Chloroform: Wonderful and Terrible
Chloroform: The Quest for Oblivion
By Linda Stratmann
Sutton Publishing, 273 pages
By Catherine MacLennan
Science is always in search of the new – the new technology, the new medicine, the new procedure, the new cure. The old miraculous cures, once crucial and cutting-edge are quickly forgotten. In Chloroform: The Quest for Oblivion, Linda Stratmann traces the “wonderful and terrible” history of a dangerous substance that once enjoyed immense popularity.
Medical history is painful reading: terrible ailments, appalling practices, “cures” and misjudgements that make the contemporary reader recoil in horror. Chloroform’s main use was as an anaesthetic during painful surgeries. The world before anaesthetics was definitely a painful one. Stratmann details the frighteningly ineffective approaches of pre-anaesthetic medicine in its attempts to deal with surgical pain: some doctors believed in hypnosis, or “a single glass of wine,” or opium - after the operation. Some believed that the Bible instructed that pain was necessary and should not be relieved. Other doctors who were concerned about their patients' well-being believed the answer was to operate with speed (and timed how quickly they could perform various procedures). Some believed in applying snow and ice; another doctor's method consisted of putting a helmet on a patient’s head, then knocking the patient out with a wooden hammer. Mostly, though, patients received absolutley nothing for the pain:
”An account of an amputation by John Woodall of St. Bartholomew’s Hospital, written in 1639, makes no mention of pain relief, but refers to the surgeon requiring five helpers, two of whom were to assist the surgeon with his instruments and needles, and the other three to restrain the patient. It was normal practice to locate the operating theatre of a hospital as far as possible from the main wards, often in a tower room, so the shrieks of the unfortunate patient could not be heard from those destined to suffer the same fate.”
In this bleak medical world, entered the imperfect, but at the time, fairly glorious, chloroform. It was discovered, as many discoveries often are, by a number of people around the same time – a German chemist, Justus von Liebig, a French pharmacist Eugene Soubeiran, and an American, Dr. Samuel Guthrie. It terms of who was the first of the three, Stratmann gives the edge to Guthrie. Guthrie was an “eccentric amateur” who had containers of human bones in his house, a distillery, vinegar factory, gunpowder mill, workshop and chemical laboratory. Like many medical pioneers, he did not hesitate testing out substances on himself, family and friends, including his version of chloroform – an alcoholic solution of chloroform. “His youngest daughter, eight-year-old Cynthia, liked to run into the laboratory, dip her fingers into the tub and taste it. He seems not to have discouraged this, but on one occasion she took too much, and fell over. When he went to pick her up he found that she had fallen sound asleep.”
Chloroform soon began being promoted by those that sought to end to painful surgeries, usually in the form of reckless demonstrations where those in attendance would inhale it enthusiasically, and pass out. There were enough successful operations under chloroform to ensure its popularity for a time. However, its use also resulted in a significant amount of sudden, dramatic deaths of young and healthy people that turned some doctors off it altogether and spurred others to seek alternatives.
When it did kill patients, doctors did not know the reason – there was debate as to whether it was it having an effect on the heart, or the respiratory system. The manner in which the chloroform was applied was also considered to be a factor, as well as the patient’s constitution. Since chloroform was popular (and anaesthetics urgently needed) the patient who died was suddenly determined to have a previously unknown medical problem that was often assigned blame in a death – not the chloroform. (That also let the doctors, or those administering the chloroform, off the hook).
It was used in the US Civil War as well as the Crimean War – but opinion was divided, with some refusing to use it. The Director General of the Army Medical Department was against the use of chloroform and believed it was "better to hear a man bawl lustily than to see him sink silently in a grave." Among the raids of the Civil War was a seizure of medical wagons, including 15,000 cases of chloroform.
While the terrible side of chloroform was already revealed in accidental medical tragedies, intentional harm also emerged. With any innovation introduced to society, the criminal element seeks to get involved for their sociopathic exploitative aims - robberies, scams, murders, doctors and dentists alone with female patients. Popular in the 1880s, the descriptions of the crimes (Stratmann goes into several in detail) have that grubby, grimy, creepy flavour typical of the Victorian era.
Though for the most part associated with the Victorian era, chloroform is still a part of modern day life, though in a less visible way – it is part of the production process of Teflon, it is a product of chlorinated water, and is used in the process of extracting DNA and RNA – a necessary part of forensic science and genetic research. Stratmann’s engaging history of Chloroform is an account of a substance that was once welcomed and feared, desperately needed, and cruelly abused. Biographical sketches are provided of the many medical pioneers as well as a few scoundrels who misued it for their own ends. In its heyday, chloroform was hailed as something that could lessen another’s pain - and it did for many, but at a price of far too many deaths. With a better understanding of chloroform and its effects, doctors were able to move on to anaesthetics that were safer.