Anesthesia: Where Did it Come From?

The commonly held Christian view of pain, 1500: it was God-given in response to man's sinful nature, most specifically regarding women and childbirth. Any attempt on man's part to relieve a suffering patient was seen as directly meddling with God's wisdom and plans. So if God wanted to punish one guy with pain, who's to say he wouldn't pass along a disease or two to anyone trying to stop this very God-given pain?

Understanding a little about the history of medicine is important for us. In the same vein of continuing to celebrate women's suffrage in 1920, we need to hear the story of anesthesia and be grateful for the continuing medical technology that allows our lives to become increasingly painless. As a scholar of medicinal history, I would like to present to you a brief but hopefully thorough (and maybe even interesting?) narrative on the birth of anesthesia in surgery.

The first hospitals in Europe appeared in the late 17th century. Physicians had no idea what germs were, let alone sanitation, and a quick surgeon was a successful one (we're talking leg amputation in less than a minute). During surgery when the conscious patient at best had a few shots of whiskey beforehand, doctors and nurses were forced to restrain the body being operated upon. Before a surgery began, doctors would ring a bell oustide the hospital signaling all doctors and nurses to assist in the operating room. These rooms were located on the top floor of the hospitals with a sunroof, and they were outfitted with thick walls and doors in order to contain the patient's cries. It's not surprising that many patients hid their ailments from doctors in order to avoid surgical trauma.

Although alchemist Raymundus Lullius discovered ether in 1275, it wasn't until 1605 when a Swiss doctor named Paracelsus used ether as pain relief, still however not in association with surgery. For us today, it is mind-numbing to contemplate the lack of enthusiasm by surgeons to develop a method countering surgical pain. In 1772, Joseph Priestly discovered laughing gas, (nitrous oxide), and in 1800, Humphrey Davy published a book detailing his experience with the inhalation of gases - it just wasn't illegal back then! A medical success, Davy described in his work how nitrous oxide eased his pain of a ruptured wisdom tooth, and he mentioned the possibility of nitrous oxide being used in conjunction with surgery; due to his own disinterest, he did not rally for its implementation. None of these guys thought there was any market for a pain-free surgerical experience.

Slowly and in pockets, dentists and surgeons began pursuing nitrous oxide and ether as pain relief beginning in the 19th century, and by 1842, dentist Elijah Pope performed the first painless tooth removal using ether. The first use of anesthesia in a surgical operation was also made in 1842 by Dr. Crawford Long, who employed ether with the painless surgical removal of a neck cyst. Although Dr. Long was the first physician to put the patient asleep during surgery, there were other doctors and dentists claiming this medical first, and this controversy eventually lay in the hands of Congress for sixteen years amidst the Civil War - apparently they didn't have enough to keep them occupied during that time.

In a medical demonstration in Boston in January 1845, dentist Horace Wells, with the support of dentist William Thomas Green Morton, attempted to painlessly extract a tooth with nitrous oxide. Due to his usage of a wooden mouthpiece for administration and a miniscule one-fifteenth of the amount of gas needed for sedation, the demonstration was a disaster, causing the patient to feel pain. An unmotivated Wells ceased his attempts with anesthetics, and Dr. Morton teamed up with physician Charles Jackson to improve the usage of ether as an anesthetic. Disguising the ether with fragrance, Morton and Jackson planned to patent their seemingly miraculous drug as Letheon. With several pain-free procedures supporting them as well as using brass instead of wood in the administration, Morton and Jackson found much success until other physicians learned of their desire to patent the anesthesia, which the medical community deemed unethical.

Morton, Jackson, and Wells all claimed to be the discoverers of surgical anesthesia, and this debate continued well into the twentieth century. In 1913 at New York University, Dr. Morton was named the inventor with the argument, "in science, credit should go to the man who convinces the world, not to the man who first has the idea or who proves that it works."

Back to the issue of childbirth and pain as punishment from God: chloroform aided Queen Victoria in the birth of her eighth child, and due to royal backing - she was, of course, believed to have been divinely chosen as monarch - Christian attitudes toward pain relief in childbirth were relaxed. Cocaine was later discovered to be very effective as a local anesthetic, and the idea of local anesthesia (what you get today when you go to the dentist or have a mole removed by a dermatologist) was born. We of course use Novacaine today instead!

Studying the history of anesthesia is relevant to scholars of medicine and a very important element in understanding physician-patient dynamics; from the early negative attitudes toward pain relief, many traits of earlier societies become apparent, such as their reliance upon religion and their relative indifference to the patient's discomfort. Most interesting are those physicians and chemists who noted the anesthetic effect of ether, nitrous oxide, and other gases and herbs, yet did not feel compelled to couple them with surgical procedures. In our society where we scoff at a nurse who must make multiple attempts to draw blood in place of one steady maneuver, it is almost incomprehensible to imagine medicine inhumanely ignoring a patient's need for pain relief and anesthetic. Once the financial potential of anesthesia was recognized, its evolution flourished into standard practice.