ACE mixture is an historical

anaesthetic An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into t ...

agent for

general anaesthesia General anaesthesia (UK) or general anesthesia (US) is medically induced loss of consciousness that renders a patient unarousable even by painful stimuli. It is achieved through medications, which can be injected or inhaled, often with an analges ...

. It was first suggested by

George Harley George Harley may refer to: * George Harley (physician) (1829–1896), Scottish physician * George Davies Harley (1762–1811), English actor and poet * George Harley (painter) (1791–1871), English watercolourist * George Way Harley (1894–1966), ...

and first used in England around 1860. In 1864 it was recommended for use by the Royal Medical and Surgical Society's Chloroform Committee. It was rarely used after the 19th century, except in Germany, where it was used for slightly longer. It was a mixture of

alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...

chloroform Chloroform, or trichloromethane (often abbreviated as TCM), is an organochloride with the formula and a common solvent. It is a volatile, colorless, sweet-smelling, dense liquid produced on a large scale as a precursor to refrigerants and po ...

and

ether In organic chemistry, ethers are a class of compounds that contain an ether group, a single oxygen atom bonded to two separate carbon atoms, each part of an organyl group (e.g., alkyl or aryl). They have the general formula , where R and R� ...

which gives the mixture its name. Its effects were said to be between that of chloroform and ether and it was used when ether alone was contraindicated. Its

boiling point The boiling point of a substance is the temperature at which the vapor pressure of a liquid equals the pressure surrounding the liquid and the liquid changes into a vapor. The boiling point of a liquid varies depending upon the surrounding envi ...

was given as . Its actual safety margin over its components alone was marginal.

Usage

ACE mixture was most commonly made up in the ratio: 1 part alcohol, 2 parts chloroform, and 3 parts ether although other ratios existed. See ' other preparations' below. Chloroform (which was first used in 1847) used on its own produces myocardial depression, however the

excitatory In neuroscience, an excitatory postsynaptic potential (EPSP) is a postsynaptic potential that makes the postsynaptic neuron more likely to fire an action potential. This temporary depolarization of postsynaptic membrane potential, caused by the ...

properties of the alcohol and ether contained with the chloroform in the ACE mixture was believed to reduce this. However, some did question this experimentally at the time. Many anesthetists favored ACE mixture and one author in 1887 in the ''

British Medical Journal ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...

'' considers the ACE mixture, at the time, the best anesthesia for general use and use in

childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...

. He states one downside; the " excited" state of patients on regaining consciousness after the anesthetic, due to the alcohol in the mixture. Another downside of the mixture, as with most anesthetics at the time, was its high

flammability A combustible material is a material that can burn (i.e., sustain a flame) in air under certain conditions. A material is flammable if it ignites easily at ambient temperatures. In other words, a combustible material ignites with some effort a ...

. Deaths have been known to occur from the mixture. However, fewer deaths from ACE mixture were reported than deaths from chloroform or ether.

Other preparations

After widespread use of ACE mixture,

anaesthetists Anesthesiology, anaesthesiology or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, a ...

would try different mixtures for different patients and different procedures. CE mixture omitted the alcohol and AC mixture omitted the ether. One doctor described using equal parts alcohol and chloroform in minor operations, but chloroform with

Eau de Cologne Eau de Cologne (; German: ''Kölnisch Wasser'' ; meaning "Water from Cologne") or simply cologne is a perfume originating in Cologne, Germany. Originally mixed by Johann Maria Farina (Giovanni Maria Farina) in 1709, it has since come to be a gene ...

(which has a high alcohol content) in dental procedures for a more pleasant experience. Despite the similar names, the anaesthetic mixture named "bichloride of methylene" did not contain the actual compound that would be called

bichloride of methylene ACE mixture is an historical anaesthetic agent for general anaesthesia. It was first suggested by George Harley and first used in England around 1860. In 1864 it was recommended for use by the Royal Medical and Surgical Society's Chloroform Commi ...

(Dichloromethane CH₂Cl₂). Instead, it was later discovered as a mixture of chloroform and alcohol marketed as the bichloride of methylene and even given the formula CH₂Cl₂.British Journal of Dental Science and Prosthetics. (1883). UK: J. P. Segg & Company., p. 692 Other mixtures were: Not included in table as they include

petroleum ether Petroleum ether is the petroleum fraction consisting of aliphatic hydrocarbons and boiling in the range 35–60 °C, and commonly used as a laboratory solvent. Despite the name, petroleum ether is not an ether; the term is used only figurativ ...

in addition to diethyl (sulphuric) ether: : Schleich's solutions for general anaesthesia (number one for light anaesthesia and number three for deep anaesthesia): ::No 1: 45 parts chloroform, 180 parts sulphuric ether, 15 parts petroleum ether. ::No 2: 45 parts chloroform, 150 parts sulphuric ether, 15 parts petroleum ether. ::No 3: 30 parts chloroform, 80 parts sulphuric ether, 15 parts petroleum ether. :Wertheim's solution: 1 part chloroform, 1 part petroleum ether and 2 parts sulphuric ether

Usage in animal testing

ACE mixture was also used to anaesthetise animals, including in preparation for

vivisection Vivisection () is surgery conducted for experimental purposes on a living organism, typically animals with a central nervous system, to view living internal structure. The word is, more broadly, used as a pejorative catch-all term for Animal test ...

Method of administration

ACE mixture could be given through drops (from a drop bottle) on a piece of (a

towel A towel () is a piece of absorption (chemistry), absorbent cloth or paper used for drying or wiping a surface. Towels draw moisture through direct contact. Bathing towels and hand towels are usually made of cotton, linen, bamboo and Microfiber, ...

), in a Rendle's mask, a cone, or through an inhaler. Inhalers included: Allis' inhaler, Junker's inhaler (with a funnel mask) for children, Clover's inhaler with bag removed (this inhaler has to be constantly lifted from the face to allow 'free air' to be admitted). Ellis proposed an inhaler to blend vapours in exact proportions, however it was impractical, but Gwathmey modified his idea and created a practical apparatus. Tyrrell created a similar idea called the 'Tyrrell's double-bottle method'.

References

External links

The Garret Museum Online Collection: Anaesthetics
which has many useful pictures and further information on each of the inhalers.

which contains a picture of Allis' Ether Inhaler

* ttp://www.general-anaesthesia.com/clover-inhaler.html Clover's portable regulating ether inhaler (1877). A notable one hundredth anniversaryA paper that shows Clover's inhaler
Ellis obstetric inhaler
a photo of Ellis' inhaler, which was used for women in labour. From Manchester Medical School Museum's

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