To an outside observer, the gathering of medical professionals in Edinburgh, Scotland in November 1847 looked suspicious. Some physicians were slumped unconscious in their seats. Others staggered around, intoxicated and giggling, taking intermittent sniffs of the pleasant vapor emitting from rags they held close to their faces. One man was hypervigilant, paranoid eyes darting around for any sign of trouble.
In the middle of these altered minds stood a very sober — and very happy — James Young Simpson, an obstetrician who had called the meeting to announce an amazing discovery. Just weeks earlier, he had come across a chemical compound virtually unknown in medicine: trichloromethane, or chloroform, a dizzying sedative that induced near-immediate sleep without any of the worrisome side effects of ether.
Chloroform, Simpson trumpeted, would bring patients much-needed anesthesia during painful procedures that would otherwise have them screaming in agony. A teaspoon dribbled into a handkerchief and inhaled would bring about a temporary and safe suffocation of the conscious mind.
Those in attendance were skeptical until Simpson began to offer demonstrations. It was just as he had advertised. Soon, chloroform would become the world’s artificial sleep of choice, landing in the birthing room of Queen Victoria and on the battlefields of several wars. It would also become vilified, with only a small margin of error between a therapeutic dose and a lethal one. Criminals and victims alike would appropriate it for devious purposes, permanently mislabeling it as an efficient way to rape, rob or kill.
That would come later. For now, Simpson looked around at the muttering, snoring doctors and had every right to believe he’d just changed the world of medicine for the better. Also, he thought it would be fun to knock people out at parties.
Although he became synonymous with it, Simpson did not invent chloroform. It was Samuel Guthrie, an American chemist looking for a more effective pesticide, who, in 1831, was the first to mix alcohol with chlorinated lime and stumble upon the compound. Within months, two other chemists had made similar discoveries in France and Germany. The liquid came to be known as “sweet whiskey,” ingested for its intoxicating effects as a nervous system depressant. But it wasn’t until Simpson sat down at a kitchen table and began to sort through various chemicals in search of an alternative to ether that chloroform would be adopted as a medical tool to ease suffering.
“Many doctors thought pain was good for you, but he didn’t agree,” says historian Linda Stratmann, author of “Chloroform: The Quest for Oblivion”. “Ether had drawbacks. It smelled awful, and the patient tended to thrash about.”
Simpson, who had once witnessed an agonizing, unsedated breast surgery as a student, was dismissive of ether, which had been used since 1842. It was flammable, a serious drawback for gas-lit procedures. The substance also tended to excite some patients: one had pulled out his intestines during a procedure.
Simpson regularly sat down in his dining room and, with the help of assistants, began sifting through alternatives. (“They were into self-administration in those days,” Stratmann says. “‘What is this? It’s dangerous? Let me try it!’”) When he got a literal whiff of chloroform, Simpson was convinced it blew ether out of the water. Without any Food and Drug Administration to slow him down, Simpson quickly went into action, enlisting a chemist to make a batch.
In November 1847, he dripped a half-teaspoon onto a cloth and clamped it over the face of a woman about to give birth. Her eyes fluttered, her child was expunged, and she awoke in distress. That couldn’t be her baby, she said. She had no memory of delivering it.
Simpson was thrilled. After calling his colleagues together, word of chloroform’s magical properties spread. (Nitrous oxide, in use by a few practitioners, had no champion like Simpson, and therefore was in limited demand.) He wrote a booklet hailing its virtues. For someone deeply concerned with how an operating room could resemble a butcher shop, Simpson endorsed it every chance he could.
Chloroform was cheap and effective and physicians didn’t need a lot of convincing to begin using it. But many patients did. At the time, the idea of sedation was novel: that one could simply be “put to sleep” was more frightening to some than the pain of surgery, and patients' nervousness would prompt them to hyperventilate during its application.
“The problem was, there was no way of controlling how much anesthetic they were getting aside from their own breathing,” Stratmann says. “So if they panicked, held their breath, and then inhaled deeply, they got a concentrated lungful.” Cardiac arrest and death would sometimes follow.
