Breaking the Barrier of Pain:

The Use of Chloroform in 19th Century Obstetrics

Kaitlyn Jorgensen, Melodi Fugate, Victoria Valdivia

Junior Division

Group Website

NHD Research Paper Total Word Count: 2,304

 NHD Research Paper:

Pain is described as an unpleasant sensation that can range from mild discomfort to agony

that has both physical and emotional components. Today, we have different anesthesias that help

resolve the problem of pain, though we did not always have these advantages. In certain fields of

medicine, such as obstetrics, there were no anesthetics used during operations. Born on June 7,

1811, Sir James Young Simpson was one of the most renowned obstetricians of his time. It was

Simpson’s life's work to find an efficient and safe anesthetic that could be used in childbirth. At

first, he introduced ether, but soon discovered the side effects that included a foul odor and

caused irritation in patients’ lungs. So, Simpson employed the use of chloroform in obstetrics

and received many accolades and high positions for its success.

James Young Simpson, a medical pioneer, was born in Bathgate, Scotland on June 7,

1811. Simpson was born on June 7, 1811 in Scotland. He was one of the best and most

influential obstetricians of the nineteenth century. Simpson began studying medicine at the

young age of 14 at Edinburgh University, and after was made “Professor of Midwifery” or

obstetrics. He was very well-known for his personality and influence of his patients and received

many honors, for example, an honorary degree from Oxford. He died in London on May 6, 1870

after discovering both ether and chloroform as effective anesthetics for women in labor. In

January of 1845, Horace Wells, an anesthetic researcher and surgeon, attempted a tooth

extraction using a form of ether called nitrous oxide. Shortly into the surgery, the patient cried

out in pain, and Wells’ experiment was marked as a failure. Simpson heard about the failure of

ether and its lengthy period of action, as well as its inconsistency to remove a patients’ pain.

Simpson made it his mission to find an alternative. This was more important than ever,​ because
so many mothers were dying during childbirth and many additional mothers were experiencing

complications​. In order to find a replacement for ether, which had a disagreeable smell, and

irritated patients lungs, Simpson experimented with several different gases. The obstetrician

discovered chloroform many months into his search. Chloroform was safer and had fewer

hazardous side effects than ether. Unfortunately, many people were opposed to chloroform, or

any type of anesthetic during childbirth, because people were very ​religious at that time, and they

felt that rendering a woman unconscious would disrupt the baby’s natural conception. They also

believed that pain during childbirth was supposed to be just that; painful. It was because of

Adam and Eve and their sin which led up to that belief. This anesthetic was eventually widely

accepted when​ ​Queen Victoria used it during her labor and childbirth period. This greatly

influenced the campaign to use chloroform nationally and globally because she was a

well-respected, global figure. So, if it was good enough for her, other people would use it as

well.

The allies of the use of chloroform as an anesthetic in nineteenth century obstetrics were

James Young Simpson, Dr. William Duncan, Dr. George Keith, Queen Victoria, and wealthy

nobles and respected doctors that supported his discovery as well as women who used it

themselves. James Simpson, Drs Keith and Duncan were the doctors who discovered the

anesthetic properties of chloroform, although, James Simpson was the first to utilize it in

obstetrics. According to “Simpson: The turbulent life of a medical pioneer.”, “On the evening of

November 4, 1847, Simpson and two colleagues, along with family members, sat in his dining

room. They sniffed a number of chemicals that do not work, then tried chloroform and crashed to

the floor. After gaining consciousness, they tried it again, the family members joining in, then
celebrated until 3 a.m. Four days later, Simpson first used chloroform in obstetrics. By the time

he announced its discovery to the Edinburgh’s Medico-Chirurgical Society on November 10, he

had used it for “some fifty cases, ‘all with entire success.’””(Wong, Cynthia A., 2011). Some

people still believed that ether was a superior anesthetic, however, so colleagues and supporters

of Simpson wrote him letters to keep fighting for chloroform. They defended his work because

the claims that the use of chloroform as an anesthetic was dangerous and caused deaths were

false. These respected figures helped to disprove them so that people would not believe false

information, and they would begin to accept chloroform. As Simpson began to spread the news

of his medical success, Queen Victoria invited him to administer chloroform to her during the

labor and birthing period of her child. This was Simpson’s opportunity to prove to the opposing

parties that chloroform was effective did not cause as many side effects as ether, in addition, he

could use the Queen’s social status to promote his new anesthetic. The conception went well and

