Before There Was Anesthesia, What Did People Do?

Explore how surgeons did surgery before the invention of anesthetic medications as you follow the development of anesthesia from the third century to the present.

Around the beginning of the third century CE, researchers began looking for anesthetics that could render patients unconscious and allow for more precise procedures. Prior to the widespread use of anesthesia, patients had to actively participate in the entire surgical process. What practices did physicians employ prior to the development of modern medicine? The evolution of anesthetic medications is researched by Sally Frampton.

Robert Liston, a Scottish surgeon, prepared to start while medical students restrained the patient and onlookers excitedly awaited. He sawed through the tibia and fibula of his patient in rapid succession, and within a few minutes, the amputation was over. Liston was known for his quick surgeries in the 1830s. This was crucial since, prior to the widespread use of anesthesia, patients had to consciously undergo every step of the surgical process. Long before Liston, researchers started looking for anesthetics that could render patients unconscious and allow for more precise surgery.

Hua Tuo, a Chinese physician, described using a powdered mixture of several herbs and wine to put patients to sleep around 200 CE. Ibn al-Quff, an Arab surgeon who lived in the 13th century, also wrote about patients who inhaled anesthetics from saturated sponges, probably including substances like cannabis, opium, and mandrake. Many scientists were considering how chemistry might be used in medicine by the end of the 1700s. As a result, nitrous oxide, ether, and chloroform were three of the primary actors in a flurry of anesthetic breakthroughs.

English chemist Humphry Davy started experimenting with nitrous oxide, sometimes known as laughing gas, in 1799 by breathing it and monitoring friends' reactions. Davy pointed out that its pain-relieving properties would make it beneficial for surgical procedures, but that wouldn't happen for many years. This was due, at least in part, to the doubts held by certain surgeons and patients regarding the efficacy and security of anesthetic medications.

Using a combination of medicinal herbs to induce anesthesia, the Japanese surgeon Seish Hanaoka successfully removed a breast tumor from a patient in 1804. However, the news never left Japan. Ether eventually attracted medical attention. Before it was utilized for recreational purposes, it was originally created.

An American physician observed that his fall while taking ether during the infamous "ether frolics" of the early 1800s was painless. He effectively removed a patient's neck tumor by etherizing him in 1842. In the interim, dentists eventually acknowledged nitrous oxide's potential. However, in 1845, an American dentist who was using nitrous oxide to sedate his patient failed to complete the procedure when the patient shouted.

Even though it was probably only an inadequate dose, the medicine suffered from the negative press. In the meantime, dentists developed techniques for tooth extraction. Additionally, an American surgeon removed the man's neck tumor in October 1846 after an American dentist gave the patient ether.

Two months later, Liston himself amputated the patient's upper leg after he had become etherized; the patient apparently came to within minutes and inquired as to when the treatment would start. Successes powered by ether then spread to Russia, India, and other countries. However, ether had drawbacks, such as unfavorable side effects. James Simpson, a Scottish obstetrician, learned about chloroform, an alternate anesthetic. And in 1847, he and two coworkers made the decision to try some for themselves.

They immediately fell asleep. Soon after, Simpson gave one of his patients chloroform during childbirth. It immediately became popular since it worked swiftly and was believed to have no negative effects, despite the fact that we now know it is toxic and probably carcinogenic. Because anesthetics weren't fully known at the time, they occasionally had fatal outcomes. Additionally, some doctors' racial and gender biases affected how much, if any, anesthetic they would administer.

Charles Meigs, an American obstetrician, argued that childbirth's discomfort was a manifestation of divine sorrow and opposed medical intervention. James Marion Sims, an American surgeon, performed experimental gynecological procedures on enslaved black women throughout the 1840s without using anesthetics. By the late 19th century, those who had access to anesthetics were having increasingly difficult operations done on them, including those that had previously been impossible.

By the early 1900s, chloroform had come to be perceived as a riskier, more toxic alternative and had lost appeal. Today, ether and nitrous oxide are still used in conjunction with more modern medications, albeit in altered forms that are safer and have fewer adverse effects while being continuously monitored by medical professionals. These innovations have made it so that time isn't always of the essence and that surgery might feel more like a dream than a source of excruciating pain.