October 16, 1996 marks the sesquicentennial anniversary of the first public demonstration of ether anesthesia - one of the most seminal events in the history of medicine.
Before 1846, any surgical operation was literally an agonizing, terrifying ordeal - a living and many times, a dying hell. Even a trip to the dentist for a tooth extraction was a much feared and dreaded experience. Before this date, preparing a patient for surgery typically involved plying him or her with opium or alcohol to the point of almost passing out and then having 4 to 10 strong men strap and hold the patient down while the surgery was rapidly accomplished. This was always accompanied by excruciating pain and a vigorous and unending screaming unless the patient fainted or died from an overdose of opium - a wrenching experience for both surgeon and patient alike. It was not uncommon that when a person was told that surgery was necessary, the patient would go home and commit suicide rather than consent to the operation, so terrifying were the stories related by previous patients who had gone under the knife. Many were psychologically affected or had nightmares about the experience for the rest of their lives.
Before 1846, the greatest recent advance in surgery was considered the suture, or stitch, introduced in the 16th century by Ambroise Pare, a French military surgeon. Before this innovation, people frequently died from bleeding or by the method used to close the wound, usually cauterization by the application of hot irons, or with amputations, the stump might be dipped in boiling pitch to seal the blood vessels.
Surgeons became very adept at performing operations rapidly - excising a bladder stone in 45 seconds or amputating a leg in 1 to 2 minutes. They had to be fast because the patient could not withstand the pain of a lengthy procedure. Surgery was a universally dreaded, feared and agonizing experience - this all changed October 16, 1846.
Ether was first synthesized in 1640 by Cordus, so it had been around a long time before it was discovered that it could be used to make a person insensible to pain for surgery. Nitrous oxide was discovered by Priestly in 1777, and in 1779 Davy actually described the pain relieving property of the gas, but nobody at that time correlated it to a possible use for relieving pain during surgical procedures.
By the beginning of the 19th century, after seeking a method for pain relief since the beginning of time, and with no real success, everyone had essentially given up and believed that pain was just a part of human existence, and that was the way it was supposed to be.
Actually, the discovery of "anesthesia" came about quite by accident. In the early 19th century, young people would gather together to have ether frolics (which would be analogous to pot parties during the 1960's). They discovered that when they sniffed the pungent, volatile, aromatic ether, they would enjoy it, get high, develop a giddiness, and sometimes pass out. At the same time, nitrous oxide was being promoted by lecturers who would go around giving out worldly knowledge in every town to crowds who would listen. They called it laughing gas and used it as entertainment to attract people to their lectures. One of the most notable of these was Samuel Colt, none other than the man who designed the first practical revolver-type pistol. At 19 years of age, when he and the chief chemist at his father's textile factory would get bored, they would indulge in a whiff of laughing gas. He then started touring the country going from town to town, lecturing and demonstrating the effects of the gas. One of the advertisements from a nitrous oxide demonstration promised: "The effect of the gas is to make those who inhale it either laugh, sing, dance, speak or fight, etc., etc., according to the leading trait of their character. They seem to retain consciousness enough not to say or do that which they would have occasion to regret." Ether, before mainly used for respiratory ailments, was also demonstrated by the itinerate lecturers in the same manner and with similar results.
It wasn't long before the more daring young people learned to just skip the lectures and brings bags of ether directly to their parties to liven up the frolics, and it wasn't even illegal! Highs could be developed quickly and they wore off completely except that occasionally people suffered bruises and even broken bones during intoxication from inhaling the gas without feeling it until long afterwards.
In December 1844, Horace Wells, a dentist, was one of the volunteers who tried inhaling nitrous oxide on stage during a demonstration by Professor Gardner Colton. One of the other volunteers injured his legs very badly during his inhalation of the gas, and when Wells afterwards asked if it was painful, he said he hadn't felt anything at all and was surprised to see blood all over his legs.
Whether it was Wells' sound reasoning or accidental observation that occurred at that time, it was that moment that eventually led to the development of anesthesia for surgery all over the world.
After the lecture Wells persuaded Professor Colton to bring a bag of nitrous oxide to his dental office where a colleague would extract a tooth while he himself was under the influence of the gas. This was accomplished, and Dr. Wells described it as no more painful than the prick of a pin.
After experimenting more in dental surgery with nitrous oxide, he then approached John C. Warren, one of the nation's foremost surgeons, at Massachusetts General Hospital in Boston. He asked Dr. Warren to allow him to demonstrate the extraction of a tooth using nitrous oxide before a group of students. A time was set for the event, but during the procedure the patient made a sound which the audience interpreted as pain and immediately jeered the procedure as a failure and the dentist as a humbug. Later the patient said that he felt no pain and didn't know why he made the sound, but it was too late - the word of the failure had already spread. Humiliated, Dr. Wells returned home and remained sick for the rest of the year.
Wells mentioned the pain relieving discovery of nitrous oxide to William Morton, a colleague who had trained in dentistry under him. At the time Morton was undertaking general medical studies under Charles Jackson, a well-known chemist and later at Harvard medical school. Wells discussed with Morton and Jackson his ideas for using nitrous oxide in surgery, but neither showed much interest.
Later, Morton was about to lose a dental case because of the intense pain fears of the patient. He asked the chemist Jackson for some nitrous oxide. He had none and off-handedly remarked that ether would work just as well. Morton then experimented with ether for dental surgery and became convinced that it would work for hospital surgery.
