THE CAUSATION OF DEATH DURING THE ADMINISTRATION OF CHLOROFORM

pressure on the lower surface of the hard palate, while ingenious, cannot be regarded as a complete explanation. It seems very probable that each of these theories is to some extent correct, but that no single one is sufficient to fully explain the mode of production of these deformities. It is, however, quite certain that interference with nasal respiration is capable of producing serious and extensive deformity of the teeth and jaws, and that by the restoration of nasal breathing this disfigurement of the maxilla can be prevented, and if seen at an early stage considerably alleviated, the constant stream of air expanding and developing the upper jaw. There are many cases of V-shaped deformity of the maxilla with anterior protrusion due to other causes, but interference with nasal respiration is so common a cause that the condition of the nose and nasopharynx should be investigated in all these cases. Breathing exercises as advised by Mr. Arbuthnot Lane are undoubtedly valuable in, some cases of naso-pharyngeal obstruction produced by the presence of an abnormal quantity of adenoid tissue, especially if the obstruction to nasal respiration is a first attack or the repetition of a previous one with a history of free nasal breathing in the interval. But when the obstruction is chronic, especially if acute exacerbations also occur, when secondary aural affections exist, and more especially when the deformities in the teeth and palate above described are present, it will be found that breathing exercises, unless preceded by operative measures, will be almost invariably ineffective, and valuable time will have been irretrievably lost.