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Early Days In the Development of Anesthesia By
Sir Humphrey Davy, in 1800, was the first surgeon to produce anesthesia by the inhalation of drugs. He discovered, by experiment upon himself, that the inhalation of Nitrous Oxide gas, commonly known as laughing Gas, had the power of relieving toothache and other pains; he described the effect as that of “Uneasiness being swallowed up for a few minutes by pleasure.” Although he stopped short at this stage, and does not seem to have used the inhalation to produce actual loss of consciousness, he, nevertheless, forecast the future by suggesting that Nitrous Oxide might be used as an inhalation in the performance of surgical operations in which “no great effusion of Blood” took place. Some thirty years later Faraday pointed out that Ether had effects upon the nervous system when inhaled, similar to those of laughing Gas. These two drugs came to be inhaled more in jest that in earnest; more as an amusing scientific experiment for the sake of the pleasure – giving excitement they set up, than for the purpose Davy had suggested. Ether, it is true, was recommended even before Davy’s day for the suffering in Asthma, but until the fifth decade of the nineteenth century no one had attempted to prevent suffering as inflicted by the surgeon or the dentist, by producing the state of unconsciousness brought about by the inhalation of such drugs as Ether, a process now known to the world as anesthesia. The persons who first made the bold experiments, which resulted in the discovery of how to produce anesthesia, were Americans; and two men were prominently concerned in the discovery. Several others made isolated and successful efforts with both Ether and Nitrous Oxide, but they lacked the confidence and courage to make their success public, and to persist in their experiments. One of these, Dr. Long of Athens, Georgia, was one of the earliest; he is said to have successfully removed a tumor from a patient under the influence of Ether in 1842, and in the Southern states he is regarded as the discoverer of anesthesia. Dr. Jackson, of Boston, a scientific chemist, laid claim to the honor of the discovery after others had fought the fight and established the practice of anesthesia. Neither of these two men, for the reasons already given, deserves the honor, which is now universally attributed to their fellow-countrymen, Wells and Morton. Horace Wells was born in Hartford, Connecticut, in 1815, and was educated to the profession of Dental Surgeon. He gave much attention to the de4sire present in the minds of many men at that time, to render dental operations painless. On Dec.10, 1844, he witnessed at a popular lecture the experiment of administering laughing gas, and noticing that a Mr. Colley, while still under the influence of the gas struck and injured his limb against a bench without suffering pain. The idea at once occurred to Wells that here was the agent of which he was in search, and the very next day he experimented upon himself. If it has ever been fortunate to have a toothache it was so for Wells that day; he was troubled by an aching molar which was removed by a colleague named Riggs, whilst he was fully under the influence of Nitrous Oxide; and thus he began what he himself called on recovering consciousness,” a new era in tooth pulling.” He proceeded promptly with his former pupil, Morton, to Boston, and gave a public demonstration of his method, which unfortunately was so imperfectly carried but that he was laughed at for his pains, and stigmatized as imposter. Wells himself states that the failure was due to the premature withdrawal of the bag containing the gas, so that the patient was but partially under its influence when the tooth was extracted. The crowd of practioniers and students gathered to see the operation ignominiously hissed Wells and Morton. Wells never recovered from the disappointment and the illness, which resulted, and although he was able to explain his discovery to the French Academy of Science in 1846, he unfortunately died insane in New York two years later. Undoubtedly he was the first to discover the practicability of Nitrous Oxide anesthesia and to proclaim the discovery with a discoverer’s zeal. Although his career ended so sadly, his efforts had, nevertheless, inspired to greater endeavor his colleague Morton, who had not only been associated in his experiments, but also had, been deeply interested in the subject for many years. William Thomas Green Morton was born in 1819; his father was a farmer in Charlton, Massachusetts. He qualified as a dentist in Baltimore and entered into successful practice in Boston. Fired with the same ambition as Wells, he made attempts to extract teeth painlessly with the assistance of drugs administered, or sometimes by hypnotism. In December 1844, after Wells failure with Nitrous Oxide Gas, he wisely abandoned that agent and investigated another, which promised better results. He experimented first with a drug known as Choric Ether, but failing to get the desired effect, and at the suggestion of the afore mentioned Dr. Jackson, he proceeded to investigate the effects of ordinary Ether. The first experiments were made on animals, and were so encouraging that he believed that he had at last found the desired agent provided the effect on human beings corresponded with that upon dumb creatures. Badly and heroically he made the necessary experiment upon himself, and on Sept. 30, 1846 inhaled Ether from a handkerchief while shut up in his room and sea6ted in his own operating chair. He speedily lost consciousness, and in seven or eight minutes