloroform; a tumor had been removed from the left breast of a patient while under the influence of chloroform, and paralysis ensued; it was considered a dangerous agent, and was, for that reason, not used at the Pennsylvania Hospital; he had known of death resulting from its use. The defence set up was, that Dr. Winslow was a graduate of twenty years' practice, eminently skilled in the use of chloroform, and that no matter how large the quantity used, or its length of application, no such effect as paralysis could result. Besides, it was on evidence that in the preceding January, the plaintiff had been kicked in the breast by one of his horses, hurled over the dasher into the street, and against the curb, his head violently striking a lamp-post, and it was contended that this was more likely to have been the cause of the paralysis. The character of the evidence on the part of the defence may be gathered from the testimony of Professor Gross. He testified that chloroform is regarded by the profession in general as a proper agent to relieve

pain; it is one of the approved remedies of the profession; in the present case he considered the length of time resulted from the want of the proper number of assistants by Dr. Winslow; don't think there is any case on record, except two referred to by Dr. Longshore, that chloroform caused paralysis; these two are cases reported by Dr. Haphold, of South Carolina, and these cases are not authentic; he has given chloroform since 1842, and under almost all circumtances; to a child of six weeks of age, and to a person of seventy-five years of age; he had given it to all classes, and never witnessed any ill effects from it; he did not think that the paralysis in this case was the result of the chloroform; in his judgment it had nothing to do with it. Professor Gross explained the effects of a concussion of the brain in producing paralysis; several months might elapse between the injury and the paralysis; he thought it not unlikely that the patient would complain of headache, etc.; though it did not follow that he would actually complain; if the man had not been kicked by a horse, he would not attribute the paralysis to chloroform from what he knew of its effects; he had given several ounces to patients; in Louisville he gave a man eight ounces, and kept him under its influence for three hours; chloroform, like many other agents which a physician is obliged to use, is dangerous; so is laudanum, etc.; if improperly used it would not produce paraly

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