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Joseph_Thomas_Clover

Joseph Thomas Clover

Joseph Thomas Clover (28 February 182527 September 1882) was an English doctor, and one of the very first doctors to devote his career to the field of anaesthesia. He is regarded as a pioneer in the field.

Early life

Clover was born in the town of Aylsham in Norfolk. 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.

He enrolled to study medicine at University College Hospital in 1844, where Joseph Lister (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 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. This site is now commemorated by a plaque which bears his name.

After several years in general practice he devoted his practice to anaesthetics, and became "chloroformist" to the University College Hospital, the Westminster Hospital and the London Dental Hospital. Clover's choice of specialty helped to fill the vacancy created by the death of John Snow in 1858.

Clover was probably present at Robert Liston's first operation under ether 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. He described the case in the British Medical Journal.

Important cases

Because of his expertise in anaesthesia, Clover was often sought out when important figures required surgery. He gave chloroform to Napoleon III of France on January 2, 1873, at Chislehurst in Kent, and again on January 6, for a procedure to break up a bladder stone. The Emperor died on January 9. Clover was a signatory to his autopsy report, together with five other physicians.

Clover gave chloroform to Alexandra of Denmark, who was then the Princess of Wales, in 1867, for the removal of a splint from a rheumatic knee, and later anaesthetised her husband Edward VII (who was then the 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, Florence Nightingale and Sir Erasmus Wilson.

Apparatus

During his lifetime Clover invented and improved many pieces of medical apparatus, including many to make the administration of anaesthesia easier and safer. Many of his inventions bore his name. Among these were:

Clover's crutch

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

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 due to accidental overdose. Clover's solution to this problem was to invent a large reservoir bag of known capacity, lined with goldbeater's skin 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, which made chloroform much safer to deliver. This meant that a vaporiser was unnecessary, but the bag was very 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's portable ether inhaler was invented in 1877.

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 John Snow.

Posthumous recognition

Together with John Snow, he is one of the supporters on the crest of the Royal College of Anaesthetists. In 1949, the Royal College of Surgeons established the annual Joseph Clover Lecture in recognition of his contribution to anaesthesia. It was given annually until 1958 and every two years thereafter .

References

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