= Solution
\b[For an 1866 discussion, distinguish conditions demanding special caution from a universal prohibition. Modern correction goes further: <chloroform> is not an acceptable routine surgical anaesthetic.] Its toxicity cannot be removed by choosing an apparently healthy person.
The historical inquiry would examine the <heart>, <lungs>, general strength and the nature of the proposed procedure. A failing circulation, suspected serious myocardial degeneration, great exhaustion or <blood loss>, and severe respiratory impairment gave strong reasons to avoid or postpone a nonessential exposure. A full <stomach>, obstruction of the <airway>, difficulty maintaining breathing, or an operation threatening to contaminate the <airway> created additional hazards. Acute intoxication or other depressant drugs could complicate administration. The balance depended partly on whether the operation was essential and on what alternative method of relieving pain was available.
It would nevertheless be historically inaccurate to declare that the contemporary profession unanimously regarded all <heart> disease as an absolute contraindication. The 1864 committee's report said that <heart> disease in general did not automatically preclude surgical use, while specifically calling for care over fatty degeneration. It also discussed the difficulty of recognizing that condition during life. Its treatment of mouth and throat operations was likewise more qualified than a universal ban.<Abstract of the Report of the Committee on Chloroform (1864)>[Uses and contraindications in surgical practice; heart disease, fatty degeneration and mouth or throat operations]{ref} This is a record of the committee's judgement, not endorsement of its safety conclusion.
The delivery conditions also matter. An uncontrolled vapour concentration, failure to ensure air entry, lack of a dedicated competent observer, or inability to respond to loss of breathing and circulation makes an already hazardous intervention less defensible. Such circumstances concern how the drug is used rather than a disease-specific contraindication. The period distinction between direct circulatory failure and respiratory failure explains why watching only one sign was inadequate.<Abstract of the Report of the Committee on Chloroform (1864)>[Physiological action, fatal exposure and administration precautions]{ref}
\b[Modern correction: <chloroform> can depress the <central nervous system>, disrupt cardiac function and cause delayed hepatic and renal injury.] Its former use as an <anaesthetic> does not make it a current option. Modern anaesthetic assessment still considers cardiovascular and respiratory reserve, <aspiration> risk, other drugs and the proposed procedure, but uses contemporary agents, monitoring and trained personnel.<Chloroform: toxicological overview by UKHSA>[Acute toxicity; central nervous system depression; delayed hepatic and renal effects]{ref}<Chloroform by the US Environmental Protection Agency>[Acute effects; cardiac effects and discontinuation as a surgical anaesthetic]{ref} In particular, absence of obvious <heart> disease is not evidence that a <chloroform> exposure is safe.
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