Joseph Clover
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Joseph Thomas Clover (28 February 1825; baptised 7 May 1825 – 27 September 1882) was an English doctor and pioneer of anaesthesia. He invented a variety of pieces of apparatus to deliver anaesthetics including ether and
chloroform Chloroform, or trichloromethane, is an organic compound with chemical formula, formula Carbon, CHydrogen, HChlorine, Cl3 and a common organic solvent. It is a colorless, strong-smelling, dense liquid produced on a large scale as a precursor to ...
safely and controllably. By 1871 he had administered anaesthetics 13,000 times without a fatality. Clover assisted at surgery of public figures including
Napoleon III Napoleon III (Charles Louis Napoléon Bonaparte; 20 April 18089 January 1873) was the first President of France (as Louis-Napoléon Bonaparte) from 1848 to 1852 and the last monarch of France as Emperor of the French from 1852 to 1870. A nephew ...
, Princess Alexandra of Denmark and her husband King
Edward VII Edward VII (Albert Edward; 9 November 1841 – 6 May 1910) was King of the United Kingdom of Great Britain and Ireland and Emperor of India, from 22 January 1901 until his death in 1910. The second child and eldest son of Queen Victoria an ...
(then Prince of Wales), Sir
Robert Peel Sir Robert Peel, 2nd Baronet, (5 February 1788 – 2 July 1850) was a British Conservative statesman who served twice as Prime Minister of the United Kingdom (1834–1835 and 1841–1846) simultaneously serving as Chancellor of the Exchequer ...
, and
Florence Nightingale Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English Reform movement, social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during t ...
. His inventions included the bulky 'Clover's chloroform apparatus' (1862), with which he was often photographed; and the compact 'Clover's portable regulating ether inhaler' (1877), which remained in use well into the 20th century. With fellow pioneer
John Snow John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the development of anaesthesia and medical hygiene. He is considered one of the founders of modern epidemiology, in part because of his work in tracing the so ...
, Clover is one of the supporters on the crest of the
Royal College of Anaesthetists The Royal College of Anaesthetists (RCoA) is the professional body responsible for the specialty of anaesthesia throughout the United Kingdom. It sets standards in anaesthesia, critical care, pain management, and for the training of anaestheti ...
.


Early life

Clover was born in the town of Aylsham, Norfolk Rushman, page 27. to John Wright Clover, a draper and shopkeeper, and Elizabeth Mary Ann Clover (née Peterson) John Wright Clover's second wife (married at Aylsham on 11 June 1821). He was educated at the Gray Friars' Priory School, Norwich. When he was 16, Clover was apprenticed as a surgical dresser to a local surgeon, Charles Gibson.Maltby, page 39. Clover enrolled to study medicine at
University College Hospital University College Hospital (UCH) is a teaching hospital in the Fitzrovia area of the London Borough of Camden, England. The hospital, which was founded as the North London Hospital in 1834, is closely associated with University College London ...
in 1844, where
Joseph Lister Joseph Lister, 1st Baron Lister, (5 April 182710 February 1912) was a British surgeon, medical scientist, experimental pathologist and a pioneer of antiseptic surgery and preventative medicine. Joseph Lister revolutionised the craft of s ...
(the pioneer of antisepsis) was a fellow student.


Career

Clover became house surgeon to James Syme upon graduation in 1846. He became Resident Medical Officer at University College Hospital in 1848, and was admitted as a Fellow of the Royal College of Surgeons in 1850. Originally Clover developed an interest in the field of urology. He practised as a surgeon, inventing two instruments for the crushing and removal of bladder stones. Ill health caused him to give up in 1853 and he turned to general practice.City of Westminster green plaques He then worked as a general practitioner in 1853. He set up his practice at 3 Cavendish Place, London, which became his home until his death in 1882. After several years in general practice he devoted his practice to anaesthetics, and became "chloroformist" to the University College Hospital, the
Westminster Hospital Westminster Hospital was a hospital in London, England, founded in 1719. In 1834 a medical school attached to the hospital was formally founded. In 1939 a newly built hospital and medical school opened in Horseferry Road, Westminster. In 1994 the ...
and the London Dental Hospital. Clover's choice of speciality helped to fill the vacancy created by the death of
John Snow John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the development of anaesthesia and medical hygiene. He is considered one of the founders of modern epidemiology, in part because of his work in tracing the so ...
in 1858. Clover was probably present at Robert Liston's first operation under
ether In organic chemistry, ethers are a class of compounds that contain an ether group—an oxygen atom connected to two alkyl or aryl groups. They have the general formula , where R and R′ represent the alkyl or aryl groups. Ethers can again be c ...
anaesthesia at University College Hospital in December 1846. Clover wrote in 1871 that he had given chloroform more than 7000 times, in addition to other anaesthetics in another 4000 cases, without a fatality. However, he lost a patient to chloroform under his hands in 1874, in a case which he described in the
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
.Sykes, page 30.


