This week’s question was asked by friends.
QUESTION: How did anesthesia come about?
ANSWER: The story of anesthesia is a tale of a crook and his willing partner. Before the Civil War, people routinely committed suicide rather than submit to the surgeon’s knife. Every detail of the operation assured pain; the floor strewn with sand and sawdust to absorb blood, trays of knives and saws and surgical gowns coated with blood. The main concern was speed, not kindness. Charles Darwin quit medicine after witnessing a screaming boy undergoing the dreaded knife.
The first hint of what lay ahead for surgery occurred in December 1844. Nitrous oxide, laughing gas, was all the rage for well over 50 years, people inhaling it to get high. A young dentist, Horace Wells, attended a frolic in Hartford, Connecticut. A dentist friend pulled a bothersome wisdom tooth out of Well’s mouth and Wells noticed no pain at all.
Wells contacted an old business partner, William Morton, who was a real criminal scumbag. His rap sheet included embezzlement, mail fraud, jilting girlfriends and passing bad checks. Morton made the decision to come clean, at least for awhile, and apprenticed himself to dentist Wells. They teamed up for a public demonstration at Massachusetts General Hospital. The tooth-yanking from a volunteer went OK, but the patient let out a groan and the uninspired crowd dispersed. Morton determined to find something better. He did, and it was ether. Ether had been around for centuries. Ether has a very low boiling point, turning from a liquid to a vapor at 95 degrees Fahrenheit.
Morton rigged up a mechanical breathing mask, complete with valves and pipes, and teamed with Dr. John Warren to operate on a local house painter who had a large tumor beneath his left jaw. Yes, in the same Massachusetts General Hospital used nearly two years earlier for the tooth extraction on Wells.
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The operation was successful and witnessed by a houseful of young medical students. A new era of medicine was launched. Surgeons used ether in the 1848 Mexican-American War and the 1861-1865 Civil War. However, chloroform was discovered in 1832 and was used in 95 percent of Civil War surgeries.
Chloroform was preferred since smaller quantities were needed and its effect was more rapid than ether. Another drawback to ether is that it is highly flammable and dangerous in an era of gas and candle lighting. Chloroform can be used around an open flame.
Chloroform was administered by placing it on a sponge at the top of a cone and putting the other end over the patient’s nose and mouth. It was administered gradually to avoid shock, averaging about nine minutes before the surgeon went to work. Contrary to popular myth, soldiers did not “bite the bullet” to endue pain. Queen Victoria (1819-1901) was administered chloroform for the delivery of the last two of her nine children, starting in 1853.
President William McKinley was shot on Sept. 6, 1901, while attending a political reception in Buffalo, New York. The president had no bodyguards. He was hit twice at close range by anarchist Leon Czolgosz using a .32-caliber pistol hiding in his handkerchief. One bullet bounced off McKinley’s sternum and did not enter his body. The other penetrated the stomach. He underwent surgery using ether as an anesthesia. Doctors probed but could not find the bullet.
A host of complications confronted the medical team. There was a lack of good lighting. Gas lighting was ruled out because ether is highly flammable. Sunlight was reflected onto the wound. The president was more than slightly obese. The best doctor for this kind of surgery was attending to a patient a good distance away. The operating doctors sewed up both the entrance and exit wounds to the stomach. McKinley survived, but died nine days later due to gangrene or other infections. The bullet was never retrieved, even after a 90-minute probe during autopsy. The shooter, Czolgosz, was executed seven weeks later.
Nitrous oxide, ether and chloroform are all single compounds. Anesthesia today consists of a cocktail of several drugs and each targets a different physiological function. Some paralyze muscles and some slow breathing, while others interfere with memory formation and others relieve anxiety. Anesthesia pushes the “pause” button on consciousness and permits doctors to do their job.
Send questions and comments to: firstname.lastname@example.org.
Larry Scheckel is a retired Tomah High School physics teacher.
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