[History of chloroform anesthesia]

The first narcosis with chloroform was performed by James Young Simpson on himself on November 4, 1847. The chemical substance had been first produced in 1831 almost simultaneously in the USA by Samuel Guthrie and in France by Eugène Soubeiran. Knowledge of the narcotic effect of chloroform spread rapidly, but very soon reports of sudden deaths mounted. The first fatality was a 15-year-old girl called Hannah Greener, who died on January 28, 1848. The opponents and supporters of chloroform were mainly at odds with the question of whether the complications were solely due to respiratory disturbance or whether chloroform had a specific effect on the heart. Between 1864 and 1910 numerous commissions in UK studied chloroform, but failed to come to any clear conclusions. It was only in 1911 that Levy proved in experiments with animals that chloroform can cause cardiac fibrillation. The reservations about chloroform could not halt its soaring popularity. Between about 1865 and 1920, chloroform was used in 80 to 95% of all narcoses performed in UK and German-speaking countries. In America, however, there was less enthusiasm for chloroform narcosis. In Germany the first comprehensive surveys of the fatality rate during anaesthesia were made by Gurlt between 1890 and 1897. In 1934, Killian gathered all the statistics compiled until then and found that the chances of suffering fatal complications under ether were between 1: 14,000 and 1: 28,000, whereas under chloroform the chances were between 1: 3,000 and 1: 6,000. The rise of gas anaesthesia using nitrous oxide, improved equipment for administering anaesthetics and the discovery of hexobarbital in 1932 led to the gradual decline of chloroform narcosis. In 1947, Ralph Waters attempted to reactivate chloroform, but failed. Possibly as a result of these efforts, however, chloroform played a role in American publications longer than elsewhere. The story of the clinical use of chloroform ended in 1976 with the second edition of V. J. Collins' textbook.