More questions about chloroform arose, mostly because the substance was ill-understood: some, for example, believed it could be strictly a respiratory depressant. But such concerns were set aside for the demand created by the Civil War, which required a fast-acting anesthetic on the battlefield. Of the 80,000 operations surveyed by Union physicians, all but 254 used anesthetic of some kind — usually chloroform, and sometimes a mixture of ether and chloroform to help mitigate the risks of either.
Any fears about induced sleep were quickly mitigated by the searing pain of a shrapnel-fed leg. The patient would inhale and the vapor would first numb the senses. Relaxation would set in, followed by a feeling of impairment. The patient would cease to move, to feel and to have any awareness of the scalpels digging into their flesh. In short, it was just what they needed.
Occasional cardiac death aside, chloroform was a wonder drug. And any lingering doubts the general public had about its administration ended in 1853, when Queen Victoria gave birth without feeling a thing.
If Simpson had been chloroform’s champion, then John Snow was its celebrity agent. A physician who shared Simpson’s enthusiasm for the compound, Snow had been called to treat the toothache of a royal lady-in-waiting. When Queen Victoria received word the extraction had been painless, she summoned Snow to anesthetize her for delivery of her eighth child. Over a period of 53 minutes, she huffed from a cloth at regular intervals, enough to act as an anesthetic without causing her to lose consciousness. The baby was born without complications. Snow returned to her chambers in 1857 to assist in delivery of her last child.
The general public hadn’t been expressly told the Queen had been sedated, but Snow’s presence was reported, and those who knew of his area of expertise allowed word to spread.
“As safe as ice skating or sea-bathing,” her majesty’s gynecologist, Sir William Priestley, was once quoted as saying. Public support of chloroform — by this time in wide use by private physicians — was strong.
In the medical world, however, there was a feeling that chloroform was unwelcome during deliveries. “Many doctors believed the pain of childbirth was good for you,” Stratmann says. “The doctors were all men and had never experienced it, obviously.” Others fretted it might impact a baby’s health, or that organ damage could result.
To the former, Simpson was nonchalant. When confronted with a baby suffering from convulsions, he placed a chloroform-soaked rag to the child’s face for up to 24 hours at a stretch. The convulsions ceased, and at ten weeks, he wrote, the infant “was reveling in the best of health.”
Dissent was usually overtaken by chloroform’s effectiveness. Asylums stocked up on bottles to use as sedation on hysterical residents; it was sold to private citizens as a cure for asthma or insomnia. Simpson toyed with the potential to use as a topical, but it only produced pain and tingling. One physician, carried away with its potential, self-administered a dose rectally. He awoke on the floor, confused, and immediately evacuated his bowels.
Snow, whose research was more practical, was the first to discover the fine line between helpful and fatal doses. At 18 minims, or roughly a quarter-teaspoon, chloroform would induce sleep. At 36 minims, it would begin to depress the lungs. Physicians began to sound the alarm that the unpredictable consumption of its vapors was like playing Russian roulette.
This didn’t prevent doctors from treating it like a recreational drug. Simpson used it as a party trick, knocking out willing accomplices; doctors and druggists sniffed it covertly for a cheap high; physician John Crombie invented an inhaler that allowed him to dose himself in titrated amounts. (A pleasure-seeker, he died of a morphine overdose.)
Despite a relative lack of knowledge and even gross negligence, there remained only a low chance of death when chloroform was introduced. But as its popularity grew, so did concern that it could be used for all the wrong reasons.
Oscar Wilde’s father, Sir William Wilde, was in acute distress. It was 1864, and the surgeon was being targeted by a former patient, Mary Travers, who insisted he had molested her while she was under the influence of chloroform. Travers published a small booklet that she circulated in Dublin to make the allegations. During a trial initiated by the Wildes for libel, it was revealed Travers invented the chloroform detail to make the whole event appear more sinister. She was fined a paltry amount; Wilde was neither convicted nor exonerated over the accusations.
From his earliest days as an advocate, John Snow insisted that chloroform could not be used on an unwilling subject. It took minutes, not seconds, to take effect, which was plenty of time for a thrashing, uncooperative victim to frustrate his or her assailant. In a few published cases, the would-be prey screamed and ran before he could be subdued. Still, the notion of chloroform as a readily available criminal tool persisted in newspaper accounts of crimes.
