Chloroform

“ There is nothing peculiar in the effects of chloroform on people advanced in years, except that its influence subsides rather slowly, on account of the slower breathing and circulation. I have given chloroform to many patients over 50seventy-five years of age, and to one as old as ninety years.
Strength or Debility. The comparative strength or debility of the patient has considerable influence on the way in which chloroform acts. ”

“ Allow the chloroform to subside, withdraw the water, and repeat the washing with the rest of the distilled water, in successive quantities of 3 oz. at a time. Agitate the washed chloroform for five minutes in a bottle with equal volume of sulphuric acid, allow the mixture to settle, and transfer the upper stratum of liquid to a flask, containing the chloride of calcium, mixed with 1⁄2 oz. of slaked lime, which should be perfectly dry. Mix well by agitation. After the lapse of an hour connect the flask with a Liebig condenser, and distil over the pure chloroform by means of a water bath. ”

“ MODE OF ADMINISTERING CHLOROFORM. The experiments previously related show that air containing rather less than two grains of chloroform, in one hundred cubic inches, is capable of causing a state of insensibility, sufficiently deep for surgical operations; but in a creature the size of the human being, an inconvenient length of time would be occupied in causing insensibility with vapour so much diluted. ”

“ The determination of the kind of labours in which chloroform should be used, or withheld, is really a matter of not much importance, because, as we pass from cases that are severe and 320protracted to those which are short and easy, the quantity of chloroform that is used, and the amount of diminution of the common sensibility, and of interference with the mental functions, become so trifling, that very little remains about which to hold a discussion. ”

“ Thomson, [38] and it is still used in medicine under that name. About the same time, M. Soubeiran distilled together the above ingredients in France, and analysed the chloroform which he obtained. His analysis, which was incorrect, led him to name the liquid bichloric ether. [39] In 1832, Liebig examined the liquid which has been since named chloroform, but as he failed to detect the hydrogen which it contains, he called the liquid chloride of carbon, [40] a name which its alcoholic solution occasionally bore afterwards when used as a medicine. In 1831, Dumas examined this liquid. ”

“ In giving chloroform freely to animals from a napkin or sponge, whilst the ear or the hand was applied over the heart, I have usually found that its pulsations became embarrassed and enfeebled before they ceased; and by withdrawing the chloroform when the heart’s action first became affected, the life of the animal could often be saved.
The importance of attending to the respiration of the patient has been previously noticed, and it is so obvious a symptom that it can hardly be disregarded, if anyone is watching the patient ”

“ Half fill a wide-mouthed bottle with [Pg 118] chloroform. On the surface of the chloroform float a layer of absolute alcohol about five to ten millimetres in depth. Place the pieces of tissue in the layer of alcohol and when they have sunk through this layer, transfer them to pure chloroform for from six to twenty-four hours according to the size of the pieces. When "cleared," the tissue becomes more or less transparent.
6. Infiltration. Place the cleared tissues in fresh chloroform with several pieces of paraffin wax and stand in a warm place, such as on the top of the warm incubator. ”

“ Chloroform.—When chloroform is saturated with fluorine, and subsequently boiled, carbon tetrafluoride, hydrofluoric acid and chlorine are evolved. If a drop of chloroform is agitated in a glass tube with excess of fluorine, a violent explosion suddenly occurs, accompanied by a flash of flame, and the tube is shattered to pieces. The reaction is very lively when fluorine is evolved in the midst of a quantity of chloroform, a persistent flame burns beneath the surface of the liquid, carbon is deposited, and fluorides of hydrogen and carbon are evolved together with chlorine. ”

“ The medicines in use for the prevention of severe pain, are always inhaled at the ordinary temperature.
27 CHLOROFORM. History and Composition. Chloroform was first made in 1831 by two chemists who operated independently of each other. The liquid, which is formed by the union of equal volumes of chlorine and olefiant gas, and which is usually called Dutch liquid, was named chloric ether by Dr. Thos. ”

“ The chloroform, which is now free from alcohol and contains all the fusel oil, is treated with a solution of 5 grammes of potassium bichromate in 30 grammes of water and 2 grammes of sulphuric acid, and then heated in a closed flask for six hours on a water bath at 85°. The contents of the flask are then distilled, the distillate saturated with barium carbonate, and the chloroform distilled; the residue is evaporated to a small volume, the excess of barium carbonate filtered off, and the filtrate evaporated to dryness and weighed. ”

“ The different effects that have been produced on the same patient at different times, and the great number of instances in which medical men have failed to make the patient insensible, show that most of the usual modes of exhibiting chloroform are extremely uncertain. ”

“ These latter compounds are not only the most objectionable and prejudicial of the impurities found in chloroform, but if present in it to any appreciable extent, they render its anæsthetic administration not only inefficient, but frequently absolutely dangerous. These deleterious chlorinated oily compounds may be removed by agitation with strong sulphuric acid, or by distillation from it. Chloroform made from wood spirit is said to be more impure than that from alcohol. When pure it is free from colour, and of a pleasant odour. ”

“ Detection of chloroform.—An adulteration with chloroform, if moderate, cannot always be detected by the odor and taste. In most cases, chloroform will considerably increase the specific gravity of the oil. Bring into a test-tube 15 drops of the suspected oil, 45 to 90 drops of alcohol, and 30 to 40 drops of dilute sulphuric acid. After thorough shaking, add 2 or 3 shavings of zinc sheet and heat until a vigorous evolution of hydrogen takes place. After again shaking, set the whole aside, and heat again when the evolution of gas becomes weaker. ”

