Facts about Anesthesia
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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