World Anaesthesia Day: Landmark Nizam-era chloroform trials that shaped modern medicine

As the world marks World Anaesthesia Day, Hyderabad’s pivotal contribution to the evolution of anaesthesia is being remembered. In the late 19th century, under the patronage of the Nizam, British surgeon Dr Edward Lawrie led groundbreaking chloroform trials that reshaped global medical consensus.

Hyderabad: As doctors and health care institutions across the world observe World Anaesthesia Day, commemorating the first public demonstration of surgical anaesthesia on October 16, 1846 in Boston, the celebrations are incomplete without acknowledging the role of Hyderabad in the development of anaesthesia as a medical science.

It was in Hyderabad and the hallowed portals of Osmania General Hospital (OGH), where the first steps in developing anaesthesia into a proven science, in the form of Chloroform trials, were taken.

---

More than a century ago, during the erstwhile Nizam’s domain, under the patronage of the Sixth Nizam, Mir Mahboob Ali Khan, British surgeon Dr Edward Laurie, who was the first principal of Osmania General Hospital (OGH) and Resident General of Hyderabad, successfully conducted and proved the efficacy of chloroform, as an anaesthetic agent.

In the 1880s, the scientific consensus, solidified by groups like the Glasgow Committee, held that chloroform was injurious to the heart and decidedly more dangerous than its rival, Ether. Dr. Lawrie, however, was a staunch proponent of chloroform, believing that patient deaths were due to improper administration causing respiratory failure, not cardiac arrest.

In 1885, Major Lawrie took charge of the Hyderabad Medical College, and, backed by the Nizam, set out to prove his claim. The first Hyderabad Chloroform Commission was established in 1888 under Surgeon P. Hehir at Afzalgunj Hospital.

The Commission’s preliminary findings, after extensive studies where chloroform was reportedly applied to 40,000 patients with no deaths, were promising. However, ‘The Lancet’ refused to acknowledge the study’s conclusion, challenging the scanty data.

The rejection triggered an unprecedented response from the Nizam, who was upset and through Major Lawrie sent a letter to The Lancet offering 1,000 pounds to cover the travel expenses for an expert to repeat the experiments in Hyderabad.

The Lancet accepted the challenge and Dr. Lauder Brunton, a celebrated heart surgeon and authority on the impact of drugs on the heart, moved to Hyderabad. Dr. Brunton arrived on October 21, 1889, where he was met with the lavish hospitality of the Nizam. The Second Hyderabad Chloroform Commission commenced work two days later, meeting daily from 7 am to 5 pm until December 18.

For 57 days, the Commission conducted meticulous experiments on 430 animals, including dogs, monkeys, horses, and rabbits, alongside clinical studies on 54 patients. They recorded blood pressure by catheterizing the carotid artery, using kymographs to generate data that convinced Dr. Brunton of Dr. Lawrie’s technique.

The conclusion was definitive: chloroform could be given with safety, provided respiration was carefully monitored. Subsequently, the debate over its efficacy was settled.

Dr. Brunton left Hyderabad satisfied, and the entire exhaustive report, published in 1891, became a landmark medical study, accepted worldwide.