UNFORTUNATE OCCURRENCE. A Patient Dies Under Chloroform.

Te Aroha News, Volume I, Issue 43, 29 March 1884, Page 6

UNFORTUNATE OCCURRENCE. A Patient Dies Under Chloroform.

(From the Auckland " Star," March 22.) It is our mournful duty to record the death of Mr James Mulholland, chief clerk at the local Deeds and Stamp Office, which occurred last evening at his residence in Pitt-street, under circumstances of a peculiarly distressing and sudden character. The facts so far as we have been able to ascertain, are as follows : — Deceased had been at his office up to Monday last, though suffering from paraphymosis, a common and by no means dangerous disease of the urinary organs. The complaint did not occasion him much pain, but created so much discomfort that on Monday he decided to lay up. His medical attendant was Dr. Dawson, but owing to the absence of that gentleman from Auckland, Dr. Stalker, who is temporarily acting as Dr. Dawson's locum tencns. was summoned to attend him. Dr. Stalker first saw his patient on Thursday last, and appears to have had no previous knowledge of the general state of Mulholland's health, or of his mode of life. Prior to Dr. Stalker being summoned, endeavours had been made to treat the complaint by means of external applications, but none of the deceased's friends had up to yesterday had any idea that a surgical operation would be necessary. Mr W. E. Bennett, a friend of the deceased's, who visited him on Wednesday last, states that had he known that an operation would be necessary he would have objected to the use of chloroform, for the reason that he was aware that some time previously Dr. Haines had informed the deceased that his constitution was completely broken up. Mr Bennett also states that Mulholland's lungs were seriously affected, and he would have regarded the use of chloroform as dangerous in the highest degree. It had been arranged between the deceased and the doctor that the operation should be peformed at 5.30 last evening. Shortly before the arrival of the doctor, Mr Hughes, clerk in the Deeds Office, and an acquaintance of the deceased, dropped in casually to inquire concerning his health, at Mulholland's earnest solicitation. Mr Hughes was prevailed upon to be present during the operation. Dr. Stalker arrived at the hour appointed, and accompanied by Mrs Mulholland, went into the bedroom where deceased was, the doctor requesting Mr Hughes to remain in the kitchen. As soon as Mrs Mulholland heard that chloroform was to be administered, a feeling came over her that her husband could not stand the administration of the anaesthetic — indeed, she states that she had previously made the same remark to Mr Hughes, adding that he was not a robust man. After the doctor and Mrs Mulholland had gone into the room, the former proceeded to examine the deceased by means of the stethescope, and also felt his pulse. Having satisfied himself by these means'that the chloroform could be administered safely, he requested Mrs Mulholland to retire. The deceased, however expressed an urgent wish that Mr Hughes should be present during the operation, and, tapping on the wall, that gentleman came in. The doctor then administered the chloriform, and proceeded with the operation, which it was expected would occupy about five minutes. After Mulholland had been under the influence of the anaesthetic for about two minutes, animation was suspended. The doctor at once used the customary methods to cause a return of suspended respiration, but to no purpose, and then despatched Mr Hughes, in his buggy, for Dr. Richardson. Mis Mulholland who observed Mr Hughes's sudden exit suspected that something was wrong and encountered Dr. Stalker at the bedroom door. In answer to her anxiousenquiry he saii " Oh, my God ! I'm so sorry. I think he's gone." Dr Richardson then returned with Mr Hughes, and the latter being informed that his services would not be further required went home. The two doctors used every effort to fan the vital spark, a galvanic battery being amongst the means used, but all to no purpose. Dr. Stalker then left the house and proceeded to the Police Station and informed the police authorities of the sad occurrence.

The Police Report. The police report on the ocourrence is as follows: —At 6.20 p.m. yesterday. Dr. Stalker, who resides in Burleigh -street, reported at the Police Station that a patient named James Mulholland had died under chloroform at his residence, Upper Pittstreet. The doctor further stated that he was attending Dr. Dawson's patients in his temporary absence. The deceased was one of these patients and was suffering from a complaint, in connection with which he requested to perform an operation. For that purpose he administered chloroform. The operation took about five minutes, and about two minutes after the deceased expired. The doctor tried the usual means to restore respiration but without success. He then sent for Dr. Richardson, who came and assisted, but all their efforts were fruitless. Dr. Stalker then came and reported the matter to the police. When the constable arrived he found the deceased lying on the bed on his back, the hands and feet cold. The body was covered with bed clothes, and lying partly across the bed.

