World Anesthesia Day commemorates the first successful demonstration of ether anesthesia on October 16, 1846. This ranks as one of the most significant events in the history of Medicine and took place at the Massachusetts General Hospital, home of the Harvard School of Medicine. The discovery made it possible for patients to obtain the benefits of surgical treatment without the pain associated with an operation. The date (16 October) is now globally recognised as World Anaesthesia Day in respect of the importance of this event.
William Thomas Green Morton (August 9, 1819 – July 15, 1868) was an American dentist who first publicly demonstrated the use of inhaled ether as a surgical anesthetic in 1846. Born in Charlton, Massachusetts, William T. G. Morton was the son of James Morton, a farmer, and Rebecca (Needham) Morton. William found work as a clerk, printer, and salesman in Boston before entering Baltimore College of Dental Surgery in 1840. In 1841, he gained notoriety for developing a new process to solder false teeth onto gold plates. In 1842, he left college without graduating to study in Hartford, Connecticut with dentist Horace Wells, with whom Morton shared a brief partnership.
In the autumn of 1844, Morton entered Harvard Medical School and attended the chemistry lectures of Dr. Charles T. Jackson, who introduced Morton to the anesthetic properties of ether. Morton then also left Harvard without graduating. On September 30, 1846, Morton performed a painless tooth extraction after administering ether to a patient. Upon reading a favorable newspaper account of this event, Boston surgeon Henry Jacob Bigelow arranged for a now-famous demonstration of ether on October 16, 1846 at the operating theater of the Massachusetts General Hospital, or MGH. At this demonstration Dr. John Collins Warren painlessly removed a tumor from the neck of a Mr. Edward Gilbert Abbott.
News of this use of ether spread rapidly around the world, and the first recorded use of ether in Britain was by Robert Liston at University College Hospital on 21 December 1846. The MGH theatre came to be known as the Ether Dome and has been preserved as a monument to this historic event. Following the demonstration, Morton tried to hide the identity of the substance Abbott had inhaled, by referring to it as "Letheon", but it soon was found to be ether. In 1852 he received an honorary degree from the Washington University of Medicine in Baltimore, which later became the College of Physicians and Surgeons.
Anesthesia, or anaesthesia (from Greek ἀν-, an-, "without"; and αἴσθησις, aisthēsis, "sensation") is a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation. Anesthesia is a unique medical intervention which does not itself offer any particular medical benefit and instead enables the performance of other medical interventions. The best anesthetic is therefore one with the lowest risk to the patient that still achieves the end points required to complete the other intervention. There are many different needs and goals of anesthesia. The goals (end points) are traditionally described as unconsciousness and amnesia, analgesia, and muscle relaxation. To reach multiple end points one or more drugs are commonly used (such as general anesthetics, hypnotics, sedatives, paralytics, narcotics, and analgesics), each of which serves a specific purpose in creating a safe anesthetic.
The purpose of anesthesia can be distilled down to three basic goals or end points:
hypnosis (a temporary loss of consciousness and with it a loss of memory)
analgesia (lack of sensation which also blunts autonomic reflexes)
The first documented general anesthetic was performed by Crawford W. Long in 1842. Unfortunately for Long, he did not publish his successes with ether for general anesthesia until 1849. Throughout Europe, Asia, and the Americas a variety of Solanum species containing potent tropane alkaloids were used for anesthesia. In 13th century Italy, Theodoric Borgognoni used similar mixtures along with opiates to induce unconsciousness, and treatment with the combined alkaloids proved a mainstay of anesthesia until the nineteenth century. Local anesthetics were used in Inca civilization where shamans chewed coca leaves and performed operations on the skull while spitting into the wounds they had inflicted to anesthetize.
Cocaine was later isolated and became the first effective local anesthetic. It was first used in 1859 by Karl Koller, at the suggestion of Sigmund Freud, in eye surgery in 1884. German surgeon August Bier (1861–1949) was the first to use cocaine for intrathecal anesthesia in 1898. Romanian surgeon Nicolae Racoviceanu-Piteşti (1860–1942) was the first to use opioids for intrathecal analgesia; he presented his experience in Paris in 1901.
Early Arab writings mention anesthesia by inhalation. This idea was the basis of the "soporific sponge" ("sleep sponge"), introduced by the Salerno school of medicine in the late twelfth century and by Ugo Borgognoni (1180–1258) in the thirteenth century. The sponge was promoted and described by Ugo's son and fellow surgeon, Theodoric Borgognoni (1205–1298).
In this anesthetic method, a sponge was soaked in a dissolved solution of opium, mandragora, hemlock juice, and other substances. The sponge was then dried and stored; just before surgery the sponge was moistened and then held under the patient's nose. When all went well, the fumes rendered the patient unconscious.
The most famous anesthetic, ether, may have been synthesized as early as the 8th century, but it took many centuries for its anesthetic importance to be appreciated, even though the 16th century physician and polymath Paracelsus noted that chickens made to breathe it not only fell asleep but also felt no pain. By the early 19th century, ether was being used by humans, but only as a recreational drug.
American physician Crawford W. Long noticed that his friends felt no pain when they injured themselves while staggering around under the influence of ether. He immediately thought of its potential in surgery. Conveniently, a participant in one of those “ether frolics", a student named James Venable, had two small tumors he wanted excised.
But fearing the pain of surgery, Venable kept putting the operation off. Hence, Long suggested that he have his operation while under the influence of ether. Venable agreed, and on 30 March 1842 he underwent a painless operation. However, Long did not announce his discovery until 1849.
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