Important cases

Because of his expertise in anaesthesia, Clover was often sought out when important figures required surgery. He gave
chloroform Chloroform, or trichloromethane, is an organic compound with chemical formula, formula Carbon, CHydrogen, HChlorine, Cl3 and a common organic solvent. It is a colorless, strong-smelling, dense liquid produced on a large scale as a precursor to ...
to Napoleon III of France on 2 January 1873, at
Chislehurst Chislehurst () is a suburban district of south-east London, England, in the London Borough of Bromley. It lies east of Bromley, south-west of Sidcup and north-west of Orpington, south-east of Charing Cross. Before the creation of Greater L ...
, Kent, and again on 6 January, for a procedure to break up a bladder stone. The Emperor died on 9 January. Clover was a signatory to his
autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
report, together with five other physicians.Sykes, page 8. Clover gave chloroform to Alexandra of Denmark, who was then the
Princess of Wales Princess of Wales (Welsh: ''Tywysoges Cymru'') is a courtesy title used since the 14th century by the wife of the heir apparent to the English and later British throne. The current title-holder is Catherine (née Middleton). The title was firs ...
, in 1867, for the removal of a splint from a rheumatic knee, and later anaesthetised her husband
Edward VII Edward VII (Albert Edward; 9 November 1841 – 6 May 1910) was King of the United Kingdom of Great Britain and Ireland and Emperor of India, from 22 January 1901 until his death in 1910. The second child and eldest son of Queen Victoria an ...
(who was then Prince of Wales) in 1877, for an operation to drain an abscess which was attributed to a hunting injury. Clover also administered general anaesthesia to Sir
Robert Peel Sir Robert Peel, 2nd Baronet, (5 February 1788 – 2 July 1850) was a British Conservative statesman who served twice as Prime Minister of the United Kingdom (1834–1835 and 1841–1846) simultaneously serving as Chancellor of the Exchequer ...
,
Florence Nightingale Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English Reform movement, social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during t ...
Rushman, page 28. and Sir
Erasmus Wilson Sir William James Erasmus Wilson FRCS FRS (25 November 18097 August 1884), generally known as Sir Erasmus Wilson, was an English surgeon and dermatologist. Biography Wilson was born in London, studied at Dartford Grammar School before St Ba ...
.


Apparatus

During his lifetime, Clover invented and improved a variety of pieces of medical apparatus, especially those for easier and safer anaesthesia. Some of these inventions bore his name, including:


Clover's chloroform apparatus

Clover's chloroform apparatus was invented in 1862. Chloroform, being much more potent than ether, was much easier to give in overdose. At a time when the anaesthetist was often an untrained assistant, many deaths occurred through accidental overdose. Clover's solution was a large reservoir bag of known capacity, lined with
goldbeater's skin Goldbeater's skin is the processed outer membrane of the intestine of an animal, typically cattle, which is valued for its strength against tearing. The term derives from its traditional use as durable layers interleaved between sheets of gold s ...
to make it airtight, into which a measured volume of chloroform liquid was placed. Inflating the bag to its capacity with a bellows provided a known, accurate and constant concentration of chloroform vapour in air, making delivery safer and more controllable. A vaporiser was no longer necessary, but the bag was large and cumbersome. A dose of 20 minims (1.18 millilitres) of chloroform per 1000 cubic inches (16.38 litres) of air would provide a concentration of chloroform vapour of 2.25%. 30 minims (1.77ml) would give 3.37%, and 40 minims (2.36ml) would give 4.5%, which Clover believed was the maximum safe concentration. Many photographs of Clover, heavily bearded, depict his chloroform apparatus slung over his shoulder.


Clover's ether inhaler

Clover invented his portable ether inhaler in 1877. Judging by the illustration on the right, it was much admired at the time. It remained in use, modified in various ways, well into the 20th century.Duncum, 1947.


Clover's crutch

Clover's crutch was a device for maintaining the patient in the lithotomy position.


Death

Clover's health was fragile throughout his life. He died of uraemia aged 57. He is buried in Brompton Cemetery, London. His grave is only 200 yards away from that of fellow anaesthetics pioneer, John Snow.


Posthumous recognition

Together with
John Snow John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the development of anaesthesia and medical hygiene. He is considered one of the founders of modern epidemiology, in part because of his work in tracing the so ...
, Clover is one of the supporters on the crest of the
Royal College of Anaesthetists The Royal College of Anaesthetists (RCoA) is the professional body responsible for the specialty of anaesthesia throughout the United Kingdom. It sets standards in anaesthesia, critical care, pain management, and for the training of anaestheti ...
. In 1949, the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations a ...
established the annual Joseph Clover Lecture in recognition of his contribution to anaesthesia. It was given annually until 1958 and every two years thereafter. A memorial plaque on the site of his clinic at 3 Cavendish Place,
Marylebone Marylebone (usually , also , ) is a district in the West End of London, in the City of Westminster. Oxford Street, Europe's busiest shopping street, forms its southern boundary. An Civil parish#Ancient parishes, ancient parish and latterly a ...
, was unveiled on 2 March 1994.


References


Bibliography

* Duncum, Barbara M., ''The Development of Inhalation Anaesthesia with Special Reference to the Years 1846–1900'', Oxford University Press, 1947. * Maltby, J.R. ''Notable Names in Anaesthesia''. The Royal Society of Medicine Press, London, 2002. * Rushman, G.B., Davies N.J.H., Atkinson, R.S. ''A Short History of Anaesthesia: the First 150 Years''. Butterworth Heinemann, Oxford, 1996. * Sykes, W.S. ''Essays on the First Hundred Years of Anaesthesia'', Volume 2. Churchill Livingstone, Edinburgh, 1960. {{DEFAULTSORT:Clover, Joseph Thomas 1825 births 1882 deaths People from Aylsham English anaesthetists Burials at Brompton Cemetery Fellows of the Royal College of Surgeons 19th-century English medical doctors