Facts about Anesthesia

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The Mandragora Plant—A Synopsis of Conquering Pain with Anesthetics

Pain is Nature’s alarm, her method of calling attention to something that is wrong with our bodies. It is her procedure for assuring that the damaged or diseased parts get the treatment necessary for her healing forces to take over. In the beginning, pain is the signal people need so they’ll be aware of a disease or injury. Later, pain becomes an obstacle to recovery because it interferes with the treatment that rest could provide.

A doctor’s first duty is often to find relief for a patient’s pain and this is usually done with a sedative drug. Early records indicate that two of the first pain-relieving remedies to be used were mandragora (now known as mandrake) and Indian hemp (hashish). The Egyptians believed that mandragora was the special gift to medicine from Ra, their Sun-God. The Roman herbalist and physician Dioscorides gave instructions for its use, “Boil the roots in wine to a third part, and preserve the juice thus procured and give one cyathus of it to cause the insensibility of those who are to be cut or cauterized.” Mandrake was the most popular anesthetic during the Middle Ages and in the Elizabethan Age it was still being used as a narcotic, as indicated by the following lines from Shakespeare:

“Give me to drink mandragora. …
That I might sleep out this great gap of time
My Antony is away.”

-from Antony and Cleopatra

The Beginning of Modern Anesthetics

That special branch of medicine now known as anesthetics may be said to date from the day on which Sir Humphry Davy, the inventor of the miner’s lamp, discovered the anesthetic properties of “laughing gas” or nitrous oxide. Davy discovered that a compound of nitrogen and oxygen (nitrous oxide) caused unusual results. At first, when Davy inhaled the gas, it produced a soaring euphoria, which soon passed into uncontrollable outbursts of laughter and sobbing, until it made him unconscious by the substance he unhesitantly called “laughing gas.” A passage written on November 21, 1846, by Oliver Wendell Holmes, a physician-poet and the father of the Supreme Court justice of the same name, provides us with evidence of when the words anaesthesia (anesthesia) and anaesthetic (anesthetic) became a part of the English language. The use of anesthetics to relieve pain during surgery was pioneered by U.S. dentists. According to the Reader’s Digest Book of Facts, Horace Wells (1815-48), a Connecticut dentist, was the first man to successfully use nitrous oxide (“laughing gas”) as an anesthetic when in 1844 he performed tooth extractions using the gas.

Another version, in Kenneth Walker’s The Story of Medicine, “The first man to employ nitrous oxide for anaesthetic purposes was Dr. Riggs ....” Based on his personal experiences (having one of his own teeth pulled by Dr. Riggs) with nitrous oxide as an anaesthesia, Dr. Horace Wells gave several demonstrations to his colleagues and in a comparatively short time the great value of the gas was established. The problem with nitrous oxide is that its effect didn’t last very long and so it was not suitable for long medical operations.

Dr. William Morton (1819-68), a Boston dentist and former partner of Dr. Horace Wells was one of the first to use ether as an anesthesia. In 1846, just two years after Horace Wells’ anesthetic success with nitrous oxide, Dr. Morton constructed the first anesthetic machine. Morton’s simple device was a glass globe housing an ether-soaked sponge so all the patient had to do was merely to inhale the vapor through one of two outlets. Morton’s invention was put to the test on October 16, 1846, in the surgical amphitheater of the Massachusetts General Hospital in Boston, when a twenty-year-old man was successfully anesthetized so a tumor could be painlessly removed from what one source said was his neck or jaw.

The history of the two anesthetics, nitrous oxide and ether, was the same in that the anesthetic properties of the two had originally been discovered in England but no further use was made of them. Dr. James Simpson (1811-70), “a well-known Edinburgh (Scotland) gynecologist,” was first to use ether in his obstetric practice. Simpson considered ether to be too unstable for his gynecological work so he looked for other anesthetic properties. After much experimentation, Simpson decided to use chloroform as a better anesthetic than either nitrous oxide or ether. He was the first man to use chloroform to relieve the pain of childbirth because he was dissatisfied with ether, not only because it irritated the eyes, and was highly inflammable, but also because there was no assurance that its use was safe. Many in Scotland protested that the use of chloroform in child labor was contrary to biblical teaching, for didn’t God say to Eve, “in sorrow thou shalt bring forth children”?

Simpson first administered chloroform in 1847 by simply sprinkling it on a handkerchief and placing it over the patient’s mouth and nose so that she could inhale the vapors. One mother was so delighted by the painless delivery that she named her child Anaesthesia. In 1853, Queen Victoria was given chloroform during the birth of her eighth child, Prince Leopold. The announcement of this in the press was received with amazement, grief, and criticism. Yet the “good Queen” participated in this form of anaesthesia and what the good Queen did was generally accepted. After Queen Victoria allowed the use of chloroform during her next child's birth, it became known in Great Britain as “anaesthesia a la Reine”. The use of chloroform in childbirth became fashionable and what was fashionable soon became moral and acceptable. Chloroform is more potent and more toxic than ether. Its use as an anesthetic dropped significantly with increased experience and knowledge of its dangers.

Anesthesia from Primitive and Ancient Sources

Cocaine is another example of a tool for medical usage which came from a primitive and ancient source. It was the Incas of Peru who regarded the coca-plant with great religious devotion and made offerings of its leaves to their Sun God. The story of anesthesia is closely linked with medical progress in the “New World,” particularly in the United States (according to British writer Kenneth Walker in The Story of Medicine). We also owe to the Incas of Peru a preparation which is now being used on a big scale in conjunction with anesthetics, the drug called curare. Curare has the special property of paralyzing the nerve endings in the muscles and when the anesthetist found it impossible to obtain good muscular relaxation by his anesthetic alone, he gave the patient an injection of this drug. Curare was used long ago by the old hunters of Peru who dipped their arrow heads in the poison because they found that by using it they didn’t lose as many arrows when the wounded prey tried to escape. The poison, curare, was absorbed from the wound into the animal’s blood stream and it quickly brought about the paralysis of its muscles. The use of an anaesthetic has now become so complicated that it is recognized as a speciality in medicine: anesthesiology. Awareness of dosages for each drug is essential to the safe use of anesthetics. The advancements in surgery could never have been made if parallel advances weren’t made in the speciality of anesthesia.

There are three natural anaesthetics . . . sleep, fainting, and death.

—Oliver Wendell Holmes (1809-94) U.S. writer and physician

Throughout America there are thousands of doctors--working in hospitals, clinics and private offices—who hurt and even fatally injure patients through incompetence or carelessness yet remain in active practice. In Denver, Richard Corbett Leonard, 8, died during a routine ear operation because the anesthesiologist allegedly fell asleep.

—From an article, “Why Some Doctors May Be Hazardous to Your Health”, by Bernard Gavzer, in the April 14, 1996, issue of Parade Magazine

A sign seen in a veterinarian’s office: The doctor is in. Sit! Stay!

—Paul Harvey, radio broadcast, December 2, 1996.

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