Simpson received a great deal of positive feedback. One of the Queen’s physicians even wrote to

him,​ ​“You will be pleased to hear the Queen had chloroform administered to her during her late

confinement. Her Majesty was greatly pleased with the effect, and she certainly never has had a

better recovery.” (Simpson, Eve Blantyre, 1896). Furthermore, Simpson’s allies influenced him

because of their letters of encouragement, which helped him to keep fighting for chloroform

even through the adversity, they also helped Simpson to convince the opposers of chloroform

that it was a genuine anesthetic.

The clergy and church were a part of the resistance of the use of chloroform in obstetrics,

because they believed it was sinful and against their religious policies. In addition, some medical

personnel believed that Ether was a better option. Many scientists, doctors, and researchers
debated the pros and cons of the use of chloroform in obstetrics. Some even attempted to put a

stop to the use of chloroform as an anesthetic in obstetrics. According to “What a Blessing She

Had Chloroform: The Medical and Social Response to the Pain of Childbirth from 1800 to the

Present. (Book Reviews)”, “Since that introduction, stormy debates over the wisdom, the danger,

the moral justification, the physiological ramifications, and the philosophical rationale of

obstetric analgesia and anesthesia have percolated through the medical and lay childbirth

literature.” (​ ​Bogdan-Lovis, Elizabeth A., 2001). Other doctors believed that chloroform could

have unprecedented emotional and physical effects. The church believed that using chloroform

in anesthesia was a way of opposing what had been preordained by God as stated in the Bible.

According to, “Chloroform In Clinical Anaesthesia”, “The ministers and elders of the church,

none of whom was likely to suffer the pains of labour, accused Simpson of arrogance in

attempting to thwart what had been ordained by God. In defence of their case they quoted the

Biblical text "In sorrow shalt thou bring forth children" (Genesis 3:16).” (Payne, JP, 1981). All

of this opposition made chloroform an unpopular method of anesthesia, by discouraging women

from using it. This also made Simpson unsuccessful in his initial attempt to popularize this

method. Simpson and his supporters kept fighting back and, eventually, using the support of the

nobles and the Queen’s social status, the resistance was silenced.

An immediate change that occured after chloroform was introduced to the public as a

viable anesthetic was that James Simpson was honored in many ways. Including being named

the official physician to Queen Victoria and being a member of the Edinburgh royal infirmary,

which was a great honor for any obstetrician of that time. Immediately after employing the use of

chloroform in obstetrics, Simpson was very pleased with his ability to take away the suffering of
mothers at the happiest moments of their life. This helped him to get chloroform to be accepted

amongst the other physicians, as he proved that he could take away the pain and, furthermore,

cause fewer deaths in childbirth. The article, “Sir James Young Simpson, M.D. On Chloroform

(November, 1847)”, “I have never had the pleasure of watching over a series of better and more

rapid recoveries; nor once witnessed any disagreeable result follow to either mother or child;

whilst I have now seen an immense amount of maternal pain and agony saved by its

employment. And I most conscientiously believe that the proud mission of the physician is

distinctly twofold – namely, to alleviate human suffering, as well as preserve human

life.”(Simpson, James Young, 1847). Over time, the use of chloroform led to reform in medical

education and obstetric care. The use and discovery of chloroform as an anesthesia dramatically

changed the pain in surgery and labor. In addition, obstetricians replaced midwives developing

patterns of practice, and giving women more freedom to have a child safely, and effectively.. As

stated in, “The Influence of Social Values on Obstetric Anesthesia”, “The major stimulus for

change emerged from a social movement—women’s rights—which began when Elizabeth Cady

