Introduction - Uppsala Monitoring Centre

Comment: the side effects were severe in comparison with those of other
emetics of the time and later in the 19th century it was used for fevers
especially bronchitis and pneumonia and the fact that it has some in vitro
antimicrobial activity supports this usage (Duffin & René, 1991) and its more
specific use in parasitic disorders was demonstrated in 1910 (Camac, 1911)
which warranted its continuation until better drugs became available.
Drug Lifespan: 1,488 years
Delay in recognition: not known
Delay in regulatory action: not known
Time span of withdrawals: 23 years
1831 Chloroform (Phedros)
In 1847 was used as an anaesthetic by Simpson of Edinburgh for use in childbirth
(Simpson, 1847).
Use: originally it was introduced as a general anaesthetic, but it was later widely
used in pharmaceutical preparations as a solvent and preservative.
ADR: in 1842 it was reported to have caused instantaneous death in four
patients by ‘paralysing the heart’ during anaesthesia (Sibson, 1848). In 1848
Professor Simpson said that a death was due to congestion of the lungs from
the effects of chloroform (Simpson, 1848). In 1858 John Snow having used
chloroform on 50 patients considered the various possible causes of death:
1. Falling back of the tongue
2. Sitting position
3. Alleged exhaustion from struggling
4. Alleged closure of the glottis
5. Alleged exclusion of the air
6. Alleged impurities in the chloroform
7. Idiosyncrasy
8. Supposed effect of the surgeon’s knife
9. Sudden death from other causes
He did not come to any conclusion. However, we can now see that numbers 3
and 8 would have caused increased secretion of adrenaline, which is now
known to be a factor in producing the ventricular fibrillation (Snow, 1989).
The BMA in 1877 appointed a committee to investigate the actions of
anaesthetics and they concluded that chloroform could cause sudden
stoppage of the heart and of respiration, and that ether was less dangerous
than chloroform (McKendrick, 1880). Others disagreed and a Surgeon Major
E Laurie who was the Residency surgeon at Hyderabad established the
Hyderabad Commission on Chloroform which reported that deaths from
chloroform are due to asphyxia and that as long as respiration was attended
to there was no problem of sudden death; this itself was disputed and a