He contacted the same great surgeon, John C. Warren, before whose audience Wells disastrous demonstration took place, and asked permission to demonstrate a new vapor to make a patient insensible to pain for surgery before an audience of students and surgeons. Dr. Warren consented.
William Morton had enough experience with ether that he knew it would work and that he would be celebrated as the one to bring this monumental gift to humanity. He also knew that whoever had a patent on it and controlled its sales would be rich beyond imagination. But, since ether had been around for centuries and could not be patented, Morton had a problem.
What Morton did was add a few harmless impurities to the ether to try to disguise its smell and named it the secret concoction Letheon. He then took out a U.S. patent on it. He being the proprietor of the patent, in a loose arrangement with Dr. Charles Jackson, the chemist who had casually previously suggested that ether could be substituted for nitrous oxide.
On October 16, 1846, William Morton arrived late to the operating theater at Massachusetts General Hospital. The small group of eminent surgeons and students were laughing at a scolding remark of Dr. Warren's criticizing Morton's tardiness when he rushed into the room short of breath after running up the stairs with his Letheon and a new inhaler he had devised.
Warren then said, "Well, sir, your patient's ready." The patient , Edward Gilbert Abbot, a thin pale man, had a bulging tumor of the jaw. Dr. Morton calmly explained to the patient what to expect and then had him breathe from the inhaler for several tense minutes. He then said to Dr. Warren, "Sir, your patient is prepared."
Dr. Warren then dexterously and quickly excised the tumor from the jaw. There was no movement by the patient, only a slight wiggle and quiet gentle breathing as in a peaceful sleep. There was no shrieking by the patient, and there had been no need to strap the patient down or have several strong men hold him still for the surgery. The audience was silent, and with awe they were convinced. After the procedure Dr. Warren turned to the other surgeons and students, and with tears in his eyes, said, "Gentlemen, this is no humbug."
The news spread quickly, but Dr. Morton refused to divulge his secret formula. He sought license fees from dentists and hospitals for using his mixture. The news of the discovery spread rapidly around the world, and within months ether was being used in Europe and all over the United States. Dr. Morton's attempted disguise of ether as Letheon had failed - a patent was then useless, and no one had a financial claim on the use of ether.
While originating this process for the sake of humanity, Wells, Morton and Jackson were at first close friends, but after the successful ether demonstration, they were driven by jealousy for the rest of their lives. Each tried to claim credit for the discovery and spent all their energies toward this goal. They became the bitterest of enemies. Though their discovery has prevented millions of people from suffering, it brought tremendous suffering to themselves -- all three died in a state of madness.
Horace Wells unsuccessfully tried to prove that nitrous oxide could rival ether as an anesthetic, but the weaker gas, nitrous oxide, alone was not as effective as ether for surgery. He then turned to chloroform and quickly became addicted to it. While under its influence he threw acid in a woman's face and was put in jail. The year was 1848, and insane and despondent, he ended his life in the jail cell by slitting a major artery in his leg, taking care to attempt to anesthetize himself first.
William Morton lived longer, all the time seeking recognition and compensation for his discovery. In 1868, he had a nervous collapse after lobbying in Washington for compensation for his monumental discovery that had relieved so much suffering in the world. While in New York City, he jumped out of a moving buggy to plunge his head in a lake in Central Park. He was dragged out of the water unconscious and died in the hospital the next day.
Dr. Charles Jackson for years made intense attacks of Morton's claims to have originated anesthesia. (Jackson also claimed credit for guncotton and the telegraph.) He became insane, was committed to an asylum near Boston where he died after 7 years of confinement.
It is significant that Dr. Crawford Long of Jefferson, Georgia, in whose honor Doctor's Day originated, had been using ether anesthesia for surgery in 1842, 4 years before Morton's public demonstration. He used it on several minor surgery cases over the next few years. He did not publicize his technique until others had done so. He did not spread the word. He sought no fame or recognition. However, his keeping it isolated in Jefferson, Georgia and failing to promote ether as anesthesia only prolonged worldwide suffering for 4 years.
Oliver Wendall Holmes, Sr., the father of the future Supreme Court Justice, was an eminent physician and was excited over the discovery of the pain killing property of ether. He wrote to William Morton after Dr. Warren successfully amputated a woman's leg under Morton's ether administration. On November 21, 1846, he wrote, "Everybody wants to have a hand in the great discovery. All I want to do is to give you a hint or two as to names, or the name, to be applied to the state produced and the agent." From the Greek an for without and esthesia for sensibility, Holmes created the words anesthetic and anesthesia.
The discovery of anesthesia opened the door for the rapid development of surgery. There are hundreds of different kinds of surgical procedures performed today which would not be possible without anesthesia. Although Wells, Jackson and Morton were only ordinary men, the coincidence of their mutual acquaintance and their combination of ideas resulted in one of the most important discoveries in all of medicine.
Leake, Chauncey D. (1947). Letheon - The Cadenced Story of Anesthesia
Selwyn-Brown, Arthur (1928). The Physician Throughout the Ages
Sykes, W. Stanley (1960). Essays on the First Hundred Years of Anesthesia
Invention and Technology (Summer, 1996) How Nobody Invented Anesthesia;12
American Heritage (October 1996). 1846,One Hundred and Fifty Years