Use Of Surgical Anesthesi Essay, Research Paper
Dennis Brindell Fradin wrote in ”We Have Conquered Pain”: The Discovery of Anesthesia, “We take it for granted that we can sleep through operations without feeling any pain. But until about 150 years ago, the operating room was a virtual torture chamber because surgeons had no way to prevent the pain caused by their healing knives.” Fradin is right. Since several analyses of archaic human bones have proven that people have suffered from disease and pain since the beginning of their existence, one can only assume the tremendous pain humans had to endure before the discovery of anesthesia. The four brilliant men who ended mankind’s suffering also had to endure immense anguish after the discovery; their involvement erupted into a maelstrom of controversy, which contributed to early deaths and insanity, even though the discovery of surgical anesthesia has had such a positive effect on humanity.1
Prior to the discovery, surgeons would tie, strap, or hold down their patients to keep them from running off during surgery. Many times, the surgeon would give alcohol or narcotics to patients in order for the patient to better face the indescribable pain. However, those that actually survived the surgery (chances are, they didn’t) swore they would have preferred death instead of the excruciating pain they had to endure.2 Even Dr. John Collins Warren, a senior surgeon before the discovery of anesthesia at the Massachusetts General Hospital in Boston, agreed that patients would rather die than have surgery. After Dr. Warren finished an amputation in 1844, before the discovery of anesthetics, he told himself, “The knife that heals must first give pain.”3
To have fully conscious, screaming patients during an operation even made surgeons not want to perform surgery. However, the discovery of surgical anesthesia changed the way most, including surgeons, perceived surgery. Although surgical anesthesia was not discovered until the middle of the nineteenth century, there were significant contributions by talented thinkers made more than one hundred years before the discovery.4 The list of those contributors includes Joseph Priestley, who discovered hydrogen in 1766, nitrogen in 1772, and oxygen and nitrous oxide in 1774 and also introduced inhalation as a way to administer medicine5, Humphrey Davy, who proved nitrous oxide was not poisonous6, and Henry Hill Hickman, who made the first successful experiments with nitrous oxide on lower animals7.
After these advances in the early nineteenth century, the most popular experiment at scientific exhibits was for the students to become intoxicated by inhaling ether or nitrous oxide, commonly called laughing gas, in the United States. Such experiments became so popular that students entertained themselves outside of class by holding ether parties. These parties, frequently called “ether frolics,” were common all over the country. It was the ether frolics that eventually led to the realization that ether can cause unconsciousness and, with that, relief of pain.8
In the small village of Jefferson, Georgia, an ether frolic was scheduled in early 1841. This event attracted the attention of Crawford Williamson Long, a young doctor living in a nearby town, who later held ether frolics in his own home as a form of entertainment. Long afterward noted that although guests at his ether parties were terribly bruised from hitting objects while unconscious, they were frequently not felt or seen until several days later. Long decided that being intoxicated with ether might produce the same degree of insensibility during a surgical operation.9
Meanwhile, James Venable, one of Long’s friends who had participated in the ether frolics, wanted Long to remove two tumors on the side of his neck. Venable was fearful of surgery, and on March 30, 1842, Long told Venable his idea to use ether during surgery as a way to dull the excruciating pain of surgery. As an added incentive, Long agreed to perform the operation for only two dollars instead of the usual rate of forty dollars for a tumor removal. That evening, Venable allowed Long to cut one of the tumors from his neck.10 Instead of screams and shouts during the operation, for the first time in history there was silence. After the operation was completed, James Venable awoke disappointed for he thought the operation had yet to begin. Only when Dr. Long held up his tumor did Venable believe that the surgery was complete. To be certain of the effects of ether during surgery, Long performed several other operations with ether, and each was a success.11
Long hardly did anything to announce his discovery. Long’s first use of ether was of importance to no one except to the four or five patients to whom Long administered. Four long years passed, and all the while ether remained unknown and unavailable to the world whose pain it might have eased.12
Laughing gas was not only used as a source of entertainment in the home, but also as a source of income for a few show-businessmen in New England. One such man was Gardner Quincy Colton, an itinerant lecturer with only limited knowledge of medicine. Colton was giving a demonstration of the effects of nitrous oxide gas at the Hartford Courant on December 10, 1844. The young successful dentist Horace Wells attended the event.13 The following is an account of how Gardner Colton remembered the evening:
On the 10thof December, 1844, I gave an exhibition of laughing gas in the city of Hartford, Connecticut. After a brief lecture on the properties and effects of the gas, I invited a dozen or fifteen gentlemen to come upon the stage, who would like to inhale it. Among those who came forward was Dr. Horace Wells, a dentist of Hartford, and a young man by the name of Cooley.
Cooley inhaled the gas, and while under its influence ran against some wooden settees on the stage and bruised his legs badly. On taking his seat next to Dr. Wells, the latter said to him, “You must have hurt yourself.” “No.” Then he began to feel some pain, and was astonished to find his legs bloody; he said he felt no pain till the effects of the gas had passed off.
At the close of the exhibition, Dr. Wells came to me, and said, “Why cannot a man have a tooth extracted under the gas, and not feel it?”
