Anesthesia: A Historical Overview

By October 21, 2015Articles, Health

Twenty-one million people in the U.S. will receive general anesthesia in a typical year.  But the ability to artificially induce any of the defining components—analgesia (insensitivity to or prevention of pain), paralysis, amnesia, and sedation/unconsciousness—is relatively new. The word anesthesia itself only first appeared in the dictionary in 1751, and was first used to describe the mental state that follows from the inhalation of ether vapor by the prominent physician, Oliver Wendell Holmes, Sr.

Only 300 years ago, surgical pain relief options were limited to the consumption of alcohol or opium (to the point of stupor), or the powers of suggestion or “positive thinking”. Magnets and hypnosis, or ‘Mesmerism’ were used to cure various ailments. Around May 1812, the English novelist Fanny Burney wrote a compelling account of her experience undergoing a mastectomy without anesthesia:

“I saw the glitter of polished Steel – I closed my Eyes. I would not trust to convulsive fear the sight of the terrible incision. Yet – when the dreadful steel was plunged into the breast…I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still [?] so excruciating was the agony. When the wound was made, & the instrument was withdrawn, the pain seemed undiminished..I concluded the operation was over – Oh no! presently the terrible cutting was renewed – & worse than ever”

In contrast, the gratitude felt by the first mother to receive chloroform for the delivery is clearly expressed by the name she gave her baby—Anaesthesia.

 

Anesthesia Through the Ages

 At Xenon Health, anesthesia is our specialty.  But how did our field progress from the prescribing of a few shots of whiskey prior to surgery to the precise science of administering by gas, injection, and infusion drugs that act on different and overlapping sites in the central nervous system? This post reviews the landmark discoveries that led to the evolution of anesthesia over the centuries, and pays homage to the innovators that shaped the field.

400 BC

  • Hippocrates recommends opium poppy use for pain-relief.

13th Century   

  • Theodoric of Lucca, an Italian physician and bishop, induces unconsciousness prior to surgery by holding sponges soaked with opium, mandrake, and hemlock under patients’ noses.
  • In 1275, the Spanish chemist Raymundus Lullius synthesizes ether, which would become the first reliable, general anesthetic—though this would not be recognized for almost 570 years.

 

16th Century  

  • Ether is first used on animals by Paracelsus in 1525. Fifteen years later, Valerius Cordus repeats Lullius’ synthesis by distilling ethanol and sulfuric acid.
  • In Malta, patients to be operated on were made unconscious with a wooden hammer.

 

17th Century  

  • Opium is first administered intravenously.

 

18th Century  

  • In 1745, the French explorer Charles-Marie de La Condamine publishes the first written account of curare, a paralytic poison derived from a plant that he observes is used on arrows by South American tribes to kill their prey. Note: This property will become important in 200 years as future anesthesia techniques will require the control of muscle relaxation.
  • Nitrous oxide (NO), commonly known as laughing gas, is isolated by Joseph Priestley in 1772. This substance became a heavily researched topic, with Dutch chemist Martinus van Marum publishing 35 papers on his studies and the nitrous oxide experiments performed during the last years of the century by Thomas Beddoes and Humphry Davy demonstrating the gas could be inhaled with analgesic effects.
  • The engineer James Watt makes two related inventions—a machine to produce NO and a “breathing apparatus” to inhale the gas.
  • In 1778, Antoine Lavoisier discovers oxygen (O2).

 

19th Century  

  • In 1805, morphine is discovered by Friedrich Serturner, who names it after the Greek god of dreams, Morpheus. It becomes the first product launched by Merck in 1827.
  • Chloroform is simultaneously discovered in 1831 by scientists in three countries. Although frequently used for about 50 years after it is discovered to have anesthetic properties in 1847, a concern about fatalities e