Mrs Mulholland's Statement. Mrs Mulholland states that her husband had been in bed since Monday last. That he was of very delicate constitution, but with the exception of the complaint treated — paraphymosis— he was in the usual health. The deceased had not told her that he was to undergo an operation.

Statement of a Friend of the Deceased. Mr W. E. Bennett, chief clerk in the City Council, who was on terms of the greatest intimacy with the late Mr Mulholland and visited him on Wednesday last, states that some time ago Dr. Haines examined the deceased, and informed him that his constitution was quite broken up. The deceased tried several times to get a policy on his life, but has failed to pass the doctor. On one occasion, a few mon hs ago, a Government insurance proposal for £1,000 had been filled up and the deceased passed the local medical officer, but the proposal was declined by Wellington. Mr Bennett further states that had he been present during the operation he would most certainly have objected to the use of the anaesthetic, knowing the poor state of Mulholland's health. Mr Bennett called at the residence at about 7.30 last evening for the purpose of paying deceased a friendly visit, and was very much shocked on finding that the uniortunate man was dead.

Dr. Stalker "Was seen this afternoon before the inquest, but he somewhat curtly declined to answer any question. He declined to answer a question as to whether the chloroform had been administered at the request of the deceased. It has leaked out, however, that at the time of the doctor's visit for the puroose of performing the operation, Mulholland was suffering considerable pain, and could not bear to have the part touched.

Other Particulars. The deceased was 33 years of age, and leaves a widow and four young children — thr eldest but four years of age — to mourn his loss. They are, we understand, totally unprovided for. Mr Mulholland has been for fifteen years in the Stamps Department, and though rather a free-living man, was regarded as a conscientous and efficient officer. He was appointed to the position by Sir Julius Vogei, who entertained warm feelings of friendship for the deceased's father, who was for some time editor of the Otago Daily Times, and had made more than a colonial reputation for literary attainments. He was the author of a number of plays. The " Ides of March " seem'to have been as fatal to the Mulholland family as to Julius Cresar, as, besides the late Mr James Mulholland, his father and mother both died in the month.