I replied I did not know.
Dr. Wells then said he believed it could be done, and would try it on himself, if I would bring a bag of gas to his office. The next day ? 11th of December, 1844 ? I went to his office with a bag of gas.14
At his office, Wells inhaled the nitrous oxide, and Dr. Riggs, a dentist who practiced with Wells, extracted his tooth without pain. Afterward, Wells learned how to prepare the nitrous oxide from Colton, and he successfully extracted teeth fifteen times without pain!15
To spread the news of his great discovery, Wells traveled to Boston, which was at that time the medical center of the nation. In Boston, Wells sought the aid of his former student, Dr. William Thomas Green Morton. Morton thought Wells’ idea had worth and suggested they discuss it with Dr. Charles Jackson, a respected chemist in Boston. Jackson simply rejected Wells’ idea, saying nitrous oxide was in fact dangerous and it was impossible to have surgery without pain.16
Wells was not discouraged, however. While in Boston, he asked permission from Dr. John Collins Warren, the surgeon at the Massachusetts General Hospital and the dean of the Harvard Medical School, to demonstrate his discovery. After a few days of lectures, Wells attempted to illustrate the effects of nitrous oxide on a patient whose tooth was to be extracted. Unfortunately, the gasbag was withdrawn too soon during the operation, and the patient began to shriek with pain. After the operation, the patient testified he did experience some pain, but “not as much as usually attends the operation,” Wells wrote in a letter addressed to the editor of the Hartford Courant, December 9, 1846. However, the public mocked the demonstration as a complete failure. “Several expressed their opinion that it was a humbug affair,” Wells wrote.17 Wells left Boston humiliated and disgraced, but still believing that surgical operations could be performed painlessly. Many other citizens in Hartford received the benefits of Wells’ discovery and later gave sworn depositions that Wells had extracted teeth for them using nitrous oxide as an anesthetic.18
As time passed, Wells’ heath began to decline. He was struck with a sudden illness and could not recover for months. To help himself recover, Wells retired from dentistry and opened a business with a partner to make and sell the foot-pumped shower bath Wells had invented.19
Dr. William Thomas Greene Morton, not discouraged by Wells’ failure, still believed the use of nitrous oxide could increase business in his own dental practice if he could perform surgery without pain. Morton again returned to Jackson for nitrous oxide, but he did not have any (for he claimed it was still poisonous). Instead Jackson suggested using sulfuric ether. Using the sulfuric ether Jackson had given him, Morton extracted Eben Frost’s tooth. Convinced that surgery could be performed without pain, Morton went to visit Dr. Warren at the Massachusetts General Hospital. At the hospital, Morton told Warren about his painless procedure but did not tell Warren that he had used ether to eliminate the pain. Instead, Morton told Warren he had used his invention “Letheon.” Warren was very interested in Morton’s “invention,” and he allowed him to try his new method on the next available patient.20
Gilbert Abbott, a twenty-year-old man with a vascular neck tumor, was to be Morton’s patient. Warren scheduled the surgery for Friday, October 16, 1846, at the Massachusetts General Hospital21 and sent an invitation to Morton, asking him to perform his new invention to the Harvard Medical Class. After receiving the request, Morton immediately gave plans for constructing his ether inhaler to an instrument maker. On the morning of the operation, Morton rushed to the instrument maker’s shop only to find the instrument unprepared. Frantically, Morton grabbed the inhaler and hurried to the hospital where Dr. Warren and the Harvard Medical Class were waiting.22 Morton applied a tube connected to a glass globe to Abbott’s lips. Four or five minutes passed, and when the patient was unconscious, the operation commenced. During the operation, the patient gave no sign of sensibility, appearing to be sleeping quietly. Before the close of the operation, the patient moved his head, body, and limbs, and muttered words that could not be heard. Fortunately, when Abbott awoke, he proclaimed he had felt no pain, simply feeling a scraping sensation.23
The operation was a complete success! Dr. John Collins Warren had performed the greatest surgery in his history. The Harvard Medical class, which had been skeptical before the operation, was now silent, knowing that they had been present at the greatest surgery ever performed. After realizing what he had just accomplished, Warren wrote:
A new era has opened on the operating surgeon. His visitations on the most delicate parts are performed, not only without the agonizing screams he has been accustomed to hear, but sometimes in a state of perfect insensibility, and, occasionally, even with an expression of pleasure on the part of the patient….
As philanthropists we may well rejoice that we have had an agency, however slight, in conferring upon poor suffering humanity so precious a gift.
Unrestrained and free as God’s own sunshine, it has gone forth to cheer and gladden the earth; it will awaken the gratitude of the present, and all coming generations. The student, who from distant lands or in distant ages, may visit this spot, will view it with increased interest, as he remembers that here was first demonstrated one of the most glorious truths of science.24
Indeed, as Dr. John Collins Warren predicted, students from distant lands and in distant ages made journeys to the historic surgical amphitheater, now called the Ether Dome of the Massachusetts General Hospital.
