the two greatest and most beneficent were the discovery of ether and
the introduction of antiseptic methods,--one of which we owe to an
American, the other to a Briton.
The production of deep sleep and the usual accompanying abolition of
pain have been subjects which have ever appeared, in some form, in
myth or fable, and to which poets of all times have alluded, usually
with poetic license. One of the most popular of these fables connects
the famous oracle of Apollo, at Delphi, whence proceeded mysterious
utterances and inchoate sounds, with convulsions, delirium and
insensibility upon the part of those who approached it. To what extent
there is a basis of fact in this tradition can never be explained, but
it is not improbable from what we now know of hypnotic influence.
From all time it has been known that many different plants and herbs
contained principles which were narcotic, stupefying or intoxicating.
These properties have especially been ascribed to the juices of
the poppy, the deadly nightshade, henbane, the Indian hemp and the
mandrágora, which for us now is the true mandrake, whose juice has
long been known as possessing soporific influence. Ulysses and his
companions succumbed to the influence of _Nepenthe_; and, nineteen
hundred years ago, when crucifixion was a common punishment of
malefactors, it was customary to assuage their last hours upon the
cross by a draught of vinegar with gall or myrrh, which had real or
supposititious narcotic properties. Even the prophet Amos, seven
hundred years before the time of Christ, spoke of such a mixture as
this as "the wine of the condemned," for he says, in rehearsing the
iniquities of Israel by which they had incurred the anger of the
Almighty: "And they lay themselves down upon the clothes laid to pledge
by every altar, and they drink the wine of the condemned in the house
of their God," (Chap. II, verse 8), meaning thereby undoubtedly that
these people, in their completely demoralized condition, drank the
soporific draught kept for criminals. Herodotus mentions a habit of the
Scythians, who employed a vapor generated from the seed of the hemp
for the purpose of producing an intoxication by inhalation. Narcotic
lotions were also used for bathing the people about to be operated
upon. Pliny, who perished at the destruction of Herculaneum, A. D.
79, testified to the soporific power of the preparations made from
mandrágora upon the faculties of those who drank it. He says: "It is
drunk against serpents and before cuttings and puncturings, lest they
should be felt." He also describes the indifference to pain produced
by drinking a vinous infusion of the seeds of eruca, called by us
the rocket, upon criminals about to undergo punishment. Dioscorides
relates of mandrágora that "some boil down the roots in wine to a
third part, and preserve the juice thus procured, and give one cyathus
of this to cause the insensibility of those who are about to be cut
or cauterized." One of his later commentators also states that wine
in which mandrágora roots have been steeped "does bring on sleep and
appease pain, so that it is given to those who are to be cut, sawed or
burnt in any parts of their body, that they may not perceive pain."
Apuleius, about a century later than Pliny, advised the use of the
same preparation. The Chinese, in the earlier part of the century,
gave patients preparations of hemp, by which they became completely
insensible and were operated upon in many ways. This hemp is the
cannabis Indica which furnishes the _Hasheesh_ of the Orient and the
intoxicating and deliriating _Bhang_, about which travelers in the East
used to write so much. In Barbara, for instance, it was always taken,
if possible, by criminals condemned to suffer mutilation or death.
According to the testimony of medieval writers, knowledge of these
narcotic drugs was practically applied during the last of the Crusades,
the probability being that the agent principally employed was this same
hasheesh. Hugo di Lucca gave a complete formula for the preparation of
the mixture, with which a sponge was to be saturated, dried, and then,
when wanted, was to be soaked in warm water, and afterward applied to
the nostrils, until he who was to be operated upon had fallen asleep;
after which he was aroused with the vapor of vinegar.
Strangely enough, the numerous means of attaining insensibility, then
more or less known to the common people, and especially to criminals
and executioners, do not appear to have found favor for use during
operations. Whether this was due to unpleasant after-effects, or from
what reason, we are not informed. Only one or two surgical writers
beside Guy de Chauliac (1498) refer in their works to agents for relief
of pain, and then almost always to their unpleasant effects, the danger
of producing asphyxiation, and the like. Ambrose Paré wrote that
preparations of mandrágora were formerly used to avert pain. In 1579,
an English surgeon, Bulleyn, affirmed that it was possible to put the
patient into an anaesthetic state during the operation of lithotomy,
but spoke of it as a "terrible dream." One Meisner spoke of a secret
remedy used by Weiss, about the end of the XVII Century, upon Augustus
II., king of Poland, who produced therewith such perfect insensibility
to pain that an amputation of the royal foot was made without
suffering, even without royal consent. The advice which the Friar gave
Juliet regarding the distilled liquor which she was to drink, and which
should presently throw her into a cold and drowsy humor, although a
poetic generality, is Shakespeare's recognition of a popular belief.
