Chloroform

In Edinburgh, I find things worth a double-take. Like the above. It's a brick from the flat on 52 Queens St.

Ah yes. Chloroform. The serial killer's best friend. Put some on a rag, grab some innocent victim from behind, shove the rag in their nose. Boink, they're out like a light.

For this, we should celebrate the life of James Y. Simpson, the first doctor to demonstrate the wonderful properties of chloroform on humans.

In fact, when he died in 1870, a Scottish holiday was declared and 100,000 citizens lined streets for his funeral parade. He now has a huge statue in the Princes Street Gardens in Edinburgh ... and the plaque above.

Am I missing something?

Chloroform is Actually Pretty Good

Well first, let's clear up the serial killer thing.

Chloroform is remarkably ineffective on humans when sprinkled on a rag. You'd have to get the victim to take a big whiff of it ... when human instinct would be to breathe as little as possible, or at least in short sharp inhales. Then even if they got the proper dose (which is tough - we'll talk about that in a minute), it would take them a full 5 minutes to collapse.

It has been used in crime, true. But not very often. Usually the victim is either complicit, or they've been knocked out with some other substance like alcohol, to which chloroform has been administered in addition. The criminal has to then keep administering it, while at the same time preventing the victim from swallowing their tongue.

It takes some skill ... you know like an anaesthesiologist? You wonder why they get paid so much? It's because it's hard.

In other words, chloroform is the Vulcan Neck Pinch of 1900's mystery novels. Looks cool - doesn't work for amateurs. (Like for instance, 12-year-old nerdy boys. I can vouch for that. )

We don't talk about the good properties of chloroform, mostly because it's not used anymore as anaesthesia. Chloroform is tricky, and the chances of fatal complications are about 1 in 3000 - which doesn't seem too bad on the surface. But there are better choices now like hexobarbital and its descendents, which have been used in the latter half of the 20th century. They are much safer.

Yet in its time, chloroform was revolutionary. There was ether, but ether has some nasty side effects like inflaming the lungs. Chloroform just plain gave you a better knockout.

So the first human it was used on was a dental procedure. But soon after, Simpson started using chloroform for patients giving birth, and that's where it really shone.

It was brave to do this on many levels. Before this, women were told that there was nothing you could do about the horrible pain of childbirth. It was Biblical. It was a decree from God, for crying out loud. And Christian ministers of the time were pointing this out: to use anaesthesia in this circumstance was like thumbing your nose at God himself.

But it wasn't just the discomfort of childbirth, which was bad enough. It was the accompanying rebellion of the body against that pain - the high blood pressure and other defenses - that endangered the child and mother's health itself. And Simpson made those connections. Chloroform made childbirth safer to all concerned.

When Queen Victoria had chloroform administered to her during the last 2 of her childs' births, it became acceptable.

And it was wildly popular. What's not to love? Women dubbed it "my beloved chloroform."

Don't get me wrong, chloroform had other uses too, like in just plain ol' surgery. But the fact that a human-synthesized substance could lessen something so baked into nature as pain in childbirth ... no wonder this guy had statues and plaques.

How Did They Figure It Out?

But this is my favorite part of the chloroform story. It seems that James Y. Simpson and his assistants Dr. George Keith and Dr. James Duncan had an interesting pastime. They used to sit around the fire in the evening and try out chemicals for anaesthetic effect.

Mmmm, different strokes I guess.

On November 4, 1847, Simpson obtained a sample of chloroform from the pharmacist. The three friends got together that evening and the conversation went something like this:

George Keith: "What do you wanna do tonight?"

James Duncan: "Oh I dunno. What do you wanna do?"

George Keith: "Oh, I dunno. What do you wanna do, James Y. Simpson?"

James Y. Simpson: "I know! Let's huff some chloroform and see if it knocks us out."

James Duncan: "SGTM."

The next morning they woke up, groggy and a little hazy. Something like this:

The experiment was not only successful, it was pretty damn lucky.

• If they had taken too little chloroform, nothing would've happened. Chloroform would've been deemed a failure.
• If they had taken too much chloroform, they'd be dead. And it definitely would have been deemed a failure. For good.

A few days later, they used it on the first patient for a dental procedure. The rest is history.

I have a standard story I pull out at cocktail parties. "The person who figured out that you should pick the coffee cherry, take the seed, roast it until it's black, pour hot water over it and let it steep, then drink it for breakfast ... that person was a genius."

Yet there was a precedent for a coffee. Birds and animals would eat the cherries off the coffee tree, spit out the flesh, then run around real fast. You had to suspect something was great about that seed.

But chloroform? Not only was it a non-natural substance, it was smelly and weird. Evidently other doctors had tried chloroform on dogs, but Simpson didn't know about these experiments beforehand.

If you are still not convinced about how lucky this all is ... can you imagine the brouhaha if they had waited 100 years. With the FDA around? Hoo boy.

Edinburgh and Doctors

James Y. Simpson was one of the more famous doctors of Edinburgh. But there were a bunch more:

• Joseph Lister - the architect of modern antiseptic surgery had an office off of Rutland Square. Amy and I pass it on our way to Pure Gym.
• Charles Bell - Discovered Bell's Palsy.
• James Blundell - Did the first human-to-human blood transfusion. I will have a lot to say about that subject in an upcoming post!
• Charles Darwin - Yup! Went to University of Edinburgh for Med School.
• Thomas Hodgkin - Discovered Hodgkin's Lymphoma
• James Lind - The inventor of the clinical trial. Chloroform discovery might have been a bit less messy had this been used.
• Alexander Wood - The inventor of the hypodermic needle.

There are so many physicians in Edinburgh, they have a club for them, the Royal College of Physicians of Edinburgh (RCPE). In fact their offices are down the street from James Y. Simpson's old haunt on Queen St.

The RCPE is running an exhibit the next few months:

Sounds like a blast! Amy and I will go some time, then maybe grab a cocktail afterwards. Expect a report!