On the following day, Dr. George Hayward, who was also present on the previous day, performed another operation using ether. This operation was also a great success. On the same day, the people of Massachusetts also first read about the famous operation performed by Warren in the Boston Daily Journal and in the Boston Post.25
Before the famous surgery using Letheon, the Massachusetts General Hospital had only averaged about one operation per week. Patients who had been avoiding surgery suddenly changed their minds. Morton hoped to become extremely wealthy by patenting Letheon, and until he secured the patent, Morton decided to keep the components of Letheon a secret. After his success, Morton could no longer hide the nature of letheon. A “capital,” or extremely serious, surgery to prove that surgery could be performed without pain was about to be taken place. The cardinal rule of medicine stated that discoveries must be shared, and the Massachusetts Medical Society would not allow secret remedies to be performed and forbade any further operations used with Letheon until Morton divulged its contents. Finally, just before the capital surgery was to be taken place, Morton revealed that Letheon was composed simply of sulfuric ether.26
After the capital surgery was completed successfully, people immediately hailed Morton as the greatest medical hero the country had ever produced. Dr. Warren lauded the discovery as “the most valuable discovery ever made, because it frees suffering humanity from pain.”27 At once, people searched for a better named than Letheon. From archaic texts, Dr. Oliver Wendell Holmes learned that the Greek physician Dioscorides had coined the word anesthesia, meaning “without feeling” nearly eighteen hundred years earlier.28
From this point on, Morton was to plunge into a dizzy maelstrom of controversy, charges and counter-charges, even to lobbying in Congress for national gratitude in the form of financial grants. Warren was wrong when he called this gift as “unrestrained and free as God’s own sunshine.” 29
Immediately after applying for a patent, Morton searched for agents to sell his inhaler. Thinking of his old partner and former teacher, Morton sent a letter to Wells, stating that he had already patented his inhaler and needed his help in promoting it in other states.30 Upon arriving to Boston, Wells watched Morton administer Letheon to other patients and perform surgery successfully. Despite Morton’s success, Wells refused to become one of his agents. He was growing jealous of his former student. After all, if Wells would have administered nitrous oxide to his patient for just a few moments longer, he would be famous. Wells felt he was not receiving his fair share of the credit. In December of 1846 Wells began campaigning for himself. Beginning with writing a letter in the Hartford Courant, Wells asked for the public to decide who the discoverer was. The day after his letter appeared, Wells wrote a letter to Morton, claiming that his accomplishments were not anything more than what he had done at least eighteen months prior to Morton’s public demonstration at the Massachusetts General Hospital.31
Within a few days of receiving Wells’ letter, Jackson, who had learned that Morton was applying for a patent from Commissioner Eddy, claimed that he deserved a share of the patent for his advice. Jackson was so convincing that even Eddy began to take his side. Jackson later visited Morton, demanding five hundred dollars as a fee for his advice. Morton agreed to pay the money, but he refused to acknowledge that Jackson’s information had been of help to him, which Jackson had hoped. As the world applauded Morton for his discovery, Jackson’s feelings turned to bitter hatred. He no longer agreed to the five hundred-dollar fee; instead, Jackson thought he deserved ten percent of the profits Morton would receive.32
Eddy advised Morton, according to a letter Eddy wrote later to the surgeons of the Massachusetts General Hospital, to give in to Jackson’s demands. Morton only wanted to appease Jackson, and he followed Eddy’s advice, while still maintaining that Jackson did not really deserve any credit or money. On November 12, 1846, Patent Number 4848 for ether anesthesia was granted jointly to Dr. William Thomas Green Morton and Charles Jackson.33
Still, Jackson was not satisfied. He realized he no longer wanted money. Jackson thought he deserved full credit for the discovery. Realizing he had two advantages over Morton and Wells, who at this time was just beginning to lay claims to the discovery, the first being that he had powerful friends in Europe, and the second being that Morton and Wells had both abandoned dentistry because they needed money, Jackson developed a plan and put it into action.34
Using his powerful influences, Jackson convinced Edward Everett, the president of the American Academy of Arts and Sciences, to allow him to give a lecture to the academy explaining the controversy with Morton. Jackson’s next step was to publish an article in the Boston Daily Advertiser about the ether discovery and the speech he was going to give to the academy. Jackson wanted to make it seem as though the American Academy of Arts and Sciences had already named Jackson as the discoverer of anesthesia. There was one problem, however. The newspaper article was set to print one day before the actual speech was to be given.35
When the daily newspaper came out on Monday, March 1, Jackson rushed hundreds of copies onto the mail boat setting sail for Europe. Not only was Morton upset at what Jackson had done but also Boston’s leading scientists were outraged. Jackson was forbidden to give a speech to the academy, and several people, including Dr. John Collins Warren, sent letters to Europe claiming that Jackson was a fraud.36 Still, the damage was done, and most of those who read the article in Europe believed Jackson should be hailed as the discoverer. To counteract Jackson’s newspaper article, Morton wrote a pamphlet titled Memoir on Sulfuric Ether. This pamphlet claimed Morton was the true discoverer because he had “risked reputation, and sacrificed time and money.” The memoir ended with the Morton’s words, “I believe I am the only person in the world to whom this discovery has, so far, been a pecuniary loss.”37