WWW Resources, History of Anesthesia Reviewed by Diane Elliott (Hist 5040 - Spring 2002) Web Sites www.johnpowell.net www.consciousness.arizona.edu www.anesthesia-nursing.com www.hmcnet.harvard.edu www.anes.uab.edu The search for painkillers and the science of anesthesia traces back to the third century BC. After the Greek god of dreams Morpheus, we got the drug Morphine, made from opium poppy, that is still used today. In a few weeks I will give birth to my second child, and so I have been considering my options with anesthesia. My options have broadened over the last couple thousand years. Curare, a poison used on South American arrows was first described in 1516. It was a muscle relaxant that killed by paralyzing the victim’s muscles. Before the 1800s, anesthesia involved either opium, laudanum, mandrake plant, cocaine-in the new world only, cannabis, or large doses of alcohol. Non drug methods of killing pain were cold, concussion, carotoid compression, nerve compression, hypnosis, and bloodletting. In 1665, the first IV injection was performed - opiate through a quill. In 1736 James Watt, the same man that created the workable steam engine, attempted to market factitious airs or gases. In 1799, Peter Mark Roget, the same man who wrote the Encyclopedia Britannica and the thesaurus did famous nitrous oxide research. Humphrey Davy discovered that nitrous oxide gas was a painkiller in 1800. He called it laughing gas. It took 44 more years for nitrous oxide to be used in anesthesia. Two years later the use of ether began, and three years after that, chloroform. These three were the first anesthetic agents because they were inhaled. In 1844, a dentist named Horace Wells demonstrated that teeth could be pulled painlessly with the use of the inhalation of nitrous oxide. This idea was not popular. In 1846, William Thomas Green Morton, another dentist , used ether on a patient with a tumor of the jaw bone. On his gravestone it says, “Inventor and revealer of inhalation anesthesia: before whom, in all time, surgery was an agony; by whom, pain in surgery was averted and annulled; since whom, science has control of pain.” Unlike nitrous oxide, which did not catch on for a few more years, ether was very popular very fast. By 1847 a doctor named James Young Simpson was using ether on women in childbirth. After 1848, either was eclipsed by chloroform. A London doctor named John Snow is often called the first anesthetist. He administered chloroform to Queen Victoria in 1853 for the birth of her eighth child. She declared it a great blessing. He also invented an inhaler and face piece. The problem, of course, with these three inhalants was the difficulty in regulating the inhaled concentration. Ether was fairly safe, but slow to work. It is also an irritant and flammable. Chloroform more easily took the pain away and was a non-irritant, but caused liver and heart poison. Nitrous Oxide worked fast, but was not very strong. Even with the knowledge of these three pain killers, surgeries performed during our Civil War were done without any anesthesia. In 1895 spinal anesthesia was used for the relief of pain. In 1898 the first spinal anesthesia for surgery was performed in Germany, and by 1899 alternatives to chloroform were becoming available. By the end of WWI the use of chloroform declined. The use of any anesthesia remained an inexact art even after WWII. There were frequent deaths due to overdose. After the attack on Pearl Harbor, hard lessons were learned. Anesthetic doses easily tolerated by health people were not tolerated by those in shock. The end tracheal tube made anesthesia safer. This is a tube that goes down the throat and allows easy inhalation and exhalation and protection of the lungs from stomach contents. Another tube technique was the blind naso-tracheal intubation, where a tube was passed up the nose and down the back of the throat down the larynx to the lungs. February 13, 1936 the American Society of Anesthetists was founded. In 1938 the American Board of Anesthesiology became affiliated with the American Board of Surgery, and by 1941 it achieved independent status.