The History of Anesthesia

"Gentlemen, this is no humbug"
Dr John Collins Warren, 17 October 1846

THE FIRST MEDICINE PRACTISE: ANESTHESIA??
GOD was first: "And the Lord God caused a deep sleep to fall upon Adam, and he slept." (Genesis 2:21). A date is not given.

FIRST TERM.
The Greek philosopher DIOSCORIDES first used the term anesthesia in the first century AD to describe the narcotic-like effects on the plant MANDAGORA. The term subsequently was defined in Bailey's An Universal English Dictionary (1721) as "a defect on sensation" and again in the Encyclopedia Britannica (1771) as "privation of the senses". The present use of the term to denote the sleeplike states that makes painless surgery possible is credited to OLIVER WENDELL HOLMES in 1846.

Anesthesia as we know it started in the early to mid 1840s.

Crawford Long of Jefferson, Georgia, removed a small tumor from a patient under diethyl ether anesthesia. That was in 1842. Crawford Long failed to publish this event, and he was denied the fame of having been the first to use diethyl ether as a surgical anesthetic. Ether was not unknown; students inhaled it during the so-called ether frolics.

Horace Wells had used nitrous oxide in his dental practice. In 1844, he failed to demonstrate the anesthetic effects of N2O in front of a critical medical audience. The patient, a boy, screamed during the extraction of a tooth, and the audience hissed. Later, the boy said that he had not felt anything. Excitement under light nitrous oxide anesthesia is common. Horace Wells died young and by his own hand.

William T. G.Morton, another dentist in anesthesia's history, successfully etherized a patient at theMassachusetts GeneralHospital inBoston on October 16, 1846. The news of this event spread worldwide as rapidly as the communication links permitted.Morton tried to patent his discovery under the name of Letheon. An English barrister later wrote: ". . . a patent degrades a noble discovery to the level of a quack medicine."

Oliver Wendell Holmes, only 2 months afterMorton's epochal demonstration of surgical anesthesia, suggested the term "anesthesia" to describe the state of sleep induced by ether. Holmes was a physician, poet,humorist and, fittingly, finally dean of Harvard Medical School.

John Snow, from London, became the first physician to devote his energies to anesthetizing patients for surgical operations. His earliest experiences with ether anesthesia date to late 1846. In 1853, he administered chloroform toQueen Victoria for the delivery of her son Prince Leopold. This shook the acceptance of the divine command: "in sorrow thou shalt bring forth children"(Genesis 3:16) and thus powerfully furthered the use of anesthesia to alleviate the pain of childbirth. Incidentally, while anesthesiologists admire John Snow for his publications and the design of an etherizer, epidemiologists claim him as one of their own because he had recognized the source of a cholera epidemic, which he traced to a public pump. By removing the pump's handle, he stopped the spread of the infection. That was in 1854. Those were the beginnings. By now, the two earliest anesthetic vapors, diethyl ether and chloroform, have been modified hundreds of times.Many descendants havecomeandgone, but their great-grand children still finddaily use. Intravenous
drugs have secured an increasingly prominent place in anesthesia, among them neuromuscular blockers - hailing back to South American Indians and their poisoned arrows shot from blow guns.Asteadily growing pharmacopeia of analgesics, hypnotics, anxiolytics, and cardiovascular drugs now fill the drug cabinets.

We still listen for breath sounds,we still watch color and respiration, and we still feel the pulse, but today we are helped by the most subtle techniques of sensing invisible signals and the most invasive methods with tubes snaking through the heart.

When we reduce the history of anesthesia to a few dates and facts, we do not do justice to the stories of the age-old and arduous struggle to alleviate pain. Inone of the more comprehensive books on ‘TheGenesis of Surgical Anesthesia', you will find a superb description of the interesting personalities and the many events that eventually paved the way to one of the greatest advances in medicine, the discovery of anesthesia.2 The book brims with anecdotes, for example the story of a woman in 1591 accused of witchcraft. One of the indictments was for her attempt to ease the pain of childbirth. She was sentenced to be "bund to ane staik and brunt in assis (ashes), quick (alive) to the death". Why society's acceptanceof pain relief changed and howobstetrical anesthesia eventually developed is the subject of another great historical book by Donald Caton.



Source:
1. Morgan, G. Edward et al. Clinical Anesthesiology. 2006; McGraw Hill, USA. page 1.
2. Essential Anesthesia From Science to Practice(Essential Medical Texts for Students and Trainees)
3. others resources.