_Disease of the Heart._ There is a very general impression that the use of chloroform is unsafe when disease of the heart exists, more particularly, fatty degeneration of that organ. This belief has been encouraged by the circumstance that this affection has been present in a few of both the real and alleged deaths from chloroform; and also by the fact that, in the accidents that have been really due to chloroform, the heart has been the organ on which it has exerted its fatal influence. When we come to investigate these cases, however, we shall find reason to conclude that the heart has probably been diseased in quite as great a proportion of the patients who have taken chloroform without ill effects, as in those who have succumbed under its influence. As regards my own practice, indeed, the only case in which death could in any degree be attributed to the chloroform, was one in which there was extreme fatty degeneration of the heart; but, on the other hand, I have given chloroform in numerous cases without ill effects where the symptoms of this, as well as other affections of the heart, were present in a very marked degree. Indeed, I have never declined to give chloroform to a patient requiring a surgical operation, whatever might be his condition, as I early arrived at the conclusion that this agent, when carefully administered, causes less disturbance of the heart and circulation than does severe pain. Whenever I have had an opportunity of seeing an operation performed without chloroform, I have carefully observed the pulse, and although none of these operations have been of a very severe nature, I have found the circulation to be much more disturbed than it would have been by chloroform carefully administered. The pulse in most of these cases has been excessively frequent during the operation, and in some instances it has intermitted to an unusual extent.