Chloroform and ether
Geoffrey Marshall established that these should not be used as anaesthetics on shocked patients although ether would initially maintain the blood pressure, before causing it to drop. Both were standard issue to the British Army medical services.
Though many of the casualties of the war were young men, many were heavy smokers and lung disease or bronchitis was not uncommon. This could make the administration of inhalational anaesthesia difficult and the patients’ reactions hard to predict.
Discovered in 1275 by Spanish chemist Raymundus Lullius and called sweet vitriol. In 1540, German scientist Valerius Cordus described the synthesis of ether and the Swiss physician and alchemist Paracelsus discovered its hypnotic effects. In 1730, German scientist Augustus Sigmund Frobenius changed its name to ether.
Discovered in the 1830s, its anaesthetic properties were not realised at first. James Young Simpson, an obstetrician in Edinburgh, was searching for a safer alternative to ether and tested chloroform on himself and two colleagues after a dinner party on the 4 November 1847. He reported falling ‘under the mahogany in a trice’ and only regained consciousness the following morning. He began to use it on obstetric patients four days later.
Early anaesthetics were often administered by the “open drop” method. The agent was dripped onto a handkerchief from which the patient inhaled the vapour. This method was particularly useful in situations where vaporisers were impractical. By the First World War, metal facemasks with layers of gauze were used, rather than handkerchiefs or towelling.