A History of Anaesthetics

 by Henry Hayter

(bmj.com)

Anaesthetics play a key role in modern medicine ,particularly as longer and more complex surgeries are undertaken due to advances in medicine; however, anaesthesiology is a relatively modern concept.  So what was there in the ways of anaesthetics in operations throughout history?

One of the earliest published recounts of anaesthesia is from late 18th century (1784) Bristol. This example of anaesthesia is very crude with the surgeon noting that their patient experienced a painless amputation after having slept on the arm. This was attributed to nerve compression by the writer of the record. Modern anaesthesia has of course changed greatly since 1784 ; instead of relying on nerve compression a cocktail of toxic drugs are used in modern anaesthesia with each drug complementing one another.

Few major advancements were made in the field of anaesthesia until 1844 when Gardner Quincy, a traveling showman, discovered the effects of N2O (Nitrous Oxide) and demonstrated them to an audience of dentists in Hartford Connecticut. Horace Wells , a local dentist who was curious about alleviating the pain caused by his operations, adopted this technique and frequently used it at his practice. Sadly the technique never spread far due to a failed talk given by Wells to an audience of Harvard medical students. In 1846  a student of Wells , called William Morton, proposed the use of ether as an anaesthetic. Unlike Wells, Morton was successful in his attempts and after a successful demonstration the technique spread across the Atlantic Ocean with the first surgery under ether being completed in 1846 London.

In 1847 James Simpson discovered the anaesthetic properties of Chloroform which was used widespread in England; however, a number of deaths that were linked to the usage of Chloroform the popularity of the anaesthetic decreased. This all changed in 1853 when John Snow used Chloroform as an anaesthetic on Queen Victoria during the birth of Prince Leopold and again in 1857 during the birth of Princess Beatrice. After John Snow’s death Joseph Clover became the leading anaesthetist in the UK. As such the figures of both Snow and Clover can be seen straddling the Crest of the Royal College of Anaesthetists.

Clover was also an advocate for the use of Nitrous Oxide in dental operations; the operations were usually short meaning that the Nitrous Oxide wouldn’t lead to brain damage or death. For the most part Clover was successful in his endeavours due to the operations being short in length.

Since 1857 anaesthesia has of course changed greatly in administration, use and composition. In 1947 another major discovery was made in the UK with muscle relaxants being discovered. This was a crucial discovery as it allowed for operations within the thoracic region to be completed with far less risk to the patient.

The evolution of anaesthesia is ongoing with new advancements being made as recently as May - a blood substitute was used on Jehovah’s Witnesses who were suffering from anaemia. It is of course highly likely that anaesthesia will continue to evolve throughout our lifetimes as new treatments become available thanks to medical innovation.