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Chloroform: 170 years of controversy

bottles_of_chloroform

Chloroform, discovered in 1831 by three independent researchers – an American, a German and a Frenchman – has had a multitude of roles. Initially viewed with suspicion, chloroform gained immense popularity after it was administered to Queen Victoria during childbirth. Used in the Crimean, Punjab and American Civil wars, it saved thousands of soldiers from suffering extreme surgical ordeals. Chloroform was also used to treat asthma and cholera, as a rather dubious ‘cure’ for gonorrhoea and as a sweetener in medicines. However, the price of this anaesthesia was many sudden, inexplicable deaths under surgery, which caused years of passionate controversy. On an even more sinister note, chloroform featured in thefts, rapes and murder. 

Chloroform as an anaesthetic

When Professor James Simpson, on 10 November 1847, rose to address the gentlemen of the Edinburgh Medico-Chirurgical Society, he was about to realise one of his longest-held ambitions. Some twenty years previously as a young medical student, he had witnessed surgery for the first time. The operation, to remove a breast, was carried out by Robert Liston, one of the leading surgeons of the day. Speed was essential, as was the physical immobilisation of the patient, either by stout leather straps or the hands of burly attendants, since not reliable anaesthetic was then known. The sight and sounds of that operation were a horror that Simpson never forgot. He had fled the theatre in great distress, determined to abandon his cherished study of medicine, and enrol as a law student.

Fortunately he soon thought better of this decision and returned to his medical studies, but he made earnest enquiries of his professors to see if anything could be done to alleviate the terrible pain of surgery. The answer he received as that nothing could be relied upon to relieve the pain with any safety to the patient. 

Simpson was not a man to be satisfied with that position, and later, as a qualified doctor, he experimented with a number of methods, including mesmerism. None of them, however, was the thing he sought. While other doctors accepted suffering as inevitable, it was clear that Simpson would not be content until he found the perfect anaesthetic. 

In 1846 news came from America of the development of anaesthesia using ether. Simpson took it up immediately and used it, controversially, in obstetrics, but soon felt it had too many drawbacks. His use of ether had, however, given him both considerable experience with an inhaled anaesthetic, at a time when many medical men were opposed to its use, and also a standard by which to judge the effects of other volatile chemicals. The quest continued.

On that November day, Simpson prepared with some pride to reveal the sober gentlemen of the Society his discovery of the anaesthetic powers of a previously little-regarded compound – chloroform.

It was common for men of his profession to offer their research and observations for the assistance of their brethren and improvement of the human condition, hoping also to gain some personal prestige. All of these must have beckoned, though Simpson was successful enough for the last two to be of little importance. What he could not have expected was that the events of that November would be the defining moments of the rest of his life. Chloroform would bring him praise and honours, but it would also unleash upon him a storm of outrage. It brought him adulation such as few men ever experience, but when his career moved on to other causes he found that what he had hoped would be his greatest works were little regarded and that, even at the end of his life, all he was remembered for was chloroform. So closely was he associated with it that he was often credited with having discovered it, or administering it to Queen Victoria, neither of which was true.

What he was about to unleash was an agent whose innocuous appearance and pungent but not unpleasant fragrance concealed a dramatic power both to save and take life. In the years that followed, there would be quarrels, controversy and confusion, with many expressions of pleasure and gratitude, and many deaths. Chloroform would revolutionise battlefield surgery, relieve distressing symptoms in numerous common complaints, and appear to effect astonishing cures – but it would also have a role to play in the crimes of robbery, rape and murder.

At the close of his address, Simpson recommended to the meeting that a committee should be appointed immediately to explore the qualities of chloroform. The gentlemen readily agreed, and the meeting was about to close but Simpson had a final flourish to perform. He may have anticipated some scepticism, but he knew his audience, and he had come prepared. Never a man to lose the opportunity for drama, he produced a bottle of chloroform and a silk handkerchief, and invited the members to sample its effects. This attitude of almost careless confidence was always to characterise his future use of and total devotion to chloroform. Mr Young, a cutler, at once presented himself as a subject. A teaspoonful of chloroform was applied to the folded fabric, Mr Young inhaled deeply, and after only a few inspirations he was unconscious. A Dr Roberts was the next to try, with the same result. A Mr Hunter followed, and must have taken less than his predecessors, for he suddenly became excited, and jumped to his feet. This caused a certain bustle in the room, as he resisted the efforts of his fellow members to hold him.

While this distraction was going on, the handkerchief was being passed around, and one by one the members applied it to their faces. All were surprised by the power of its effect. Gentlemen who might not have arrived at the meeting with the intention of becoming drunk soon found themselves in a state of intoxication. Others, having taken a more concentrated whiff, slumped unconscious in their seats. No doubt Simpson viewed the scene with amusement and satisfaction. Once recovered, the doctors were agreed that the sensation was delightful, and some were eager to repeat the experiment. Fortunately, no one was worse the wear for his experience. Had one of the audience died on that occasion, as might very well have happened, the future of chloroform would have been in some doubt, and history would have been a little different.

Extracted from Chloroform: The Quest for Oblivion by Linda Stratmann 

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