Abstract
The administration of chloroform by John Snow to Queen Victoria to provide analgesia for the delivery of her children was a pivotal moment in the development of anaesthesia. It has long been thought that this was the only occasion she had experienced anaesthesia but examination of her diaries shows this to be untrue.
Queen Victoria’s receipt of chloroform analgesia for two of her children’s deliveries has been well documented.1,2 Several learned anaesthesia historians have written that she did not ever receive chloroform after this, but such statements are not true.3,4 On 4 September 1871, at Balmoral Castle in Scotland, she had the incision and drainage of an abscess performed by Joseph Lister, who had arrived from Edinburgh that afternoon. Her extensive diary writing has been digitalised and can be accessed online, and it is from this that this ‘new’ information has been taken. 5
On 3 August 1871, while at Osborne House on the Isle of Wight, Queen Victoria awoke from her normal night’s sleep to find her elbow had been stung while she slept, and the arm was now stiff and sore. This did not cause any interference with her daily activity over the next week and after four days she felt the arm was much better, but then on 9 August she noted that her arm was still ‘rather bad’. Over the next few days she continued to feel unwell, and by 13 August she was suffering from a very sore throat. She left the Isle of Wight on the afternoon of 15 August and moved to Windsor Castle. She remained somewhat unwell and consulted with her physician, Sir William Jenner, on the following day, but no specific therapeutic intervention was recorded in her diary at this time. She started to feel more discomfort from her arm again and noted that the area that had been stung a fortnight before had still not healed. That night and the following day she travelled some 500 miles to Balmoral Castle; Sir William Jenner accompanied the Royal Household. Over the following days she remained unwell with increasing pain from her throat and difficulty in swallowing. Her throat symptoms eased on the 20th when she ‘felt something give way in her throat’ and she felt much better. By 24 August her throat was much better, but her arm was getting much worse and the following day she noted that there was a ‘lump’ underneath the arm. By the 29th the pain was increasing, and she remained unwell. She noted that ‘My arm no better & will not yield to any treatment. Every kind of thing has been tried’. On 3 September, in the face of no improvement, her physician Dr William Marshall, who had been appointed Resident Medical Attendant to the Queen that year, implored her to obtain a second opinion and suggested that Mr Joseph Lister, Professor of Surgery in Edinburgh, be asked to attend. Eventually the Queen agreed, and Lister was sent for. He arrived the following afternoon.
She wrote in her diary journal on the 4th: Sir Wm Jenner explained everything about my arm to him (Lister) but he naturally said he could do nothing or give any opinion, till he had made an examination. I had to wait nearly half an hour before Mr Lister and Dr Marshall appeared! In a few minutes he had ascertained all & went out again with the others. Sir Wm Jenner returned saying Mr Lister thought the swelling should be cut, he could wait 24 hours, but it would be better not. I felt dreadfully nervous, as I bear pain so badly. I shall be given chloroform, but not very much, as I am far from well otherwise, so I begged that the part might be frozen which was agreed on. – Everything was got ready & the 3 Doctors came in. Sir Wm Jenner gave me some whiffs of chloroform, whilst Mr Lister froze the place, Dr Marshall holding my arm. The abscess, which was 6 inches in diameter was very quickly cut & I hardly felt anything excepting the last touch, when I was given a little more chloroform. In an instant there was relief. I was then tightly bandaged, & rested on my bed.
6
This further administration of chloroform to Queen Victoria has been overlooked by numerous anaesthesia historians. It appears not to have been a full surgical anaesthetic but a further episode of ‘chloroform a la reine’ as utilised by John Snow during her labour. The analgesia provided by the chloroform was enhanced by the use of a surface cooling spray on the skin overlying the abscess.
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship and publication of this article.
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
