Anesthesia and Anesthetics

Anesthesia

October 16, 1846
Boston, Massachusetts, USA

One of the most important innovations in history is that of Anesthesia. Anesthesia (from Greek “lack of sensation”) is the condition of having bodily sensation, especially pain, blocked or temporarily removed.

It is almost impossible to imagine in our modern age that throughout the vast majority of human existence, humans had very little relief for pain. During painful childbirth, injury, illness and early surgery; people were dependent on courage, herbs, drugs or alcohol to ease pain, often with limited success.

Man tried many methods to help him deal with severe pain. Some methods such as herbal treatment or shaman rituals seem whimsical today. Other relief methods such as alcohol had limited success but then induced the secondary pain incurred as the body recovered from the alcohol ingestion.

When no relief alternatives were available one had no choice but to endure the pain at hand. The term for facing adversity in a stoic manner, “bite the bullet”, is derived from battlefield surgery when a soldier was given a bullet to bite on to help him endure very painful surgery or wound repair.

Early Forms of Anesthesia

Early pain reducing remedies early Man used are found in ancient records.

Mandragora and Indian hemp or hashish were common and relatively effective pain relieving treatments. Mandragora comes from the Mandrake plant which is related to the potato family. Hashish is a narcotic product composed of compressed or purified preparations of stalked resin glands, called trichomes, collected from the buds of the female cannabis plant.

Opium, a highly addictive narcotic drug derived from the Papaver somniferum plant, was a very popular ancient pain relieving and euphoria inducing remedy. Opiumwas highly popular throughout the ancient and pre-modern world due to its success in helping ease pain.

Sumerians, from Mesopotamia, cultivated the opium poppy as early as 3400 BC. Sumerians passed this “miracle drug” to the Assyrians who in turn passed opium to the Babylonians. Next, the Egyptians would learn the value of opium.

The knowledge and use of opium would flow from Egypt across Mediterranean Sea trade routes to various civilizations including the Phoenicians and the Greeks. In circa 460 BC, the famous Hippocrates, “Father of Medicine”, acknowledged the benefit of opium as a narcotic and styptic in treating diseases. Later, around 330 BC, Alexander the Great and his armies introduce opium to the people of India, Persia and other eastern and Middle Eastern kingdoms.

China and other Eastern civilizations learned of opium from Arab traders around 400 AD. Health healers and doctors recognized the value of opium in controlling pain. However, the addictive and euphoric qualities of opium use caused growing problems for all civilizations.

In 1680, English apothecary, Thomas Sydenham, introduced Sydenham's Laudanum, a compound of opium, sherry wine and herbs. His pills along with others of the time become popular remedies for numerous ailments.

Sir Humphry Davy

The beginning of a more effective, more controllable and less damaging use of a pain reliever began during the 1800s. Sir Humphry Davy (December 17, 1778 – May 29, 1829) may have been the first person to launch what is now known as the science and medicine of Anesthetics.

Davy, a respected and prolific scientist, chemist and inventor was renowned for his work with alkali and alkaline earth metals. He was also famous for his contribution to the discoveries of the elemental nature of chlorine and iodine. He is credited with making the first arc lamp which was used as a miner’s lamp to help miners see deep underground.

Davy along with many luminaries of the age such as James Watt, Robert Southey and Samuel Taylor Coleridge were regular users of Davy’s recreational and experimental nitrous oxide or “laughing gas”. Nitrous oxide gas was first synthesized by the famous English chemist and naturalist, Joseph Priestly in 1772.

James Watt, Davy’s friend, built a gas chamber for use by Davy and his friends to experiment with nitrous oxide inhalation and its effects. One of Davy’s experiments wanted to determine if nitrous oxide combined with wine could help eliminate or reduce the pain of hangovers. Davy’s notes indicated laughing gas did indeed help alleviate the pain of a hangover. However, surprisingly, Davy did not pursue more experimentation of using nitrous oxide as an Anesthetic to help relieve pain.

A similar gas, ether, was also popular during this time. During the 1830’s, college students were using ether to get into a euphoric, silly and enjoyable state. These popular parties were called “ether frolics”. Using nitrous oxide, “laughing gas”, show vendors charged customers upwards of 25 cents to watch people intoxicated on laughing gas make fools of themselves.

Horace Wells

In 1844, a dentist named Horace Wells attended a local “laughing gas” show.  During the show, an intoxicated user of the gas ran around wildly through the theatre. During his ranting chase, he severely injured his leg. Stopping to catch a breath, he realized that he was bleeding profusely. Doctor Wells approached the man to offer help. Wells was shocked to learn that the injured man told him that he felt no pain whatsoever, despite his severe wound.

Wells seized upon this extraordinary occurrence and decided to experiment the idea of using nitrous oxide as a pain reliever during dental surgery. He actually had an assistant pull one of his own teeth while he was under the influence of nitrous oxide. He recorded that he did not feel any pain. However, there was a drawback to nitrous oxide. The pain relieving intoxication effect of nitrous oxide did not last long so it was not suitable for long surgeries or painful medical procedures.

Dr. William Morton

A former dental student of Horace Wells, Dr. William Morton (1819-1868), needednitrous oxide for a patient that had immense fear of pain. Dr. Morton learned from his chemist supplier that nitrous oxide was unavailable but his supplier suggested that he use ether which had very similar qualities and should accomplish the goal of relieving pain.

Dr. Morton experimented with etherand quickly realized its value as an Anesthetic for surgery. He designed history’s first Anesthetic machine. His machine used a simple glass globe that housed an ether soaked sponge. The patient simply inhaled the vapors through the globe’s outlet to achieve the intoxicated state needed to feel no pain.

On October 16, 1846, Morton used his new invention on a patient in the surgical amphitheatre of the Massachusetts General Hospital. The patient was successfully anesthetized during the surgery that painlessly removed a tumor from the jaw of the patient.

The surgery patient, a Mr. Gilbert Abbot, told Dr. Morton and the assembled observers that he did not feel any pain during the surgery. This incredible news astonished the dental and medical observers. After several more demonstrations of painless surgery using ether, the dental and medical industries were transformed forever. News of this wonderful new pain reliever and procedure spread across the world. Man had finally found a way to deliver substantial pain relief and allow for much more life saving medical procedures.

Although many gentlemen were involved with experimenting with gases and procedures that would eventually allow for the successful use of Anesthesia, Dr. William Morton is generally credited with launching the general and innovative practice of Anesthesia.

The room where Dr. Morton performed his history making surgery still stands today. The room is located in the Bulfinch Building at the Massachusetts General Hospital in Boston. In 1965 it was declared a National Historic Landmark.