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—Apropos of a recent discussion in the Paris Académie de Medécine, Prof. Dastre classifies the causes of fatal accidents resulting from the administration of chloroform as follows: Primary syncope, respiratory or cardiac; secondary syncope; toxic apnœa. In the first class death results from the first inhalations (initial shock); this occurs from reflex cardiac syncope in nervous, impressionable individuals weakened by suppuration or hæmorrhages, or in individuals otherwise healthy who suffer from irregularity of the heart's action (in animals with those which exhibit habitual cardiac irregularity, as the dog), or they arise from reflex apnœa under analogous conditions. In the second class (secondary or bulbar syncope) narcotism is more advanced; the heart's action may be arrested suddenly or gradually; the arrest of respiration may be slow and progressive or sudden from tetanic spasm of the glottis. The third class of cases comprises those of fatal intoxication in which the
MEDICAL PROGRESS. JAMA. 1889;XIII(16):559–560. doi:10.1001/jama.1889.02401120017002
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