It wasn’t the journalists who were entirely at fault but rather a growing number of people who would blame their bad behavior on chloroform. “If you were found in bad company, you could excuse it by saying you were chloroformed,” says Stratmann. “Drinking to excess could be pardoned — at least, in the eyes of certain law enforcement — by claiming you were an unwitting victim of the chlorinated fumes."
In other reports, a growing number of physicians and dentists began to endure frequent accusations of illicit behavior by drugged patients. Courts found it difficult to determine fault when one of two eyewitnesses had been unconscious. By the 1870s, more medical professionals began to have a third person in the room as a corroborating witness.
Such sensational newspaper accounts did not go unnoticed by fiction writers. Hungry for devices that could excuse incapacitation, they grabbed on to chloroform as a catch-all solution. What could be simpler than a cloth shoved into someone’s face?
Charles Dickens had met Simpson in 1847, shortly after the novelist’s wife had suffered a miscarriage. When his wife got pregnant again a few years later, he insisted their doctor use chloroform to ease her labor. His magazine, Household Words, ran several pro-chloroform articles between the 1850s and 1870s. During the climax of his 1857 masterpiece, “A Tale of Two Cities”, one character subdues another with an unnamed substance placed over his nose. Because the two are in a jail cell, the afflicted can’t run. Knowing Dickens’s fondness for the drug, it’s likely he declined to name it only because the historical novel is set decades prior to its discovery.
By the early 1900s, as crime fiction began to experience a surge in popularity, a surplus of authors who were interested in medical trivia helped further chloroform’s reputation as a tranquilizer. “Arthur Conan Doyle was a doctor in Edinburgh,” says Stratmann. “Whether he gave it to anyone, I don’t know, but it does come up in his fiction.” At least three Sherlock Holmes stories feature the vapor, including one where Holmes himself administers it — too quickly, Stratmann believes. But Doyle was an inspiration to many, and it’s possible his work helped influence the pulp writers that followed.
“I think the concept got momentum because there’s a fundamental human desire to have a quick and easy power over people,” Stratmann says. “It’s like a magic lamp or magic word.”
The 20th century would eventually confine chloroform to a stereotype in fiction. Designer, laboratory-concocted sedatives became the norm; airway support was mandatory. The notion of holding a handkerchief over someone’s face until they passed out became quaint.
Yet chloroform hung on through the 1940s. Unlike elaborate anesthesia set-ups, it was portable and easy to carry on house calls. World War II saw frequent use for the same reasons it had been found on earlier battlefields. But despite a low rate of death—perhaps 5.4 cases per one thousand—more researchers began to fret over liver toxicity.
For the first time, the drug was more available in pulp novels, on radio and in the burgeoning world of television than in hospitals. Emma Peel succumbed; so would Wonder Woman and Nancy Drew. The sight of attractive actresses falling victim to the drug would later inspire the ultimate testament to chloroform’s cultural impact: a permanent installation as an internet fetish. Sites like SleepPeep.com celebrate the perceived eroticism of a woman slipping into unconsciousness, peaceful and subservient to suitors. Terrible memes of men with rags looming behind women have also cropped up, leading to a cultural stigma of chloroform as date-rape drug.
That continued homogenization of chloroform as a harmless intoxicant has led to some close calls. In researching her book, Stratmann discovered a college in Wisconsin in the 1970s that was holding “sniffing parties” to huff the chemical until catatonia set in. “There was just no real understanding of how dangerous the stuff is,” she says. “[Fiction] gives the public an idea it’s safe. It’s actually very easy to kill someone with it.”
Stratmann, who has written several crime novels herself, flinches whenever she sees the myth persist. “Even now, I can watch crime dramas and see someone being chloroformed once or twice a month. And every time, I want to throw something at the TV set.”
Chloroform hasn’t left the modern world completely. It’s used in DNA labs as a tissue solvent; trace amounts can be found in the air following chlorination of water or in the breath of people showering in treated water. Most will continue to recognize it not for its role in pioneering rapid-onset anesthesia, but by the fact fictional criminals keep it in their coat pockets.
Simpson, who died in 1870, never wavered in his support of the drug. He believed physicians had a duty to comfort their patients physically and emotionally, sparing them the trauma of incisions. He spent his final days writing letters to old sparring partners, apologizing if his efforts on behalf of chloroform had been too combative. With his wife by his side, he fell into his final sleep. The Queen sent her regards.