DEATHS UNDER ANÆSTHETICS.

DEATHS UNDER ANESTHETICS.

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choked with whitebait, and whether he would cause an endeavour to be made to prevent fish from being so sacrificed and the machinery from being blocked. Mr. Campbell Bannerman, in his reply, said that such an accident did occur about six months ago, but since a grating had been placed in the culvert there had been no further damage to machinery or sacrifice of whitebait. We are led to wonder whether the fish were in reality whitebait or the small fry of pure fresh-water fish, amongst which it is not improbable that dace and roach were included. It would be still more interesting to know whether, after all, such an occurrence is not evidence of the unsatisfactory state of the river, for is it not conceivable that the fish which blocked the condensers had only sought refuge in the comparatively pure and distilled water which, we imagine, would be discharged from the arsenal condensers ?2 There is little doubt, however, that the condition of the water in the lower reaches of the Thames has improved considerably during the last few years, and we know of several instances in which pressure has been brought to bear upon the owners of factories situated on the banks of the river who have hitherto exhibited little care to prevent the pollution of the water with works’ refuse. We congratulate the authorities on their vigilance in this matter. Contributing, doubtless, in a still greater degree to the improved condition of the river are the stronger and more satisfactory measures which have of late years been adopted in the treatment and disposal of the sewage at the Barking and Crossness ontfalls. In view,

indeed, of recent complaints there now seems reason to doubt whether the condition of the Thames below bridge is any worse than that above. -

DEATHS UNDER ANÆSTHETICS. A DEATH under an anaesthetic occurred recently in Mr. Lawson Tait’s private hospital in Birmingham under painful circumstances. The patient was a lady who had been under Mr. Tait’s care some ten years before, when she had been successfully operated upon. On the present occasion, having seen Mr. Tait, she was told it was necessary to undergo a slight operation. With this view the lady entered the house and was duly prepared for the operation. A preliminary examination proved her to be in good health, her organs free from disease, with the exception of the local ailment. One hour and a half after admission, Mr. Tait’s assistant commenced to give the patient an anæsthetic composed of one part of chloroform and two parts of ether. Before the patient was her breathing became irregular and spasmodic, while her countenance became cyanosed and her pulse was observed to cease. The anassthetic was at once and artificial stopped, respiration was carried on for forty minutes. No recovery took place. A necropsy seems by the report before us to have revealed congestion (? antemortem) of the vessels of the brain. Death was, according to the pathologist, due to cerebral coma, the result of apoplexy produced by the anaesthetic. This is so unusual a form of fatality that it would be of very great interest to the profession to have a full report of the pathological lesions made public. Haemorrhage into the substance of the brain in persons the subject of arterial disease is reported to have followed the use of ether, especially when the patient has struggled and the ether has caused violent coughing and hence straining. In the present case no arterial or cardiac disease appears to have been present and no especial mention of struggling is made. The mixture employed is one largely used by Mr. Tait, and, as far as we know, has never yet proved fatal. The Vienna mixture is a similar compound, but contains more ether, that body being present in three times the amount of chloroform. We have also received reports of two

fully under,

under chloroform which occurred in one day city of Sydney. In the first case, a single woman, aged twenty-eight, was chloroformed to allow of an operation being performed for the relief of left side empyema. Sh& succumbed before the third stage of anxsthesia was reached, the respiration failing and finally ceasing. Chloroform was given from a mask. The patient was pyrexial, the heart displaced by the effasion, and her general state one of great. gravity. Artificial respiration failed to restore the patient. deaths in the

We are not told whether the fluid was at once liberated upon the dyspnceic state becoming pronounced. The other case is of a far different kind, and one which we venture to think cannot but show, if proof be needed, that

druggists are not sufficiently qualified to practise as dentists, and should not undertake so serious a matter as the removal of twenty-four teeth at one sitting when the patient is under the influence of chloroform. It is the consensus of opinion that nitrous oxide gas should be used in dental practice, and that when that is insufficient the patient should be given a general anaesthetic in her own home under the same rigorous conditions as to dieting, posture, and general precautions as are adopted when a surgical operation is undertaken. The patient, a woman aged twenty-six, went to a druggist’s shop, where a medical practitioner gave her chloroform in the afternoon. She was very timid, and became unconscious in about fifteen minutes. About half an ounce of chloroform was given from a mask, which was taken off the face "every now and then." The patient sat in an inclined chair. During the extraction she screamed, and after twenty-four teeth were pulled out she collapsed and never recovered. She turned very white. The druggist said he often took out as many teeth at one sitting, and had once before had a case when the patient collapsed, but eventually came round. We rely for our information upon the Sydney Herald. Morning -

THE LIVERPOOL SCHOOL OF

MEDICINE.

Liverpool School of Medicine, through the splendid munificence of Mr. George Holt, who has given the sum 05 £ 10,000 for the purpose of endowing a Pathological chair, has made a great stride, and we heartily congratulate the authorities of University College, Liverpool, on the good fortune that has befallen them. The early career of the medical school of the second city in the empire was reviewed in 1872, on the occasion of the opening of the new buildings, by Mr. Mitchell Banks, whose name will always be associated with Liverpool teaching, and his address, from which it will now be opportune to quote, will be found in out columns.1 The school was founded in 1834, by a coalition of private lecturers, and with gradual fluctuations attained by 1872 to a number of students that necessitated the formation of new buildings to carry on the work if it was to be maintained at the level of the increased requirements of medical teaching. The original lecturers were Mr. Batty, Mr. Dawson,Mr. Formby, Mr. Gill, Dr. Malins, Dr. Philp, and Dr. Reynolds, and the first sessions were held in rooms in Back Colquitt-street, belonging to the Royal Institution, whence the original title of the school, the I I Liverpool Royal Institution School of Medicine "was derived. From the beginning the Liverpool School of Medicine was recognised as a teaching body by the University of London, but the Edinburgh College of Surgeons for D time refused their acknowledgment. The school was not well supported by the town at first, and in 1867, when new buildings and increased accommodation were earnestly required, the subscriptions, after much and insistent begging, only amounted to C6000 ; and even this sum would probably not have been forthcoming had it not been for a generous donation of £ 1000 from Mr. Pemberton Heywood. THE

1 THE LANCET, Oct. 19th, 1872.