DELAYED CHLOROFORM POISONING AND ALLIED CONDITIONS.A NOTE ON THE CAUSE OF THE ANATOMIC AND CLINICAL CHANGES OBSERVED.

During the past two years surgeons have been aroused to the importance and frequency of delayed chloroform poisoning, and the literature of the subject has received a number of important additions. This has been so thoroughly discussed in the recent article by Bevan and Favill¹ that it is unnecessary to go into the details of the matter here, beyond mentioning a few of the salient features. The condition rarely results from ether narcosis, but follows chloroform narcosis in probably no insignificant proportion, if we include all the non-fatal intoxications following operations under chloroform. A period of 10 to 150 hours elapses between the time of anesthesia and the appearance of the symptoms, generally between twenty-four and forty-eight hours. The symptoms are those of a profound toxemia, and in the urine are found organic acids and sometimes amido acids (leucin and tyrosin). At autopsy the anatomical changes are striking, most prominent