HISTORY OF ANAESTHESIA - lecture handout, ODP course Bristol 18/01/02

You can click on any of the pictures to get an enlarged view

Ancient and Mediaeval times

Drugs available for relief of pain Alcohol Opium (Poppy) Hyoscine (Mandrake + others) Cannabis (Hemp) Cocaine – in New World only	Henbane	Hop & Hemp	Poppy

Non drug methods Cold Concussion Carotid compression Nerve compression Hypnosis Blood letting	Clamp for compression anaesthesia

Leading up to 1846

1516 action of curare observed 1540 ether synthesised 1562 Paré used nerve compression 1628 Harvey described circulation of blood 1665 first IV injection – opiate through a quill 1772 Mesmer – ‘animal magnetism’ 1777 Priestley prepares N2O	Humphry Davy	Henry Hill Hickman
1800 Davy described analgesic action of N2O 1800+ laughing gas and, later, ether used as social intoxicants
1807 Larrey - snow for amputations 1821 Brodie gives ether to guinea-pigs; 1842 Hickman uses CO2 on animals 1831 Guthrie et al - Chloroform synthesised 1842 Clarke and Long used ether for operations; unreported	Crawford Long	Horace Wells
1843 First FRCS – before both anaesthesia and antisepsis! 1844 Wells used N2O; public demonstration at MGH ‘failed’; cries of “Humbug” 1845 Esdaile – 73 operations under hypnosis 1826–45 at the Mass. Gen.Hosp. there were only 333 operations over 20 years.	William Morton	Charles Jackson

Mesmer practising Animal Magnetism

Pneumatic Institute, Bristol

Social Note

In the 17/18th centuries: public executions = entertainment.

Before 1846 there had been 25 years of peace, rapid industrialisation and rapid growth of towns.

By 1830 there was overcrowding, not enough clean water, poor sewerage; not enough graveyards.

In 1833 the Factory Act was passed; 1841-48 the Mines Act, Ten Hours Act, Public Health Act.

 

 October 16th 1846 

First successful public demonstration of anaesthesia Massachusetts General Hospital, Boston  Anaesthetist: William Thomas Green Morton Agent: Diethyl Ether Patient: Gilbert Abbott Operation: Excision of tumour under jaw Surgeon: John Collins Warren Comment: “Gentlemen, this is no humbug”	painting by Robert Hinckley
a replica of Morton's inhaler	Ether dome c. 1930

 

	Anaesthesia Memorial, Boston
	photo by Whelan Moore

Inscription on Morton’s tombstone:
	Inventor and Revealer of Inhalation Anesthesia: Before Whom, in All Time, Surgery was Agony; ByWhom, Pain in Surgery was Averted and Annulled; Since Whom, Science has Control of Pain.

Some events after 1846

 

1847 Simpson 1847 Snow 1847 Snow 1848 Heyfelder 1854 Snow 1865 Lister 1878 Macewen 1884 Koller 1891Tuffier 1892 Schleich 1894 1897	Chloroform On the Inhalation of Ether chloroform regulating inhaler Ethyl chloride used in Germany Broad St pump-handle removed carbolic spray first oral ETT; flexible brass, 3/8" diam cocaine first partial pneumonectomy; no ETT infiltration LA anaesthetic charts first death from a motor car	James Simpson
1895 Corning 1898 Bier 1904 1907 1920 Rowbotham 1921 1934 1937 Macintosh	spinal anaesthesia for relief of pain spinal anaesthesia for surgery procaine – a huge advance intra-tracheal insufflation (chloroform) blind nasal intubation with wide bore tube lumbar epidurals cyclopropane, thiopentone 1st European chair of anaesthesia	John Snow
1941 1942 1946 1951 1952 Ibsen 1956 Johnstone 1980 onwards	Trilene curare first used in anaesthesia lignocaine suxamethonium IPPR for bulbar poliomyelitis introduces halothane use of halothane declines, as new ethers introduced

Acknowledgement of source of pictures: Wells and Morton are from the Clendenning library; Morton's inhaler and Jackson from http://neurosurgery.mgh.harvard.edu/History; compression clamp, Hickmann, Simpson, Snow, Koller, Corning and the Ether Dome from Victory Over Pain by Victor Robinson. Sigma, London 1947; Davy from Bristol City Museum; Hinckley painting from Countway Library of Medicine.

Part 2 of this lecture handout is a comparison of anaesthetic agents available in 1847

Part 3 of this lecture handout is on the stages of anaesthesia

Home  (to visit other articles/book on the history of anaesthesia)