Stanton and Lucretia Mott convened a meeting in 1847 in Seneca Falls, New York. The focus of

the meeting was the economic and political rights of women, but reformers realized that women

could not achieve parity unless they were well educated and healthy. A major deterrent to good

health, they believed, were the cumulative effects of repeated pregnancies. Accordingly, as they

campaigned for the vote, they also sought ways to improve women’s health. Specific goals

included founding schools dedicated to the education of women physicians, improved teaching

of obstetrics in all medical schools, replacement of midwives with obstetricians, and

hospitalization for delivery followed by several weeks of recuperation. In this context, the use of
anesthesia for childbirth raised an issue.”(Caton, Donald, 2015). The discovery of chloroform

gave more freedom to women to have a painless childbirth, and dramatically decreased the pain

involved in surgery and labor.

The significance and legacy of Simpson’s work with anesthetics in obstetrics was

important because he discovered a way to relieve pain with chloroform, which caused fewer side

effects than ether. According to the article, “James Young Simpson”, published by the World of

Health, “His reputation and promotional talents eventually helped overcome opposition to

anesthesia generally and to its use in obstetrics. Chloroform and ether have not been used as

human anesthetics since the 1950s; in the past few decades synthetic gases with fewer side

effects have replaced the older agents. Yet Simpson's work a century and a half ago legitimized

the use of medical interventions to relieve the pain of labor. Millions of women around the world

whose labor pains have been eased by various types of anesthesia have benefited from Simpson's

groundbreaking efforts.” (Schlager, Neil & Lauer, Josh, 2000). Moreover, Simpson’s legacy was

that anesthetics after his time were based off of his research. The breaking of this barrier drove

confidence into science and medicine at that time and led to great improvements in obstetrical

and general care.

Once this barrier was broken it had an affect both economically and socially. Queen

Victoria’s acceptance of chloroform influenced the campaign to use chloroform nationally and

globally. As did the support was widely renowned and respected nobles. Now that citizens were

using and accepting chloroform, the economy soared. According to, “World of Health”, “In

November of 1847 (the same year he was appointed physician to the Queen in Scotland),

Simpson began to employ chloroform in obstetrics and labor...It was not until 1853, when Queen
Victoria accepted the use of chloroform for the birth of her son that criticism of Simpson began

to subside.”(Narins, 2006). Once the Queen had validated chloroform as an anesthetic, both

Europe and America gained lots of influence and power due to their newfound knowledge that

they could now sell to other countries. The popularity of chloroform during this time also

brought an abundance of pregnant women to Scotland to receive treatment. This significantly

boosted the economy. “Queen Victoria gave birth to her eighth child with the successful

administration of chloroform. This quickly silenced all opposition to Simpson and his stance on

pain-free childbirth. Simpson was subsequently awarded honorary memberships of the most

distinguished medical societies in Europe and America and enjoyed more power and influence

than ever before. Simpson’s authority now extended well beyond obstetrics and midwifery and

his influence extended beyond Scotland.” (Physicians of Edinburgh, 2019). The breaking of this

barrier caused many changes economically and socially for doctors and citizens everywhere.

The political effects of Simpson’s discovery of chloroform were that debates broke out

“over the wisdom, the danger, the moral justification, the physiological ramifications, and the

philosophical rationale of obstetric analgesia and anesthesia…” (Bogdan-Lovis, Elizabeth A.,

2001). Many scientists, doctors, and researchers debated the pros and cons of the use of

chloroform in obstetrics, and it received a lot of backlash, Especially since it went against some

religions by altering the natural state of the mother. Some even attempted to put a stop to the use

of chloroform as an anesthetic in obstetrics, but Queen Victoria quelled these dissenters when

she expressed her pleasure with the entire process of the administration of chloroform and lack

of pain and/or complications during the conception. Once this had happened, the people used it

as a sign that chloroform was a safe anesthetic in obstetrics.