“ As first obtained, the crystals of the symmetrical chloride resemble irregularly shaped pieces of amber, both in color, and in lustre. On recrystallization from chloroform or ether, they may be obtained perfectly colorless, and are often of very simple crystallographic form. The chloride crystallizes in the monoclinic system, and possesses a very remarkable crystallizing power, in which respect it differs noticeably form its isomer. Even in chloroform solution that is far from dry, crystals appear with the greatest ease. ”

“ I have not yet been able to determine satisfactorily the exact proportion of chloroform which requires to be absorbed to arrest the respiration of animals of warm blood. I believe there is a definite proportion which has this effect, but there are two reasons why it is not so easy to ascertain it, as to ascertain the proportion which causes the minor degrees of narcotism. 70In the first place, the breathing often becomes very feeble before it ceases, so that the animal inhales and absorbs but very little chloroform, and remains on the brink of dying for some time. ”

“ FATAL CASES OF INHALATION OF CHLOROFORM. If it were possible for a medical man to mistake or disregard the symptoms of approaching danger, and to go on exhibiting vapour of chloroform, diluted to a proper strength, till the death of the patient, this event would take place slowly and gradually, as in Experiment 23, related above, 121and every other experiment in which the air did not contain more than five per cent. of vapour. The action of the heart would survive the respiration ”

“ Air, when saturated only at 60° Fah., contains 12 per cent. of vapour of chloroform, and at 70° 19 per cent. (p. 33) ; and 8 or 10 per cent. in the inspired air is capable, as we have seen, of causing sudden death by paralysing the heart; but in practice the air is usually far from being saturated, in passing over a handkerchief or similar material, even at the temperature at which it is inhaled; and this is generally lowered considerably by the absorption of caloric by the chloroform, as it changes its condition from a liquid to a vapour. ”

“ Once, he observed that in his opinion sulphuric ether was a safer narcotic than chloroform. Why, then, said a listener, do you not use ether? I use chloroform, he resumed, for the same reason that you use phosphorus matches instead of the tinder box. An occasional risk never stands in the way of ready applicability. On another occasion, after one of the meetings of the “Medical Society,” when the subject of a specific cholera cell had been under debate, some one asked him, as a poser and rather ironically, where he thought the first cholera cell came from? ”

“ Solly’s patient is not at all inconsistent with death from spasm of the glottis arising from this cause. If, however, the patient died from the vapour of chloroform, we must conclude that he inhaled it at one moment not sufficiently diluted with air.
The chloroform in this case was administered by a non-medical person—a sort of surgery-man. After this accident, however, the chloroform in St. Thomas’s Hospital was always entrusted to some one belonging to the profession. ”

“ The method employed was to bring the chloride and an excess of aniline—somewhat more than four molecules—together in chloroform solution. The flask was then boiled for about an hour, when the chloroform was distilled off. During the boiling as well as the distillation more or less bumping occurs in consequence of the aniline hydrochloride which separates, and constant shaking of the flask is sometimes necessary. The residue which is in a thick, gummy condition in consequence of the presence of an excess of aniline, was digested with water acidulated with hydrochloric acid. ”

“ It is best to add a tube, bent at right angles and going to the bottom of the flask, to draw air continuously through the apparatus. During the whole process, the tube containing the lime is kept at a red heat. The chloroform is decomposed, and the chlorine combines with the lime. The resulting calcic chloride, mixed with much unchanged lime, is, at the end of the operation, cooled, dissolved in dilute nitric acid, and precipitated with silver nitrate. Any silver chloride is collected and weighed and calculated into chloroform. ”

“ The ultimate and greatest effect that chloroform is capable of producing on the animal body is to destroy the irritability of the muscles, and produce the post-mortem rigidity. Either the whole body or a single limb can be rendered instantly rigid by injecting the arteries with a little chloroform shaken up with water. The rigidity remains for weeks in the dead body, and would probably be permanent if the chloroform were prevented from evaporating. ”

“ The results obtained in these experiments were entirely due to the degree of dilution of the vapour; for the quantity of chloroform employed was, in every instance, more than would have killed the animal in a much shorter time than the experiment lasted, if it had been conducted in a smaller jar. It is assumed that the proportions of vapour and air remain unaltered during the experiment; for the quantity absorbed must be limited to what the animal can breathe in the time, which is so small a part of the whole that it may be disregarded. ”

“ It is consequently one of the most volatile liquids employed in medicine, with the exception of sulphuric ether and amylene.
The Vapour of Chloroform is more than four times as heavy as atmospheric air. It has a specific gravity of 4·2 at 60° Fah. Under ordinary circumstances, the vapour of chloroform has of course no separate existence, but is always mixed with air. It can exist in a pure state only when the temperature is raised to 140° or upwards ”

“ However this may be, it is pretty certain that the blood generally remains fluid in the human body after death from chloroform, only because it usually remains fluid in every kind of sudden death. When a patient dies slowly of illness, the body cools gradually before death takes place, and ammonia keeps exhaling in the breath, if Dr. Richardson is correct, whilst the formation of this alkali must be almost suspended. In many cases, we know that coagulation of the blood commences before the respiration and circulation have ceased. ”

“ On the day of the accident, he was first rendered insensible in the ward by chloroform poured on a piece of lint which was held a short distance from the nose and mouth. Having partially recovered during his removal into the operating theatre, the chloroform was reapplied, and Mr. Allan relates what occurred as follows: “About half a drachm of chloroform was now poured on some lint, which was held to the nostrils, and he then became fully under the influence; respirations good; pulse frequent, feeble. ”

“ They are generally cheerful and exhilarated by it, and are less liable to be depressed by its prolonged use, than those who come quietly under its influence. Although the patients who struggle bear the chloroform well, when it is carefully and judiciously administered, it is not improbable that the struggling has been now and then an indirect cause of accident. The muscular spasm and rigidity do not occur till about three-quarters as much chloroform has been absorbed as can be present in the system with safety ”