Chloroform a knockout discovery

Instruments and documents from the career of Dr James Young Simpson are on display in the Surgeons' Hall museum

At its centrepiece, a glass decanter typically intended to be filled with brandy. This particular evening its contents something considerably more potent.

Dr Simpson's guests had come to debate one of the hot medical issues of the day across the dining table. Now it was time for "dessert".

It was early November 1847, a time of rapid medical advances led from the front by Edinburgh's brilliant scientific minds. Now, in this dining room at number 52 Queen Street, these willing volunteers were about to take that medical understanding to a completely new - if, apparently, slightly bizarre - level.

The evening ended on the kind of "high" that modern party-goers who choose to dabble in illicit substances might recognise: one chap was said to be unable to stop laughing hysterically, another's deep bass voice broke into squeaky falsetto, there's even a wild suggestion that the host ended up standing on his head before falling into a deep, peaceful, and untroubled sleep.

That, at least, is how one imaginative writer chose to sum up events that unfurled at one of the most significant house parties to ever be held in Edinburgh's New Town.

Quite what Dr James Young Simpson and his guests really got up to between inhaling an aromatic dab of chloroform and falling head first into their slumber is secondary to the astonishing realisation next morning when they woke: the sudden knowledge that their dining room experiment was about to change medical science forever.

Of course, Dr Simpson knew immediately the significance of what had happened, even if his version of post-dinner events was more succinct: "We all ended under the mahogany in a trice," he later wrote.

Within weeks, chloroform was being used to anaesthetise Edinburgh surgical patients and ease the pain of childbirth. Before long it would gain approval from no higher authority than Queen Victoria herself. And the discovery made that evening would affect medicine for years to come.

Now, 200 years since the discovery of chloroform, the life and work of Simpson - in particular the role he played in easing generations of women through the trials of childbirth - is being celebrated with a major exhibition at the Royal College of Surgeons museum at Surgeons' Hall.

Alongside fascinating pathological exhibits - some more gruesome than others - will be a selection of his personal belongings; notes, prescriptions and his pen, his hat, the childbirth implements he designed and the glass decanter bottle which once contained his precious chloroform.

There are also items typically kept within the museum's restricted access areas and rarely seen by the public, including adult bone and foetal pathology samples and detailed illustrations which demonstrate the complexities of childbirth at the dawn of modern medicine.

The major exhibition also examines how the Bathgate-born pioneer's determination to modernise childbirth clashed with religious beliefs at the time and how, at odds with many of his fellow professionals, he supported women in medicine and the introduction of midwives in hospitals.

Of course, these days there will be few women to have given birth in Edinburgh who won't know the name Simpson - the Royal Infirmary of Edinburgh's Simpson Centre for Reproductive Health is the country's busiest maternity unit. Around 6000 new lives enter the world within its walls every year.

Yet childbirth for the women of Simpson's era and earlier was often a miserable experience, one which the son of a baker resolved to end.

He was, explains Chris Henry, heritage manager at Surgeons' Hall, fiercely ambitious with a brilliant mind that had seen him enter Edinburgh University aged just 14 and achieve his first medical qualification four years later - even though he was still too young to actually receive a licence to practise medicine.

"When he applied for the Chair of Midwifery at Edinburgh at the age of 28, the established figures within the Faculty of Medicine regarded him as a young upstart who should not have dared to put himself forward," explains Chris, who compiled the new exhibition.

"After vigorous canvassing, Simpson was appointed, although only by one vote. He was furious his ambitions had come so close to being thwarted and seemed to be at war with the medical establishment throughout his life."

The public, however, adored him. Simpson pioneered obstetrics techniques and redesigned equipment like forceps to help achieve better outcomes for patients and their babies, while the door to his Heriot Row medical practice was open to all, however hard up.

But it was his discovery of chloroform's anaesthetic benefits, later combined with Joseph Lister's antiseptic which was, says Chris, one of the greatest medical breakthroughs.

"Before anaesthetics, surgery was a rough and ready affair. Just prior to Simpson's discovery, ether had been used. But ether was neither cheap nor easy to transport - it's highly volatile - and caused vomiting. A cheaper and more neutral anaesthetic was required."

Chloroform was first produced in 1831 but its analgesic qualities had never been tested until that curious evening in November 1847.

Simpson, by all accounts a witty and convivial character, seems to have had little trouble enticing his private assistant James Matthews Duncan and Professor of Chemistry George Keith to join him in an experiment that could easily have gone terribly wrong - inhale too much and chloroform can kill.

But when Simpson woke next morning, he was instantly convinced he had found the solution to a problem that had perplexed surgeons since the first painful incision was made.

Later he recalled the party's response to their first sample of the chloroform's power: "Immediately an unwonted hilarity seized the party - they became bright-eyed, very happy and very loquacious - expatiating on the delicious aroma of the new fluid . . . then all was quiet, and then - a crash."

His wife's niece Agnes Petrie, also indulged and clearly quite enjoyed the experience, singing "I am an angel" as she fell asleep.

It was a rather risky and slightly bizarre experiment but it changed the course of medicine. "They sat around the dining table, and set about a series of tests," adds Chris. "The idea was that the last man standing would make notes. Yet it was very dangerous, and very surprising that he didn't have any casualties.

"Chloroform was beneficial for patients because they didn't have the pain but it also meant that surgeons could operate without someone thrashing around. The advantages in terms of what they could do - they could suddenly operate on different parts of the body - were huge."

The Accoucher, James Young Simpson, is on now at the Surgeons' Hall Museum, Nicolson Street. www.museum.rcsed.ac.uk

Innovator

JAMES Young Simpson was born in Bathgate in 1811 and went on to invent several instruments for extracting deceased foetuses which ultimately saved the lives of many mothers.

He became one of Queen Victoria's Scottish physicians and she endorsed chloroform, using it when she delivered Prince Leopold in 1853.

One side effect of his chloroform discovery was the upsurge in its use for recreational purposes - chloroform parties which involved guests inhaling the vapour for enjoyment were held regularly in smart dining rooms around the country.

Simpson's death, aged 58, plunged the city into mourning. More than 100,000 people lined the route of his funeral.