Joseph Thomas Clover
Encyclopedia
Joseph Thomas Clover 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
Aylsham
Aylsham is a historic market town and civil parish on the River Bure in north Norfolk, England, about north of Norwich. The river rises near Melton Constable, upstream from Aylsham and continues to Great Yarmouth and the North Sea, although it was only made navigable after 1779, allowing grain,...

, Norfolk to John Wright Clover, a farmer, and Elizabeth Mary Ann Clover (nee Taylor) . 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 .
Clover enrolled to study medicine at University College Hospital
University College Hospital
University College Hospital is a teaching hospital located in London, United Kingdom. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London ....

 in 1844, where Joseph Lister
Joseph Lister, 1st Baron Lister
Joseph Lister, 1st Baron Lister OM, FRS, PC , known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery, who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary...

 (the pioneer of antisepsis) was a fellow student.

Career

Clover became house surgeon to James Syme
James Syme
James Syme was a pioneering Scottish surgeon.-Early life:He was born on 7 November in Edinburgh. His father was a writer to the signet and a landowner in Fife and Kinross, who lost most of his fortune in attempting to develop the mineral resources of his property...

 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
Fellowship of the Royal College of Surgeons
Fellowship of the Royal College of Surgeons is a professional qualification to practise as a surgeon in the United Kingdom and Republic of Ireland...

 in 1850. Originally Clover developed an interest in the field of urology
Urology
Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...

. He then worked as a general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...

 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
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....

 and the London Dental Hospital. Clover's choice of specialty helped to fill the vacancy created by the death of John Snow
John Snow (physician)
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of epidemiology, because of his work in tracing the source of a cholera outbreak in Soho, England, in 1854.-Early life and education:Snow was born 15 March...

 in 1858.

Clover was probably present at Robert Liston
Robert Liston
Robert Liston was a pioneering Scottish surgeon, and the son of the Scottish minister and inventor Henry Liston, whose father was also a Robert Liston, Moderator of the General Assembly of the Church of Scotland....

's first operation under ether
Diethyl ether
Diethyl ether, also known as ethyl ether, simply ether, or ethoxyethane, is an organic compound in the ether class with the formula . It is a colorless, highly volatile flammable liquid with a characteristic odor...

 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
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

.

Important cases

Because of his expertise in anaesthesia, Clover was often sought out when important figures required surgery. He gave chloroform
Chloroform
Chloroform is an organic compound with formula CHCl3. It is one of the four chloromethanes. The colorless, sweet-smelling, dense liquid is a trihalomethane, and is considered somewhat hazardous...

 to Napoleon III of France
Napoleon III of France
Louis-Napoléon Bonaparte was the President of the French Second Republic and as Napoleon III, the ruler of the Second French Empire. He was the nephew and heir of Napoleon I, christened as Charles Louis Napoléon Bonaparte...

 on 2 January 1873, at Chislehurst
Chislehurst
Chislehurst is a suburban district in south-east London, England, and an electoral ward of the London Borough of Bromley. It is south-east of Charing Cross.-Toponymy:...

, Kent, and again on January 6, for a procedure to break up a bladder stone. The Emperor died on 9 January. Clover was a signatory to his autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 report, together with five other physicians.

Clover gave chloroform to Alexandra of Denmark
Alexandra of Denmark
Alexandra of Denmark was the wife of Edward VII of the United Kingdom...

, who was then the Princess of Wales
Princess of Wales
Princess of Wales is a British courtesy title held by the wife of The Prince of Wales since the first "English" Prince of Wales in 1283.Although there have been considerably more than ten male heirs to the throne, there have been only ten Princesses of Wales. The majority of Princes of Wales...

, in 1867, for the removal of a splint from a rheumatic knee , and later anaesthetised her husband Edward VII
Edward VII of the United Kingdom
Edward VII was King of the United Kingdom and the British Dominions and Emperor of India from 22 January 1901 until his death in 1910...

 (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
Robert Peel
Sir Robert Peel, 2nd Baronet was a British Conservative statesman who served as Prime Minister of the United Kingdom from 10 December 1834 to 8 April 1835, and again from 30 August 1841 to 29 June 1846...

, Florence Nightingale
Florence Nightingale
Florence Nightingale OM, RRC was a celebrated English nurse, writer and statistician. She came to prominence for her pioneering work in nursing during the Crimean War, where she tended to wounded soldiers. She was dubbed "The Lady with the Lamp" after her habit of making rounds at night...

  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 these inventions bore his name. Among these were:

Clover's crutch

Clover's crutch was a device for maintaining the patient in the lithotomy position
Lithotomy position
The lithotomy position is a medical term referring to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations...

.

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
Goldbeater's skin
Goldbeater's skin — the outer membrane of calf's intestine — is a parchment traditionally used in the process of making gold leaf by beating, reducing gold into mere 1μm-thick leaves....

 to make it airtight, into which a measured volume of chloroform liquid was placed. Inflating the bag to its capacity with a bellows
Bellows
A bellows is a device for delivering pressurized air in a controlled quantity to a controlled location.Basically, a bellows is a deformable container which has an outlet nozzle. When the volume of the bellows is decreased, the air escapes through the outlet...

 provided a known, accurate and constant concentration of chloroform vapour in air, which made chloroform much safer to deliver . This meant that a vaporiser
Anaesthetic vaporiser
An anaesthetic vaporiser is a device generally attached to an anaesthetic machine which delivers a given concentration of a volatile anaesthetic agent.The design of these devices takes account of varying*ambient temperature*fresh gas flow...

 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. 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.

Death

Clover's health was fragile throughout his life. He died of uraemia aged 57 . He is buried in Brompton Cemetery
Brompton Cemetery
Brompton Cemetery is located near Earl's Court in South West London, England . It is managed by The Royal Parks and is one of the Magnificent Seven...

, London. His grave is only 200 yards away from that of fellow anaesthetics pioneer, John Snow .

Posthumous recognition

Together with John Snow
John Snow (physician)
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of epidemiology, because of his work in tracing the source of a cholera outbreak in Soho, England, in 1854.-Early life and education:Snow was born 15 March...

, he is one of the supporters on the crest of the Royal College of Anaesthetists
Royal College of Anaesthetists
The Royal College of Anaesthetists 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 anaesthetists, physician assistants - and practising critical care...

. 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 .
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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