The Chloroform Committee Report of 1864, Royal Medical and Chiurgical Society (pp.323-442).

Med.-Chir. Trans., 47. - London, Longmann, 1864, (56), 447 pp., 10 lith. Taf., Holzschnitte, original Leinbnad; Rücken erneuert. Report of the Committee appointed by the Royal Medical and Chirurgical Society to inquire into the use and the Physiological, Therapeutical and Toxical Effects of Chloroform, as well as into the best mode of Administrating it, and of Obviating the Ill Consequences resulting from its Adminsistration. By 1863 the number of cases in which death 'could be positivley assigned to the inhalation of chloroform' had reached the formidable total of 123. "Facts so important" led the Royal Medical and Chirurgical Society (now the Royal Society of Medicine) to appoint a Committee "to give their anxious attention to devise means for obviating such accidents". Among the distinguished members of the Committee were T.B. Curling, the Chairman, George Harley, William Marcet, Richard Quain and Francis Sibson. B.W.Richardson and Charles Kidd, both in the front rank of practising anaesthetists, were called in in an advisory capacity; and J.T.Clover, "although not a member of the committee attended at their request nearly all meetings for experiments, admininstered the chloroform, and contrived, from time to time, with remarkable ingenuity, special apparatus for carrying them out". A long report was published in the Medico-chirurgical Transactions in 1864. "The committee", it began, "have chiefly confined their physiological report to observations which they have themselves made . Experimenting on dogs, the Committee observed the physiological effects of different percentages of chloroform vapour on various organs and functions of the body, in particular, upon the heart and upon respiration." They proceeded to make similar tests with ether and compared the two sets of results. Their final conclusions . "Whilst . (a) general similarity may be traced in the action of ether and of chloroform, there is an important contrast in their influence on the heart. Chloroform depresses the action of that organ, and frequently kills by inducing syncope. Ether, on the other hand, exerts but a very slight depressing influence on the force of the heart's action". "Hence death, when produced by ether, is almost invariably due to the failure of the respiratory movement, and the heart is generally found to continue its pulsations for some time after the respiration has ceased" (p.333). In addition to investigating the effect of chloroform upon the heart under normal conditions the Committee also carried out experiments to test the action of chloroform on the heart when the vagal nerves and been severed, either before or during chloroform inhalation (p.331). In experimenting with dilute anaesthetics mixtures the Committee used "Mr.Clover's apparatus, in consequence of the exactness with which the quantity of chloroform administered through it can be regulated. The effect of air impregnated with from 1 to 15 per cent. of the vapour was thus observed.". "If", said the Committee, "a mixture composed of from 2 to 4 per cent. of chloroform vapour and 98 or 96 per cent. of atmospheric air be inhaled, there is little or no risk to life". "In some cases it is indispensable to employ as much as 4 1/2 or even 5 per cent. of the vapour. But if a larger dose (one 10 per cent) be inhaled, alarming symptoms are liable to supervene. At times, even with every care, and with the most exact dilution of the vapour, the state of insensibility may in a few moments pass into one of imminent death". "It is therefore extremly desirable to obtain an anaesthetic agent which shall be capable of producing the requisite insensibility, and yet is not so dangerous in its operation as chloroform". "Ether, to a certain extent, fulfils these conditions, but its odour is disagreeable, it is slow in its operation, and gives rise to greater excitement than chloroform. The committee therefore concur in the general opinion which in this country .…