Imatges de pàgina
PDF
EPUB

that may be re-enforced and something that may be added. I would specially re-enforce the points relating to the immediately rapid administration of chloroform and the danger of that practice.

I.

I have closely observed the condition of persons who are most susceptible to danger, and have pointed out several times that there is a large number of persons who may be designated the morituri, persons ready to die at any moment from very slight disturbing causes affecting their nervous balance and nervous organisation. To proceed to administer to these the vapour of chloroform hastily is to cause a sudden reflex easily made fatal. By some curious forecast, which many call fear, and which, in fact, is a natural fear and hesitation, the morituri are often, without reason as it seems to the bystander, conscious, as by a premonition, of facing a danger that may prove fatal. In several instances they have expressed this alarm, and in one painful case with which I am acquainted the patient, who to the very last opposed administration, was in the end overpersuaded to commence inhalation, and was dead before a drachm of the narcotic had been inhaled, the " sharpness" of the vapour appearing to excite a spasm of the chest under which the heart ceased to beat. This was a death from syncope of the lesser circulation, syncope caused partly by nervous fear and partly by nervous reflex and shock.

II.

It is right to repeat the cause of the danger arising from morbid feebleness of, or mechanical difficulty in, the heart. It will be recalled that I found, by experiment, how practically difficult it is to stop the action of the

heart of a healthy and strong animal before the respiration has completely stopped, and that the heart will go on beating under chloroform after the respiration has completely ceased. It was in such cases as these I succeeded so readily in restoring to life, by artificial respiration, animals that were, to all appearance, actually dead. From such observations an inference has been drawn that death under chloroform cannot be induced by a direct effect upon the heart. The error is distinct, and is committed with little consideration. A healthy heart cannot be killed directly by chloroform. So much may be granted. In proper language of thought, a healthy heart cannot receive through the lungs sufficient chloroform to kill it when it is in its full activity. But a feeble heart, or a mechanically obstructed heart, or a heart enervated, irregular in its motion, or tremulous from anxiety or fear, is in quite a different condition. A very small amount of chloroform entering into such a heart may be sufficient to stop its beat, or a very slight obstruction to its pulmonary current of blood may be sufficient to paralyse the right side and to break a column of blood which, once broken, is probably never reunited. The pulmonary circuit of vessels left for a few seconds empty of blood is filled with gaseous matter, against which even an active contraction of the right ventricle has no power to force on a charge of blood. I found this to be the fact in the dead animal immediately after death; I failed to drive over a column of fluid by the pressure of the syringe at a degree much more decisive than could ever be expected from the contraction of the right ventricle. The pulmonary artery, with the nozzle of the syringe through its orifice and firmly tied, would expand under the pressure largely, and during the expansion, however gently induced,

would sometimes rupture; but no pressure would force the fluid, without injury, over the pulmonic circuit from the right into the left heart when once the continuous stream was broken.

III.

It is well to re-enforce the lesson of the risk of prolonging the administration of chloroform, after the dangers of the first degree are over, so as to lead to storage of chloroform in the tissues with after-reabsorption of it into the circulation from the various organs in which it is retained. Chloroform in vapour condenses in the blood, and so condensed is excreted into the permeable tissues, the alimentary canal, and the cellular structure generally. There is no evidence that it undergoes any elementary decomposition within the body; consequently when it is stored up largely it continues to act after it ceases to be required. Hence the cause of danger in those whose tissues are diseased, and the danger of long-continued administration after the immediate risk of breach of continuity in the circulation, incident to the first stage, has been safely passed.

THE PHYSIOLOGY OF DREAMS.*

"We are such stuff

As dreams are made of, and our little life
Is rounded with a sleep."

F we take the word "stuff" as meaning our bodies living and moving in what we consider the activity of consciousness, and if we consider sleep as resembling the infinite repose of the space through which we are being carried by the planet, then truly the great poet is right to the letter. Every one of us is dreaming now. Between that which we are now doing and that which we are doing when we are said to dream in sleep there is this simple difference only, if it be a difference, that in the present or wakeful state the will directs or moves with the phantasy, and that in the dream of sleep the will is passive, neither suggesting nor directing the course of the story.

There is a romance about dreams in sleep; and whoever-poet, novelist, historian, philosopher-would investigate the influence of dreams of sleep on dreams of wakefulness would find subject matter for a life of labour. Some of the mightiest events in the whole of human life, some of the most persistent, have had their origin in the shortest of involuntary, sleeping dreams. Lecture delivered at the Royal Institution of Great Britain, April 29th, 1892.

VOL. IX.

9

Men do not seem to will dreams; dreams come without will, that is to say without being willed consciously, therefore they are dreams; but having come, they do not necessarily pass away when the conscious will returns into activity. Some dreams do-and this is fortunatebut all do not, and it is because some come without being summoned and remain afterwards that they are a mystery. For this reason they were ghostly messengers to the larger part of mankind in days of simple life, when science had no presence nor explanatory reason. Why should dreams come if they are neither wanted, expected, nor called? They must be provoked by messengers unseen and to the world at large unknown. Little wonder that they should have played their marvellous parts, and that, to fervid natures, immortal spirits, gods themselves, should have, as it has been assumed, spoken to men in dreams, when gods and spirits, formulated by the minds of men, were accepted as firmly by belief as if they were veritable fact; as if believing and knowing were one and the same thing, which practically they are in an immense number of matters, even in a modern community that boasts the possession of the Royal Institution itself!

Great men, as well as little, have put their interpretations on dreams according to their cherished beliefs. Hannibal the mighty, with his one eye, wished to steal -I am bound in honesty to use the unvarnished term "wished to steal"-from one of the temples of Juno a pillar of gold which he had drilled into and found to be the metal unalloyed. Thereupon Juno appeared to Hannibal in a dream, and like a virago-she had the credit of being of that stamp even to Jupiter-threatened Hannibal that if he dared to take away the pillar of gold from her temple she would have her reprisal;

« AnteriorContinua »