Imagine being hypnotized before a root canal.
It’s natural to get anxious before a medical procedure or surgery. Even something that doesn’t involve cutting your skin, like a colonoscopy, can induce jitters as soon as the anesthesiologist hooks you up to a heart monitor.
Now imagine a time before anesthesiologists, IVs, and “happy gas.” Anesthesia may be a pretty well-oiled machine now, but it hasn’t always been so slick. Consider how many procedures today require some type of numbing or “going under,” and you’ll have an idea of how impactful the discovery of anesthesia was for the global population.
Easing the Pain of Surgery: The Early Beginnings
There’s plenty of evidence that ancient populations hunted for ways to make surgeries less painful. Humans have found Egyptian hieroglyphics showing people applying pressure near a limb in order to make the arm or leg “fall asleep,” which could reduce sensation during the rare operation.
In the late 13th century, the Italian physician Theodoric Borgognoni was known for the “soporific sponge,” which was a sponge soaked in a special recipe containing ingredients like opium, mulberry juice, and ivy, according to the medical historian Fielding Hudson Garrison. The sponge would then be held under the patient’s nose and inhaled to induce sleep. (Garrison notes, however, that this method could probably be traced back to ancient India.)
Another common strategy was “mesmerizing.” This was a term used to describe hypnosis used for pain relief in surgery. The first documented use of this was in the mid-18th century by the Scottish physician James Esdaile.
While this might sound inadequate by today’s anesthesia standards, remarkably, most of Esdaile’s patients survived their complex surgeries, such as amputations and tumor removals, using only mesmerism for pain. This was considered impressive: Most surgery patients prior to the 19th century died of shock or excessive bleeding.
Groundbreaking Discoveries in the 19th Century
The 1800s were a huge time in medicine. Many common diseases were discovered and defined, techniques were developed, tools were invented, and sterilization practices were standardized. The invention of modern anesthesia is no exception.
A number of doctors and scientists had been experimenting with or studying the potential of different substances that might be able to induce sleep for surgeries. In the 1840s, it was a dentist who finally put it to practice publically, according to medical historian Stephanie J. Snow, PhD.
Horace Wells, a dentist in Boston, saw an exhibition that demonstrated the “exhilarating” effects of nitrous oxide, which the exhibition called “laughing gas” (sound familiar?). He watched one participant inhale the gas and then run around so wildly that he bruised his legs on benches and began to bleed.
This gave Wells an idea. He asked the exhibitioner to help him with an experiment, in which he inhaled nitrous oxide and removed his own tooth. It was successful, and he continued using this procedure for tooth extractions for a number of patients. Yep: Nitrous oxide is still the “laughing gas” used for your cavities and fillings today.
Just a year later, another Boston dentist William T. G. Morton successfully demonstrated a painless surgery using a liquid called ether. It was this public and charismatic demonstration that many say launched the practice of anesthesia as it’s known today.
Refining the Art of Anesthesia
While the 19th century was a time of discovery, the 20th was a time of refinement. Previously, doctors like Morton would dip a rag in ether and cover the patient’s mouth to allow them to inhale. After the 19th century, however, more elaborate equipment, such as masks and IVs, were developed to make anesthesia safer and more precise.
As the practice of anesthesia became more widespread, it became a discipline in its own right. The Anesthesia and Analgesia journal was founded in 1922 (and is still in publication today), and the British Journal of Anaesthesia was founded the following year.
Thanks to these inventions and discoveries, surgeries became more common and more successful. What was once considered impossible—not feeling pain during surgery—was suddenly being successfully performed to improve and save lives.
Doctors tried a number of gases and compounds to find which worked best for general anesthesia. Several were attempted and eventually abandoned, such as cocaine and heroin (for obvious reasons), chloroform (which was found to be toxic to the liver), and eventually even ether (which worked well but was just too flammable).
Today’s anesthesiologists use isoflurane, desflurane, and sevoflurane (first used in 1980, 1987, and 1990, respectively). While these may be safer, more reliable, and better tolerated by the human body, they still owe credit to the early anesthesiologists for attempting the “unachievable.”
You could make a compelling argument that anesthesia is *the* most impactful invention in health care. Sure, new and impressive surgeries may be curing ailments and saving lives, but most wouldn’t be possible without anesthesia.
Archer WH, Wells H. The history of general anesthesia. J Am Dent Soc Anesthesiol. 1960 Feb;7(2):12-14.
Becker DE, Rosenberg M. Nitrous oxide and the inhalation anesthetics. Anesth Prog. 2008 Winter;55(4):124-131.
Evans FJ. An introduction to hypnosis. In: Fredericks LE, ed. The use of hypnosis in surgery and anesthesiology: psychological preparation of the surgical patient. Springfield, IL: Charles C Thomas Publisher LTD, 2001. p. 3-20.
Garrison FH. An introduction to the history of medicine. Philadelphia, PA: W.B. Saunders Company, 1913. Chapter seven: The medieval period (1096-1438); p. 124-177.
Hudson AE, Herold KF, Hemmings HC. In: Hemmings HC and Egan TD, eds. Pharmacology and Physiology for Anesthesia. Philadelphia, PA: Saunders, 2013. Chapter ten: Pharmacology of inhaled anesthetics; p. 159-179.
Leake CD. The historical development of surgical anesthesia. The Scientific Monthly. 1925 Mar; 20(3):304-328.
Snow SJ. Blessed days of anaesthesia: how anaesthetics changed the world. Oxford, England: Oxford University Press, 2009.
Timeline of important dates and events in the development of anaesthesia. History of Anaesthesia Society. (Accessed on February 1, 2019 at http://www.histansoc.org.uk/timeline.html.)