Coroner's Inquest.— Verdict Exonerating the Doctor. An inquiry into tho circumstances attending the death of the late James Mulholland was held this (Saturday) afternoon at the Naval and Family Hotel, Karangahape Road, before Dr. Philson (Coroner) and a jury, of whom Mr W. P. Hargrave was chosen foreman. Mr T. Cotter, solicitor, was present on behalf of the relatives, and Drs. Richardson, Stockwell, and Kenderdine were present, besides Dr. Stalker, who had administered chloroform to the deceased. Dr Stalker now deposed. lam a duly qualified medical practitioner. I was called to attend deceased on Thursday last, at a quarter past two. I visited him at his house in Upper Pitt-street, and found him suffering from paraphimosis. On that afternoon I ordered a purgative of Epsom salts and hot fomentations, in the hope of thereby reducing the inflammation. I was informed that this condition had existed from the beginning of the week. I visited him yesterday (Friday), at 5 p.m. I found the ulceration sloughing, and inflammation was worse. I thereupon informed the patient that it would be necessary for me to operate. He then requested me to give him chloroform. I said, yes ; I had brought some with me for the purpose. He then rapped on the table for his wife to come, which she immediately did. There was a man in the room named Hughes, whom I requested to remain to assist me. Mrs Mulholland remarked that the patient was delicate, whereupon I sounded his heart with a stethescope, and found no evidence of disease. I then asked Mrs Mulholland to bring me towels, which she brought, and cold water ; I also asked for a sponge, but I did not get it. Mrs Mulholland then withdrew, and I proceeded to administer chloroform. This I did alone, because I believed the operation was so trifling as not to require professional assistance, as I had frequently seen it done elsewhere. I administered the chloroform on a handkerchief, following the Edinburgh school. I poured a small quantity on the handkerchiel. I did not measure it, but estimated it at half a drachm. The handkerchief was kept well away from the patient's face to dilute it with air. Mr Hughes stood behind me ready to hold his hands. Afrer about two minutes the patient, who had hifchei'to been quiet, began to enter the second stage of inhalation, and became excited. During all the time I kept my finger on the conjunctiva of the eye, so that I might know when reflex action -was abolished and the patient fairly under the influence of the chloroform. This took place in about five minutes. I found it necessary to repeat the chloroform twice, making in all, I should think, three drachms, but I did not measure the quantity. Insensibility took place within five minutes. I then removed the handkerchief, and at this time the patient was breathing regularly and mildly stertorous. I then proceeded with the operation, and accomplished it successfully. The patient continued to breathe regularly for about a minute after the operati 'i was over, and then the breathing si' lenly ceased. I immediately commenced arti icialrespi' ation afterSylvester'smethod. I did not feel the pulse at this time ; I was too anxious about the artificial respiration. At the same time I begged Mr Hughes to throw open the window, which was done ; and to bring me some cold water, which was dashed on the face and chest. The patient gave two deep sighs ?t intervals of I should think a minute and a-half, whilst I during the whole time carried on the artificial respiration. I requested Mr Hughes at the same time to go for Dr. Richardson, who arrived in a few minutes. Dr. Richardson relieved me of the artificia 1 respiration, by substituting Marshall Hall's method, whilst I drew forward the tongue, and dashed Mater on the face. Dr. Richardson continued the artificial respiration for twenty minutes, but no sign of life was perceived. Dr. Richardson next went for Dr. Hooper, who applied the galvanic battery, but without avail. I informed Mrs Mulholland of the result, and proceeded at once to giveinformation to the police. I may say, in addition, that the patient's previous history was previously unknown to me. I did not consider him a delicate-looking man. I did not detect any signs of heart disease. He had no cough. I do not know whether he was subject to chest disease. I was unaware at the time, but I have since learned that he was an extremely intemperate man. There was no sign of delirium tremens about him. I have been informed since that he has frequently had delirium tremens. It was at his own special request that I administered chloroform ; not at my suggestion. But I thought it advisable that chloroform should be given, because the patient felt the pain so acutely, and I could not perform the operation otherwise. I could not examine the parts properly on account of the pain produced. Had I known that the patient's habits were intemperate, and that he had been subject to delirium tremens, I would not have given the chloroform. He was not convulsed. The case did not appear to me require the attendance of a second practitioner. I have often given chloroform by myself. It is not at all unusual at Home for practitioners to administer chloroform by themselves. They do not always require a second practitioner for miner operations. lam not able to account for fatal result in this case. I believe the 'fatal results on the administration of chloroform to be one in three thousand. By Mr Cotter : I am 29 years of age, and before practising in Auckland I had made two voyages as a ship surgeon. I had feneral practice in Edinburgh as a student, was also in the Stirling District Asylum. I had no general practice as a surgeon before coming to Auckland. I arrived here January 19th last, and was registered on March 4th in the colony. I began practice here five weeks ago. I have been in charge of Dr. Dawson's practice since Wednesday last. The deceased was one of Dr. Dawson's patients — not one of my own. Dr. Dawson , never mentioned Mr Mulholland to me. I visited him in conformity with a request forwarded to Dr. Dawson's surgery on Thursday. I visited the deceased on Thursday and on Friday, but did not make up my mind to perform an operation till the Friday. I had brought the chloroform with me on the Friday, but did not mention it until deceased asked for it. It is not the usual custom to inquire into the patient's previous history before administering chloroform. I did not do so on this occasion, but examined the heart first. It is usual to