awoke in possession of the greatest discovery that had even been revealed to suffering humanity. We can picture the man gradually awakening in his chair, first to the consciousness of his great achievement; sitting with his physical from excited by the influence of the drug which he had inhaled, and his soul stirred to its deepest depth by the expanding thought of the far reaching effects of what he had done. In describing his experiment he said, “ It partially suffocated me but produced nor decided effect. I then saturated my handkerchief and inhaled it from that. I looked at my watch and soon lost consciousness. As I recovered I felt a numbness in my limbs with a sensation like a nightmare and would have given the world for some one to come and arouse me. I thought for a moment I should die. At length I felt a slight tingling of the blood in the end of my third finger and made an effort to touch it with my thumb, but without success. At a second effort I touched it, but there seemed to be no sensation. I pinched my right thigh, sensation was imperfect; I immediately looked at my watch, I had been insensible between seven and eight minutes.” He further states, preable the same day, “Twilight came one. The hour had long past when it was usual for patients to call. I had just resolved to inhale the Ether again and have a tooth extracted under its influence, when a feeble ring was heard at the door. Making a motion to one of my assistants who started to answer the bell, I hastened myself to the door, where I found a man with his face bound up, who seemed to be suffering extremely. “ Doctor,” he said, “ I have a dreadful tooth, but it is too sore, I cannot summon courage to have it pulled; cant you mesmerize me?” I need not say that my heart pounded at this question, and that I found it difficult to control my feelings, but putting a great constraint on myself I expressed my sympathy, and invited him to walk into my office. I examined the tooth and in the most encouraging manner told the poor sufferer that I had something better than mesmerism, by means of which I could take out his tooth without giving him pain. He gladly consented, and saturating my handkerchief with Ether I gave it to him to inhale. He became unconscious almost immediately. It was dark. Dr. Heydon held the lamp. My assistants were trembling with excitement, apprehending the usual prolonged scream from the patient, while I extracted the firmly rooted bicuspid tooth. I was so much agitated that I came near throwing the instrument out of the window. But now came the terrible reaction. The wrenching of the tooth had failed to arouse him in the slightest degree; he remained still and motionless as if already in the embrace of death. The terrible thought flashed through my mind that he might be dead- that in my zeal to test my new theory, I might have gone too far, and sacrificed a human life. I trembled under the sense of my responsibility to my Maker, and to my fellow man. I seized a glass of water and dashed it in the man’s face. The result proved most happy. He recovered in a minute, and knew nothing of what had occurred. Seeing us all standing around he appeared bewildered. I instantly, in as clam a tone as I could command, asked, “ are you ready to have your tooth extracted?” “Yes”, he answered in a hesitating voice. “It is all over,” I said, pointing to a decayed tooth on the floor. “ No,” he shouted, leaping from the chair. The name of the man who thus for the first time underwent an operation under anesthesia induced by Ether was Eben Frost.” The nature of the agent used by Morton was kept a secret only a short period; the steps he took to bring his discovery before the medical profession would hav3e rendered it difficult if not impossible, even if Ether had not the penetrating tell-tale odor. Morton laid his method before one of the surgical staff of the Massachusetts General Hospital, Boston, the same institution where Well’s ill-managed demonstration had taken place two years before; he requested with complete confidence to be allowed to exhibit the powers of his agent. The surgeon was skeptical, but wisely consented, after having satisfied himself that there was no rush to life. a patient suffering from a tumor was chosen, and readily consented to act as a subj3ect for demonstration. A large crowed of professional men and students assembled in the surgical theater on the morning of Oct. 16, 1846, the day chosen for the trial. The senior hospital surgeon, Dr. J. Collins Warren, was to perform the operation. The spectators, many of whom no doubt recollected the failure with laughing gas, were disposed to deride when the appointed hour past and Morton did not appear; but the delay was due only to the desire of the Dentist to bring a proper inhaler, and although the crowd received him with a chilling reserve, and the occasion was one fit to try the nerve of the strongest, Morton did not lose his presence of mind. He promptly anaesthetized the patient, and as unconcernedly as does the modern administrator, nodded to the surgeon that the patient was ready. From the first moment that the knife touched the patient until the operation was concluded, no sound, no movement indicated that he was suffering. The men who had scoffed once and had come, even the surgeon, to scoff again, realized the success and wonder of it, and remained to admire. “Gentlemen, this is no humbug,” exclaimed Dr. Warren, as he finished his handiwork. When the patient recovered he was questioned again and again, but stoutly maintained that he had felt no pain- absolutely none. “Gilbert Abbot, aged twenty, painter, single,” was the description of the