 When the barrier of pain was broken by the discovery of chloroform, it had an everlasting

effect on obstetrical care for women across the globe. The renowned obstetrician, James Young

Simpson, made this groundbreaking discovery, which at first wasn’t accepted due to its religious

ramifications and the possible danger of this new and unknown anesthetic. This new type of

anesthesia was eventually accepted due to strong supporters, and was used as a replacement for

ether. Due to this great success and milestone for obstetricians and doctors, Simpson received

many accolades and honors for his success. Obstetric care and its anesthesia wouldn’t be what it

is today without Simpson and his discovery of chloroform’s anesthetic properties.

 Annotated Bibliography

Primary Sources:
1. Simpson, Eve Blantyre. Sir James Y. Simpson. Anderson & Ferrier, 1896.

This source was used as a primary source to tell us a truthful and first hand account of

Simpson’s life from someone that knew him personally and followed his medical

achievements and career.

Secondary Sources:

2. "James Young Simpson." World of Health, Gale, 2006. Gale In Context: Science,

https://link.gale.com/apps/doc/K2191100331/GPS?u=mira63459&sid=GPS&xid=600e93

1f. Accessed 7 Sept. 2019.

This source was used to explain who Sir James Young Simpson was and why he was

important to 19th century obstetrics.

3. Wong, Cynthia A. “Simpson: The turbulent life of a medical pioneer” Journal of Clinical

Investigation, vol. 121, no. 9, 2011, p. 3365. Gale Academic Onefile,

https://link.gale.com/apps/doc/A266225585/AONE?u=novaseu_main&sid=AO

NE&xid=a842b012. Accessed 21 Sept. 2019.

This source was used to explain what the allies of chloroform did to help Simpson get the

medical world to accept chloroform as a safe anesthetic in obstetrics.

4. Bogdan-Lovis, Elizabeth A. “What a Blessing She Had Chloroform: The Medical and

Social Response to the Pain of Childbirth from 1800 to the Present. (Book Reviews).”

Victorian Studies, vol. 43, no. 4, 2001, p. 686+. Gale Academic Onefile,

https://link.gale.com/apps/doc/A82671304/AONE?u=novaseu_main&sid=AONE&a
 mp;xid=ee3d9c6b. Accessed 13 Sept. 2019.

This source was used to explain what the opponents of the use of chloroform as an

anesthetic did to attempt to put a stop to its use.

5. “Sir James Young Simpson, M.D.- On Chloroform (November, 1847).” SOAP, Society

for Obstetric Anesthesia and Perinatology, 18 May 2018,

https://soap.org/about-us/soap-history-10-29-18/sir-james-young-simpson-m-d-on-chloro

form-november-1847/.

This source was used to explain one of the immediate effects of breaking the barrier of

pain, and what it meant for mothers around the world.

6. "James Young Simpson." Science and Its Times, edited by Neil Schlager and Josh Lauer,

vol. 5, Gale, 2000. Gale In Context: Science,

https://link.gale.com/apps/doc/K2643412306/GPS?u=mira63459&sid=GPS&xid=d2039c

a1. Accessed 7 Sept. 2019.

This source was used to explain the impact and legacy that Simpson left behind when he

discovered chloroform as an efficient anesthetic. In addition, it explains the importance of

the use of chloroform as an anesthetic in obstetrics.

7. Payne, JP. “Chloroform in Clinical Anesthesia.” ​British Journal of Anesthesia​, 1981,

https://bjanaesthesia.org/article/S0007-0912(19)30527-6/pdf.

This is an article written in 1981 from the British Journal of Anesthesia. ​This helped me

understand the reasoning behind the resistance.

8. Caton, Donald. “The Influence of Social Values on Obstetric Anesthesia.” ​Journal of

Ethics | American Medical Association,​ American Medical Association, 1 Mar. 2015,
https://journalofethics.ama-assn.org​/article/influence-social-values-obstetric-anesthesia/2
 015-03​.
This is an article from the Journal of Ethics American Medical Association written by
Donald Caton. T​his helped me understand what legacy was left after the breaking of this
barrier.