give chloroform without making inquiries — as in the case of accidents brought suddenly into an hospital, I did not question the wife or Mr Hughes as to whether the deceased had been of intemperate habits. The deceased did not seem to be a delicate man. Excepting the disease from which he was suffering, there was no indication that the deceased was not a man who had been careless of himself. I esteemed the operation necessary to save the parts affected trom furtner destruction. It is a common practise of medical practitioners to administer chloroform witdout another medical man being present. When one can get such assistance it is better to have it. It is not always customary to make inqniries regarding the patient's state of health, but it is usual. Frederick Hughes, clerk in the Deeds Office, gave evidence concerning his acquaintanco with decoascd. and aftor narrating the circumstances that led up to his presence at the time of the death, proceeded :-- After the performance of the operation, the doctor asked me to open the window. I tried to do so, but could not from the inside. Mis Mv\holland opened it from the verandah. 1 had no idea that there was anything amiss. I then procured some wator for tho doctor, which was thrown on deceased's face. At the doctor's request I went for Dr. Kichardson, and returned to deceased's houso with that gentleman. I saw tho deceased, but could not say if he was alivo then. Dr. Stalker then told me that I might leave, which I did. Did not hear the deceased ask Stalker to give him chloroform, nor did I hear Dr. Stalker propose to administer it. I did not know that it was to be administered till tho last moment. I did not know that deceased was dead till thib morning. So far as lam personally aware, deceased was sober and steady. I think that the doctor said ho thought Mulholland was dead. I never saw Mulholland the worse of liquor ; had no knowledge of his habits. Mrs Mulholland, wife of the deceased, who was visibly affected, deposed : My late husband's ago was 33. Ho was not a healthy man —he always had a dry cough, His habits were not always sober and steady. He was never affected with delirium tremens. He was taken seriously ill on Monday last, and took to his bed. Dr. Dawson hod been attending him previously, and told me to send for Dr. Stalker. On Thursday I sent for him to attend my husband. He saw him on Thursday and on Friday, My husband told me he did not think he would be able to undergo an operation without chloroform, but I did not object to its use. Shortly after the doctor arrived I heard a scfllue in the room and the doctor told me it was all over. Dr. Arthur Richardson, sworn, deposed : I was not acquainted with the deceased. At about 5.30 yesterday afternoon I was called to deceased's residence, and found him iying in bed with every appearance of death ; no respiration or circulation, and the features pallid. The pupils were dilated — more than would be usual in health ; no froth at the mouth. The limbs were flaccid. Dr. Stalker, who was present during my visit, told me he had been giving chloroform to reduce paraphymosis, and that the patient had suddenly died. I endeavoured to restore artificial respiraiion, but without effect I have this day made a post mortem examination of the body. I found the body fairly well nourished. I examined the brain. The sinuses were gorged with blood, and the superior longitudinal sinus was obstructed by the matting together of the membrane with lymph. It did not form a complete obstruction. The venticles contained a large quantity of serum, smeliing of chloriform. The sub stance of the brain was healthy No apoplectic clot. There was nothing in tho brain to shew intemperate habits. I then opened tho chest. The pericardium and heart were quite healthy. Venticles and auricles were quite empty. There was no congestion, ossification, or fatty degeneration. The lungs were gorged with blood, but appeared otherwise normal. There was a faint smell of chloriform — the dead apply smell of that drug. I opened the abdomen ; found a little food in the stomach, and a little fluid. The liver was rather large, but otherwise healthy. It was not " nutmegged." Intestines and kidneys were normal — no sign of Bright's disease. I ehould cay that death resulted from coma, but I should say that the lungs had closed their action before tho heart I believe that the administration of the chloroform was sufficient to account for the coma, but that it would be sensibly modified by the prevention of free circulation by the obstruction in the brain. By Mr Cotter : As a rule, chloroform is not administered without the presence of a second doctor. That is the rule, but it is not strictly kept. It is usual, also, to examine the heart and to make a few inquiries as to the state of health. If an apparently healthy person applied to be placed under chloroform it would not be considered necessary to do more than examine the heart. 1 have used chloioform in similar cases to that of Mulholland, but merely to the extent to i-ender the patient barely insensible. In the cases where I administered the chloroform myself, I have always had a i eliable person present. Deceased was a club patient. The clubs refuse to pay the fee of a second doctor, and expect the doctor to perform the operation himself. The fault lies on the clubs. Ido not consider it wise to risk life for the sake of a club. By Dr. Stalker : The knowledge that a man is of intemperate habits would be sufficient in a life insurance office for him to be refused. The jury, after a quarter of an hour deliberation, returned the following verdict : — "That James Mulholland, on the 21st day of March instant, being about to undergo a surgical operation, and with due precaution, being subjected to the vapour of chloroform, it so happened that by the poisonous action thereof the said James Mulholland, through misadventure and misfortune, then and there instantly died. The following ryder was added : " The jury are of opinion that no medical practitioner should administer chloroform without a qualified assistant being present." Dr. Stockwell : And no blame attaching j to the doctor in the present case ? The Foreman : None. Dr. Stockwell : Well, perhaps the jury will add that to the rider. The Foreman (to the jury) : Gentlemen, are you all agreed. The jury signified their concurrence with the addendum which was then made. Dr. Stockwell then asked Dr. Philson had \he given chloroform without qualified assistance beside him. Had he done it thousands of times ? Dr. Philson : Most commonly. Not thousands of times, but in hundreds of instances. The proceedings then terminated.

Sydney Taiwhanga was on board the flagship at Tauranga Regatta, and informed his native friends that he was acting as special reporter to one of the newspapers of the town. In 1882, the Union S.S. Co, contributed £1961 17s 5d to Dunedin dock receipts, and in 1883 this increased to £2610 0s Bd. The total vessels docked last year was 65, yielding a revenue of £3120 15s Id.