Bichloride of methylene

A.C.E. mixture (or ACE mixture) is a historical anaesthetic agent for general anaesthesia. It was first suggested by Dr. 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 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, chloroform and ether 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 was given as 48°C and it was measured in Drachm.

A.C.E. 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 properties of the alcohol and ether contained with the choloroform in the A.C.E. mixture was believed to reduce this. However, some did question this experimentally at the time.

Many anaesthetists favoured A.C.E. mixture and one author in 1887 in the British Medical Journal considers the A.C.E. mixture, at the time, the best anaesthetic for general use and use in childbirth. He states one downside; the "excited" state of patients on regaining consciousness after the anaesthetic, due to the alcohol in the mixture. Another downside of the mixture, as with most anaesthetics at the time, was its high flammability.

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

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