Queen’s Birthday Special

It seems serendipitous that last week’s posts were obstetric related and today is the Queen’s Birthday holiday…

Queen Victoria was a relatively early adopter of anaesthesia and received chloroform anaesthesia for the birth of her 8th and 9th children, Leopold in 1853 and Beatrice in 1857. The chloroform was administered via an open drop technique, during the second stage of labour, with the aim of achieving semi-consciousness. The Queen is quoted as saying the chloroform was “soothing, quieting and delightful beyond measure”

 


It was James Simpson who, in 1847, first suggested the use of anaesthesia for labour. Initially obstetricians were almost universally opposed to the use of anaesthesia for labour, citing it as unnecessary for a natural process and concerned for the safety aspects.

John Snow, who anaesthetised Queen Victoria on both occasions, was a physician with a career spanning interest in anaesthesia. He experimented widely, on animals, using different inhaled substances in an attempt to find superior anaesthetic agents. He realised that the volatility of an agent declined as it was vaporised , due to the drop in temperature. Consequently he developed and early vaporiser, with a brass chamber which was immersed in water, to minimise temperature fluctuations. He appears to have been a man of great scientific rigour, which likely inspired confidence amongst the Queen’s physicians and eased the path for her to receive anaesthesia, when she and Prince Albert requested it. He was also a strong proponent of a doctor separate to the surgeon administering the anaesthetic. One of his major works On Chloroform and Other Anaesthetics and their Administration was published following his death is 1858. If you click on the title it will take you to a copy of the book, with William Morton’s name handwritten across the top!

John Snow made another great contribution to medicine as an epidemiologist. He was a believer that cholera was transmitted by contaminated water, contrary to popular belief at the time. Following an outbreak in London in 1854, he conducted an extensive epidemiological investigation tracking the details of victims and non victims to identify where they sourced their water. He identified the likely source as a pump on Broad Street, Armed with his research, he went to town officials and convinced them to remove the pump handle, making it impossible to draw water from the pump. The outbreak stopped almost instantly! It wasn’t until 1883 that Vibrio cholerae was isolated by Robert Koch and the means of transmission confirmed.

John Snow died age 45. Just imagine what he might have contributed to our speciality ( and others) if he had lived a long life……

John_Snow

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