RT Journal
A1 Krone CR
T1 NEcrosis of the liver after chloroform anesthesia
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1909
FD June 12
VO LII
IS 24
SP 1940
OP 1940
DO 10.1001/jama.1909.02540500042016
UL http://dx.doi.org/10.1001/jama.1909.02540500042016
AB To the Editor: 
    —May I be permitted to comment on the conclusions reached by Drs. John R. Williams and W. D. Becker in their report of a case of "Necrosis of the Liver After Chloroform Anesthesia," The Journal for May 8, 1909, page 1488? Under title, "Postoperative History," a typical picture of the second stage of acute yellow atrophy of the liver is drawn. These second stage symptoms became rapidly deepened on the third day after operation and chloroform anesthesia, ending in death forty hours after the first indication of any mental disturbance.The history of the case points very clearly to a severe bacterial infection before the operation. We are shown a patient "subject to attacks of 'indigestion' from childhood." Turbid, dark-brown urine, of acid reaction, and showing albumin blood cells and hyalin casts found postmortem can be assumed to have been present four days before death at the