1147THE USE OF CHLOROFORM IN DENTAL PRACTICE.

1827), and WILLIAM BAKER ; in 1861, JOHN RAYNER

(L.S.A., 1842 ; M.R.C.S. Eng., 1859; L.R.C.P. Edin., 1860 ;

M.R.C.P. Edin., 1864) and EDWARD WESTALL; in 1862,’WILLIAM SHERWIN.

The information as to the sources whence these particularscmight be gleaned was supplied a considerable time ago byMr. S. WAYLAND KERSHAW, M.A., the leained and courteouslibrarian at Lambeth Palace.

Annotations.

ANNUAL REPORT (1894) OF THE MEDICAL OFFICEROF HEALTH OF THE ADMINISTRATIVE

COUNTY OF LONDON.

"Ne quid nimis."

WE have just received a copy of Mr. Shirley Murphy’s thirdannual report as medical officer of health of the administra-tive county of London. The report for 1894 is a substantial,folio volume running to about 170 closely printed pages andplentifully illustrated with charts, diagrams, &c. Relating- as they do to the health and sanitary condition of the

population of the English metropolis, which now numberslittle short of four and a half millions, these reports havecome to possess an importance not inferior to that attachingto the similar publications of the medical staff of the

Local Government Board. The volume before us has

been evidently prepared with the same care that had

’been shown in the compilation of its two predecessors.The subject matter is arranged in two main sections-

the first statistical, the second administrative-and theseare supplemented by a series of appendices, eleven in all,which give to the entire work a completeness that leavesnothing to be desired. In consequence, however, of the

bulkiness of the volume, and the costliness of its illustra-

tions, there is little hope that it will obtain adequate generalcirculation. Having regard to this consideration and to the- great interest attaching to so important a work, at least toLondoners, we have resolved to deal with its several sectionssomewhat in detail, and to review the various points for thebenefit of the readers of THE LANCET in our issues of the’next few weeks.

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THE USE OF CHLOROFORM IN DENTAL PRACTICE.

A DEATH under chloroform which has recently occurred,during the performance of a dental operation serves as asad comment enough upon the correspondence which hasrecently taken place in our columns upon the subject of thejustifiability of using chloroform during the extraction ofteeth. The particulars of the case are as follows. The

patient, a girl aged thirteen, suffered from neuralgia due totwo carious teeth. Her health not being good the removalof the teeth was deferred and her general health attendedto. However, a recurrence of pain occurred and hermedical practitioner deemed it advisable to call in a

local dentist and decided to give the child chloro-form. At the inquest he was asked why he did not

give the girl ether, and his reply is reported to havebeen that he thought that she would stand chloroformbetter. No reason for this assertion is given, nor is

.any mention made of any lung or renal condition beingpresent which would have contra-indicated the employment,-of ether. The patient appears to have dreaded the pain, but

was reassured when she was told that chloroform would

1 THE LANCET, March 21st and 28th, 1896.

spare her all discomfort. The anæsthetic was given from amask" slowly and cautiously. Barely a drachm had beengiven when she was ’under.’"

" The dentist had some diffi-

culty in getting out the first tooth. Although the

patient did not feel anything at first she called out" oh " before the tooth was out and twisted herselfround. At this moment " the pulse was good and shebreathed deeply, the face became red." No more chloro-

form was given. The extraction of the second tooth wasthen attempted. The girl grew white in the face, the pulseimperceptible, and the breathing stopped. The usualrestorative measures failed to restore animation. The

chloroform used was from a good maker and had beensafely used for another patient. The chloroformist statedthat death was due to heart failure, and added "perhapsfright had something to do with it."-In addition to

the above we note that the Times of the 22nd inst. con-tains the following ;-" One of the district coroners of theWest Riding, Major Taylor, has held an inquest at Idle onthe body of Lavinia Sawdon, fourteen, who died while underthe influence of chloroform on Friday afternoon last,administered by Joseph Priestley, herbalist and maker ofartificial teeth.’ The case has since been before the

magistrates. Evidence as to the death of the girl was given.She called at the shop of Priestley to have two teeth drawnand she consented that chloroform should be used. She diedin a chair after a second dose had been administered.

Priestley had no assistance. Dr. R. Honeyburne spoke tothe girl being perfectly healthy, and said a medical manwould never, as a rule, both administer chloroform andextract teeth. The coroner at the inquest directed the juryto consider whether the act of Priestley was a grossly rashact or whether it was a case of misadventure. The jury de-liberated an hour and brought in a verdict of ‘Manslaughter’against Priestley. Before the West Riding magistrates hepleaded Not guilty’ to the charge and reserved his defence.He was committed for trial at the next Leeds Assizes, bailbeing accepted." -

THE FALCON-COURT IMPROVEMENT SCHEME.

THE London County Council, in pursuance of a schemefor the improvement of an insanitary district of

Southwark, propose to sweep away no less than 111 houses inFalcon-court and adjoining courts and alleys. The evidenceof Dr. F. J. Waldo, medical officer of health of the district,as given before the Local Government Board representative,bears out the fact that the destruction of these premises isan undoubted improvement. The Falcon-Court area, said Dr.

Waldo, is hemmed in on the west by lofty model dwellings,on the east by houses lining the Borough High-street,and on the north and south by warehouses. In addition a

manufactory, the Midland Railway Receiving Depot,and other warehouses stand between the parallel courtsand alleys comprised in the unhealthy area. This arrange-ment-an obstructive one-taken in conjunction with anexisting faulty construction and grouping of houses in

the area in question, effectually prevents a due admis-sion of light and air. The dwellings themselves in manycases have no means of obtaining a through ventilation, andin those instances where a backyard is present such yard isusually narrow and insufficient for purposes of ventilation.

The cellars, especially of the back-to-back houses in Falcon-court, often contain the waterclosets, ash-pails, and othersanitary conveniences. They also serve as kitchens and aregenerally used for the washing and drying of clothes as wellas for other purposes. The occupied houses cover togetherone acre, thirty poles-that is to say, rather under one and aquarter acres-and upon that space 822 human beings areconcentrated. The population density for the whole parishof St. George the Martyr is 211 to an acre, as against 5a