man whom was performed the first surgical operation under the influence of Ether.” New of the great success spread rapidly, and Morton and others repeated the experiment in America, and similar work was taken up thoughtou6t Europe. It can be said that Morton derived much benefit from his discovery. Although the greatness of it was recognized in his lifetime, and he received several honors and presents, he entered prolonged squabbles concerning the discovery, which worried him into a state of ill-health, ending in his death in 1868. A monument was erected over his grave by the citizens of Boston, bearing the following concise description of his achievement:- “William T.G. Morton, Inventor and revealed of anesthetic inhalation, By whom pain in surgery was averted and annulled; Before whom in all time surgery was agony, Since whom science has control of pain.” Whilst the discoverer of Nitrous Oxide Anesthesia, Horace Wells, was dying from chagrin and inaction, and the revealer of anesthetic inhalation by Ether, William Morton, was wasting time in unworthy disputes concerning priority, and fruitless endeavors to gain pecuniary reward, a bolder than either had taken up the work where they had left it, with the high object of pursuing it until he had forever established the benefit to humanity which he recognized in it. This bolder was Sir James Simpson. He went straight forwards and onwards, strong in his endeavor; undeterred by the jeers of the ignorant, the opposition of the prejudiced or the attacks of the jealous, with no thought of or any wish for reward except that which was to come from the depth of suffering hearts. James Young Simpson, who will ever be remembered as the discoverer of the pain-annulling power of Chloroform, was born in the village of Bathgate in Linlithgowshire, where his father, David Simpson, was a banker, in the year 1811, at a period when there was room for a hero in the practice of the healing in the British Isles. During the Christmas holidays of 1864 Simpson was in London, and discussed the new discovery with Liston who was one of the first to operate under Ether in Great Britain at University College Hospital. The great surgeon thought that the chief application of the process would be in the practice of rapid operating; it was at first believed that the inhalation could be borne for only a brief period. Simpson speedily showed that no evil resulted if the patient remained under the influence of the vapors for hours. In the month of January 1847, he gained for the Edinburgh Medical School the proud honor of being the scene of the first use of anesthetics in obstetrical practice. In March of the same year he published a record of cases of parturition in which he used Ether with success; and had a large number of his paper printed and distributed far and wide, at home and abroad, so eager was he to popularize amongst the members of his profession the revolutionary practice which he introduced. From the day on which he first used Ether in midwifery until the end of his career he constantly used anesthetics in his practice. He quickly perceived , however, the shortcomings of Ether, and having satisfied himself that they were unavoidable, he set about his next great step, namely, to discover some substance possessing the advantages without the disadvantages of Ether, in the midst of is now immense daily work he gave all his spare time, often only the midnight hours, to testing upon himself the effects of numerous drugs. With the same courage that had filled Morton he sat down alone, or with Dr. George Keith and Dr. Matthews, his assistants, to inhale substance after substance, often to the real alarm of the household at 52 Queen Street. Appeal was made to scientific chemists to provide drugs hitherto known only as curiosities of the laboratory, and for others that their special knowledge might be able to suggest. The experiments usually took place in the dining room in the quiet of the evening or the dead of night. The enthusiasts sat at the table and inhaled the particular substance under trial from tumblers or saucers; but he summer of 1847 passed away, and the autumn was commenced before he succeeded in finding any substance, which at all fulfilled his requirements. All this time he was battling for anesthesia, particularly in its application to midwifery, he was meeting with what appears now as an astonishing amount of apposition, on varying grounds from all sorts of conditions and persons; but the vigor and power of his advocacy and defense of the practice in the days when laughing gas and Ether were the only agents known, were as nothing to that which he exerted after his won discovery at the end of 1847. The suggestion to try Chloroform came first from a Mr. Waldie a native of Linlithgoshire, settled I Liverpool as a chemist. It was a “Curious Liquid,” discovered and described in 1831 by two chemists, Soubeiran and Liebig, simultaneously but independently. In 1835 Dumans, the French chemist, first accurately ascertained the chemical composition. Simpson was apparently not aware that early in 1847 another French chemist, Flourens, had drawn attention to the effect of Chloroform on animals, or the would probably have hastened to use it upon himself experimentally, instead of putting away the first specimen obtained as unlikely; it was heavy and not volatile looking, and less attractive to him than other substances. How it finally came to be tried is best described in the words of Simpson’s colleague and neighbor, Professor Miller, who used to look in every morning at 9:00 o’clock to see how the enthusiasts had fared in the experiments of the previous evening. |