As to the heart, its condition is invariable. Death begins at the heart, and yet this organ continues to act after respiration has ceased; but it is only a feeble action of the right side, and there is no pulsation in the arteries, even in the aorta, so that the cardiac contraction is altogether inefficient. The right cavities of the heart are uniformly filled with blood, the left contracted and empty. The arteries also are empty, or exhibit but a slender line of blood. On exposure after death, if in less than half an hour, an active motion of the right auricle and ventricle takes Poisoning through the Stomach. Cases of poisoning from chloroform taken into the stomach are not frequent. I have examined the records of ten which have occurred since the medicine came into use; and the following is a summary of the symptoms. The first effects are those resulting from the irritant impression on the stomach, a sensation of severe burning and pain in the epigastrium, with efforts to vomit, sometimes successful, but generally ineffectual. in a very short time the brain becomes affected. in some instances the patient exhibits signs of exhilaration in brightness of the eye, and attempts at singing; and, in one case, there was even dancing; but in general nothing of this kind has been noticed, and the first observable symptom of a cerebral character has been stupor, which has usually come on at a period of time varying from five to fifteen or twenty minutes from the taking of the poison. The comatose condition is profound, so that the patient cannot be roused, and is quite insensible to painful impressions. The pupil at this stage is generally contracted and insensible to light, and the eyes fixed. The pulse and respiration are little affected as to frequency, and, though the breathing is sometimes stertorous, the face retains its ordinary colour, or is but slightly flushed. But in a short time decided symptoms of depression appear; the pulse becoming slower and feebler, the respiration slower, the surface cooler, the pupils usually dilated, and the face of a purplish or livid hue. in two or three hours the prostration is extreme; the respiration being very slow or quite suspended, the pulse scarcely if at all perceptible at the wrist, the extremities cold, and the face and neck of a deep purple; and, unless life be sustained by artificial means, or the quantity of the poison has been insufficient to produce death by its depressing influence, the patient perishes. in most, however, of the recorded instances, the system has reacted either spontaneously or through the means applied. Consciousness usually returns in about six hours, more or less, and, under favourable circumstances, the patient returns to health without serious inconvenience. The breath throughout usually smells strongly of chloroform. But in general there place, which may continue for an hour, at a temperature between 60° and 80° F.; but there is not the least propulsive power.

The lungs are never congested, after death purely from chloroform, owing to the primary action on the heart.

The brain and nervous centres present no serious organic injury. Dr. Richardson has seen venous congestion of the vessels, but never, even after prolonged death, effusion or rupture.

The liver is usually a little congested; the spleen more so; the kidneys scarcely affected. in many cases, there is some redness of the gastric mucous membrane, owing, as the doctor believes, to the elimination of the chlorine by this emunctory. Hence, too, the vomiting after inhalation. (B. and F. Medico-chir. Rev., April, 1863, p. 484.) - Note to the third edition.

are other dangers to encounter. in consequence of the violently irritating properties of the chloroform locally, if the stomach happens to be empty at the time, severe inflammation ensues; and, after recovering from the stupor, the patient is attacked with burning pain in the stomach, vomiting and sometimes purging, and other symptoms of gastritis, which may or may not terminate favourably. Out of ten cases of poisoning from the internal use of chloroform, one terminated fatally from prostration in the third hour; one from the same cause in six hours, the remedies employed having probably retarded the result; a third after nine hours, in which death was ascribed to excessive reaction in the brain; and four others from gastric inflammation after reaction, one at the end of at least thirty-one hours, a second in thirty-six hours, a third in forty-eight hours, and the fourth on the eighth day. in a doubtful instance, not included in the above number, death took place in thirty-four hours, with excessive vomiting and violent dyspnoea, the effects apparently of severe gastritis and intense pulmonary congestion; but, as the patient was previously in bad health, and was intoxicated with ardent spirit at the time of taking the chloroform, it is impossible to determine in what degree the result was ascribable to the latter poison. in this instance, the lungs were found after death so much congested that they did not collapse; and it is highly probable that they were diseased before the chloroform was taken. in the three remaining cases, the patients recovered; but one of these only after the use of active stimulation, and of galvanism to sustain artificial respiration. One of the fatal cases was that of a child four years old, who had swallowed about two drachms of the poison;* a second was that of an adult who had taken an ounce and a half;"]" in a third death resulted from two fluidounces;++ and in a fourth six ounces were supposed to have been taken;§ but in the last two cases, the patients surmounted the immediate effect, and died of the subsequent gastritis. in the remaining fatal cases, one died from an ounce and a half;|| another from four ounces; ^[ and in the third the quantity was unknown.** in two of the cases from which recovery took place, the patient had swallowed two ounces; # in a third only an ounce.~~ After death in the stage of reaction, the prominent anatomical characters are reddening, thickening, softening, and even erosion and ulceration of the mucous membrane of the stomach. The brain when examined has generally been found in its natural condition; but the membranes are sometimes congested. The lungs are often congested, and, in one of the instances reported, were greatly so, with effusion of blood in small patches like pulmonary apoplexy. (See Am. Journ. of Med. Sci., Oct. 1866, p. 511.) From what has been said above, it appears that the chief danger of over-doses of chloroform by the stomach is that of gastric erosion and inflammation; and that, though the medicine is capable of producing death from its immediate depressing effect, yet this result need not be apprehended from any ordinary remedial dose.