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Portrait of Anaesthesia

Science · Medicine & the body

Anaesthesia

First public demonstration 1846

Medicine — surgery and pain relief

The controlled, reversible abolition of sensation that made modern surgery possible. Before 1846, operations were done at speed on conscious patients; on 16 October that year the dentist William Morton gave diethyl ether to Gilbert Abbott in the operating theatre of the Massachusetts General Hospital, and the surgeon John Collins Warren announced to the audience that it was no humbug. Chloroform followed in Edinburgh the next year, cocaine gave local numbness in 1884, and muscle relaxants completed the modern technique in the 1940s. The word itself was coined in 1846 from the Greek for "without sensation".

How to spot them

  • ▸16 October 1846, Boston — the demonstration that ended surgery on conscious patients
  • ▸The room is preserved as the Ether Dome; the words were 'Gentlemen, this is no humbug'
  • ▸Ether first, chloroform in 1847, cocaine for local use in 1884, curare-type relaxants from 1942
  • ▸Queen Victoria's use of chloroform in 1853 made it respectable — 'chloroform à la reine'
  • ▸Oliver Wendell Holmes coined the name; a bitter priority dispute followed

Key facts

16 October 1846, in a domed operating theatre at Massachusetts General Hospital (1846)

William Morton gave ether while John Collins Warren removed a neck tumour from Gilbert Abbott

'Gentlemen, this is no humbug' (1846)

Warren to the assembled surgeons, after the operation succeeded silently

Three doctors slumped unconscious round a dinner table in Edinburgh, November 1847 (1847)

James Young Simpson testing chloroform on himself and two colleagues

John Snow at the birth of Prince Leopold in 1853, making a controversial practice respectable (1853)

Queen Victoria's chloroform — 'à la reine'

Humphry Davy's laughing gas evenings at the Pneumatic Institution in Bristol (1799)

Davy suggested nitrous oxide might be used in surgery; nobody acted on it for 45 years

An operation at Jefferson, Georgia in 1842 that went unpublished for seven years (1842)

Crawford Long's use of ether, which cost him the credit

Oliver Wendell Holmes's coinage of 1846, from the Greek for 'without sensation' (1846)

He proposed the word to Morton in a letter

Karl Koller numbing an eye with cocaine in Vienna in 1884 (1884)

The beginning of local and regional techniques; the idea came via Sigmund Freud

Key ideas

  • Modern general practice is a triad — unconsciousness, pain relief and muscle relaxation — achieved with separate drugs, rather than one agent pushed to a dangerous depth.
  • The delay is the puzzle: nitrous oxide and ether were both known and their effects described decades before anyone used them to prevent surgical pain.

Quick-fire facts

  • •The first successful public demonstration was on 16 October 1846 at Massachusetts General Hospital; the room is now known as the Ether Dome
  • •William T. G. Morton, a dentist, gave the ether; John Collins Warren operated on Gilbert Abbott
  • •Crawford Long had used ether in Georgia on 30 March 1842 but did not publish until 1849; 30 March is US National Doctors' Day
  • •Horace Wells's nitrous oxide demonstration at the same hospital in January 1845 failed, and the audience cried 'Humbug!'
  • •Humphry Davy investigated nitrous oxide at Thomas Beddoes's Pneumatic Institution in Bristol in 1799 and named it laughing gas
  • •Oliver Wendell Holmes Sr proposed the word 'anaesthesia' in November 1846
  • •James Young Simpson introduced chloroform in Edinburgh in November 1847 after testing it on himself
  • •John Snow administered chloroform to Queen Victoria at the birth of Prince Leopold on 7 April 1853, and again in 1857
  • •Karl Koller demonstrated cocaine as a topical eye anaesthetic in Vienna in 1884; lidocaine, synthesised in 1943, replaced it
  • •Curare-type muscle relaxants were introduced by Harold Griffith and Enid Johnson in Montreal in 1942
  • •Morton tried to patent ether under the name 'Letheon', and the resulting priority dispute ruined several of the claimants
  • •Main modern categories are general, regional (spinal and epidural) and local

Drill it — 9 cards

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Sources