Dr Mark Lidwill investigates fatal anaesthetic ether impurities in Sydney in 1915

In December 1915, an article was published by Dr Mark Lidwill in the Medical Journal of Australia ( MJA ), which discussed the clinical features of a series of deaths over a few months in Sydney which were regarded as very unusual following ether anaesthesia. These deaths stimulated Lidwill, at that time in general practice and a visiting Anaesthetist/Physician at the Royal Prince Alfred Hospital, to gather a committee of four chemists to investigate. After much work sulphur impurities from the manufacture of ether were found to be the problem though the exact compounds were not identified. This impurity could be neutralised by potassium permanganate. This problem had arisen as Australia stopped importing ether from Germany at the start of the First World War and commenced manufacturing its own ether. There was no time during wartime to expand on these investigations. This MJA article was in advance of other world anaesthetic literature addressing ether impurities until the 1920s to 1940s, none of which mentioned the MJA article. This failure to report their chemical research in detail was unfortunate, as it was some years ahead of most other interest in the chemistry of clinical complications of ether anaesthesia due to impurities. Forty years later, after Lidwill had retired, he noted more details of these deaths and the investigations that revealed the problem and its solution. These later articles and some earlier chemical investigations into contaminants of ether are discussed, and Lidwill’s research into ether impurities compared to them.