Essential Clinical Anesthesia: History of anesthesia

Although anesthetic properties of nitrous oxide and ether were discovered in the 1800s, surgical operations were likely carried out under varied degrees of analgesia from times immemorial. Opiates, alcohol, cannabinoids, belladona derivatives, soporific sponges, and mesmerism were used to offer relief during surgery and are a testament to man’s ingenuity. Joseph Priestley (1733–1804, UK) discovered oxygen in 1771, and nitrous oxide in 1772. Humphry Davy (1778–1829, UK) discovered the analgesic properties of nitrous oxide in 1800 and termed it “laughing gas”; however, he did not use it in any clinical setting. In the United States, recreational use of ether and nitrous oxide was common in the 1840s (ether frolics and laughing gas parties). William E. Clarke (1819–1898, USA), while a medical student, was the first to administer ether for dental extraction in January 1842. On March 30, 1842, Crawford W. Long (1815–1878, USA) administered ether to James Venable during removal of a tumor from his back. Long continued using ether during surgery, but did not publish his findings until 1849. During an evening of public entertainment in 1844, Gardner Quincy Colton (1814–1898, USA) administered nitrous oxide to Samuel A. Cooley. Cooley injured himself as he was returning to his seat but did not feel any pain for a few minutes. Horace Wells (1815–1848, USA) attended the same demonstration and believed this was due to the analgesic effects of nitrous oxide. The next morning, fellow dentist John M. Riggs (1811–1885, USA) removed one of Wells’ teeth painlessly while Colton administered nitrous oxide. Wells used nitrous oxide for pain relief in his own dental practice, but when he attempted to demonstrate this effect at Massachusetts General Hospital in 1845, the subject cried out in pain during the procedure, although later admitting that he did not remember any pain. However, Wells’ reputation never recovered from this apparent fiasco, and his life ended tragically in 1848. William Thomas Green Morton (1819–1868, USA), an associate of Wells, was present during the failed demonstration. He consulted with Harvard professor Charles T. Jackson (1805–1880, USA) and conducted experiments with ether. On October 16, 1846 Morton performed the first successful public demonstration of ether anesthesia while surgeon John Collins Warren (1778–1856, USA) removed a vascular tumor from the neck of Edward Gilbert Abbott. October 16 has thereafter been celebrated as Ether Day, and the amphitheater in which the procedure took place, Ether Dome, has been preserved as a museum at Massachusetts General Hospital, Boston. News about the anesthetic properties of ether and nitrous oxide spread rapidly, and other agents were investigated for such properties. Obstetrician James Y. Simpson (1811–1870, UK) introduced chloroform for relief of labor pain in Edinburgh in 1847. John Snow (1813–1858, UK) is recognized as the first physician to work full time as an anesthetist. Relief of labor pain remained controversial until Snow administered chloroform to Queen Victoria (1819–1901) during the birth of Prince Leopold in 1853, and Princess Beatrice in 1857. Equipment to administer anesthetics developed over the next several decades, and the risk of anesthesia became evident as reports of anesthesia-related deaths appeared in newspapers and medical journals. Karl Koller (1857–1944, Austria) discovered the local anesthetic properties of cocaine, when applied to the conjunctiva, in 1884. William S. Halsted (1852–1922, USA) used it for a nerve block later that year, and August Bier (1861–1949, Germany) performed the first clinical spinal anesthetic in 1898, and introduced intravenous regional anesthesia in 1908. Harvey W. Cushing (1869–1939, USA) and Ernest A. Codman (1869–1940, USA), while medical students, introduced anesthetic records in 1894. Caudal epidural anesthesia was introduced independently by Jean A. Sicard (1872–1929, France) and Fernand Cathelin (1873–1945, France) in 1901. Henry Edmund Gaskin Boyle (1875–1941, UK) introduced a