Earliest Anesthetics
Earliest anesthetics refer to the historical methods and substances used to relieve pain during medical procedures. The origins of anesthetic practices can be traced back to the first century, with Aulus Cornelius Celsus documenting the use of opium extracts for inducing sleep and treating ailments like earache and colic. Throughout the Middle Ages, various narcotics were mentioned, but cultural beliefs, such as the notion that pain was divinely sanctioned, hindered their widespread use. It wasn’t until the late 18th century that significant advancements in chemistry and the discovery of gases like nitrous oxide began to shape anesthetic practices. Joseph Priestley discovered nitrous oxide in 1772, and while initially seen as a potential preservative, it later gained attention for its effects on pain relief, particularly by Humphry Davy. In the mid-19th century, practitioners like Crawford Long, William Morton, and Horace Wells explored the use of nitrous oxide and ether to facilitate painless surgeries, marking a pivotal shift in medical procedures. Ether emerged as a crucial anesthetic for more invasive surgeries, while nitrous oxide found its niche in dental applications. This evolution laid the groundwork for modern anesthetic techniques, highlighting the interplay between scientific discovery and medical practice.
Earliest Anesthetics
Date 1799
The study of inhalant vapors at the Pneumatic Medical Institute led to Sir Humphry Davy’s discovery that nitrous oxide, or laughing gas, could be used to alleviate pain. The gas was the first inhalant used as an anesthetic.
Locale Clifton, Bristol, England
Key Figures
Sir Humphry Davy (1778-1829), chemist who was the first to describe the effects of nitrous oxide as an anestheticThomas Beddoes (1760-1808), physician and founder of the Pneumatic Medical InstituteJames Watt (1736-1819), builder of the first apparatuses to deliver the gasesJoseph Priestley (1733-1804), a clergyman and amateur chemist who discovered nitrous oxide
Summary of Event
The earliest attempts at using agents for relief or prevention of pain date to the first century. The Roman encyclopedist and medical writer Aulus Cornelius Celsus noted the use of poppy seed extracts (opium) as a means of inducing sleep and as a treatment for earache and colic. Literature of the Middle Ages made frequent reference to a variety of narcotics, but several factors prevented the widespread application of such measures.
A common belief was that pain originated with God, and that to mitigate pain was to incur God’s wrath. Certainly, some church clerics, and even medical personnel, supported such a belief, but there is little evidence of widespread support for this idea. More critical was ignorance in understanding the concept of dosage in using what were potentially fatal narcotics. A greater level of safety was developed only after an experimental approach was applied in testing such agents.
The latter part of the eighteenth century was noted for significant advances in chemistry. Among these advances was the discovery of the chemical elements, particularly those associated with atmospheric gases. This led to a better understanding of chemical compounds. Nitrous oxide, a colorless gas often referred to as “laughing gas,” was discovered by the English chemist and clergyman Joseph Priestley in 1772, after he had heated ammonium nitrate with iron filings. Priestley, despite having no formal education in chemistry, also discovered oxygen, carbon monoxide, and carbon dioxide. He hoped to use nitrous oxide as a preservative. Though unsuccessful, Priestley did suggest that since the gases he discovered clearly were necessary for life, their use might have medical applications.
In the late 1780’s, the English physician Thomas Beddoes attempted to use the newly discovered gases as inhalants in the treatment of disease, believing that some illnesses, such as tuberculosis, might respond to therapy with increased or decreased exposure to various inhalants. In 1798, he founded the Pneumatic Medical Institute in Bristol to study inhalants and disease treatment. James Watt, noted for his work on engines, was hired to build the apparatuses to manufacture the gases. Beddoes also hired a young scientist, Humphry Davy, to oversee the work as superintendent.
Although Davy clearly realized the significance of nitrous oxide for inhalation anesthesia, the procedure’s application was overlooked by the medical establishment of the times. After noting the effects of the gas in the relief of pain associated with headaches or inflammations of the gum, the result of tooth decay, Davy resigned his position at the institution in 1801 and was hired as director of the chemical laboratory at the Royal Institution of Great Britain in London (and served as its president from 1820 to 1827). He devoted the remainder of his scientific career to the study of chemistry. The institution he founded produced no significant research on inhalation therapy. Nitrous oxide, although still used on occasion for its anesthetic properties, became better known as an intoxicant that induces a sense of exhilaration.
Significance
The use of gas to alleviate pain, and its use as a form of anesthesia appropriate for surgery, was not dismissed or forgotten by the medical establishment. During the mid-nineteenth century, Crawford Long, a graduate from what is now the University of Georgia, William Morton, a dentist, and Horace Wells, also a dentist, began testing various gases for their ability to create euphoria or even sleep in prospective surgical patients. Utilizing both nitrous oxide and then ether, each independently applied the ability of these gases to induce sleep, allowing for surgical procedures with a minimum of pain to the patient. Ether proved more useful for invasive surgery, and nitrous oxide was used in treating tooth and gum disease.
Bibliography
Cartwright, F. F. “Humphry Davy’s Contribution to Anesthesia.” Proceedings of the Royal Society of Medicine 43 (1950): 571-578. A biography of Davy as well as a description of his early application of nitrous oxide to anesthesiology.
Davy, Humphry. Researches, Chemical and Philosophical, Chiefly Concerning Nitrous Oxide or Dephlogisticated Nitrous Air, and Its Respiration. London: J. Johnson, 1800. Reprint. London: Butterworth, 1972. Davy’s work outlining his research on nitrous oxide. Includes illustrations and a bibliography.
Franco, Avelino, et al. The History of Anesthesia. Amsterdam: Elsevier Science, 2002. A collection of papers from a symposium that examines the development of anesthesia from antiquity through modern times.
Nuland, Sherwin. Doctors: The Biography. New York: Vintage Books, 1988. Nuland provides biographical descriptions of leading figures in the history of medicine.
Waller, John. Einstein’s Luck. New York: Oxford University Press, 2002. The author explores the myths behind scientific discoveries, including the question of whether religious objections truly existed in the alleviation of pain.
Wolfe, Richard, and Leonard Menczer, eds. I Awaken to Glory. Boston: Boston Medical Library, 1994. A collection of essays on the history of anesthesia. Emphasis is placed on the role of Horace Wells and his “rediscovery” of nitrous oxide. The period during which Davy reported his results is also discussed.
Wynbrandt, James. The Excruciating History of Dentistry. New York: St. Martin’s Press, 2000. An often humorous history of dental practices, as well as the history of anesthesia.