Middleton, a tragic writer of Shakespeare's day, in his tragedy known
as "Women beware Women," refers in the following terms to anesthesia in
surgery:
"I'll imitate the pities of old surgeons
To this lost limb, who, ere they show their art,
Cast one asleep; then cut the diseased part."
Of course, of all the narcotics in use by educated men, opium has
been, since its discovery and introduction, the most popular and
generally used. Surgeons of the last century were accustomed to
administer large doses of it shortly before an operation, which, if
serious, was rarely performed until the opiate effect was manifested.
Still, in view of its many unpleasant after-effects, its use was
restricted, so far as possible, to extreme cases.
Baron Larrey, noticing the benumbing effect of cold upon wounded
soldiers, suggested its introduction for anesthetic purposes, and
Arnott, of London, systematized the practice, by recommending a
freezing mixture of ice and salt to be laid directly upon the part
to be cut. Other surgeons were accustomed to put their patients into
a condition of either alcoholic intoxication or alcoholic stupor.
Long-continued compression of a part was also practised by some, by
which a limb could, as we say, be made to "go to sleep." A few others
recommended to produce faintness by excessive bleeding. It was in 1776
that the arch-fraud Mesmer entered Paris and began to initiate people
into the mysteries of what he called _animal magnetism_, which was soon
named mesmerism, after him. Thoroughly degenerate and disreputable
as he was, he nevertheless taught people some new truths, which many
of them learned to their sorrow, while in the hospitals of France
and England severe operations were performed upon patients thrown
into a mesmeric trance, and without suffering upon their part. That a
scientific study of the mesmeric phenomena has occupied the attention
of eminent men in recent years, and that hypnotism is now recognized
as an agent often capable of producing insensibility to pain is simply
true, as these facts have been turned to the real benefit of man by
scientific students rather than by quacks and charlatans.
In 1799, Sir Humphrey Davey, being at that time an assistant in the
private hospital of Dr. Beddoes, which was established for treatment
of disease by inhalation of gases, and which he called The Pneumatic
Institute, began experimenting with nitrous oxide gas, and noticed its
exhilarating and intoxicating effects; also the relief from pain which
it afforded in headache and toothache. As the results of his reports, a
knowledge of its properties was diffused all over the world, and it was
utilized both for amusement and exhibition purposes. Davey even wrote
as follows of this gas:
As nitrous oxide, in its extensive operation, appears capable of
destroying physical pain, it may probably be used with advantage during
surgical operations in which no great effusion of blood takes place.
It is not at all unlikely that Colton and Wells, to be soon referred
to, derived encouragement, if not incentive, from these statements of
Davey. Nevertheless, Velpeau, perhaps the greatest French surgeon of
his day, wrote in 1839, that "to escape pain in surgical operations is
a chimera which we are not permitted to look for in our day."
Sulphuric ether, as a chemical compound, was known from the XIII
Century, for reference was made to it by Raymond Lully. It was first
spoken of by the name of ether by Godfrey, in the Transactions of the
London Royal Society, in 1730, while Isaac Newton spoke of it as the
ethereal spirits of wine. During all of the previous century it was
known as a drug, and allusion to its inhalation was made in 1795 in a
pamphlet, probably by Pearson. Beddoes, in 1796, stated that "it gives
almost immediate relief, both to the oppression and pain in the chest,
in cases of pectoral catarrh." In 1815, Nysten spoke of inhalation of
ether as being common treatment for mitigating pain in colic, and in
1816 he described an inhaler for its use. As early as 1812 it was often
inhaled for experiment or amusement, and so-called "ether frolics" were
common in various parts of the country. This was true, particularly for
our purpose, of the students of Cambridge, and of the common people in
Georgia in the vicinity of Long's home. It probably is for this reason
that a host of claimants for the honor of the discovery appeared so
soon as the true anesthetic properties of the drug were demonstrated.
There probably is every reason to think that, either by accident or
design, a condition of greater or less insensibility to pain had been
produced between 1820 and 1846, by a number of different people,
educated and ignorant, but that no one had the originality or the
hardihood to push these investigations to the point of determining the
real usefulness of ether. This was partly from ignorance, partly from
fear, and partly because of the generally accepted impossibility of
producing safe insensibility to pain. So, while independent claims
sprang up from various sources, made by aspirants for honors in this
direction, it is undoubtedly as properly due to Morton to credit him
with the introduction of this agent as an anesthetic as to credit
Columbus with the discovery of the New World, in spite of certain
evidences that some portions of the American continent had been touched
upon by adventurous voyagers before Columbus ever saw it.
The noun "anesthesia" and the adjective "anesthetic" were suggestions
of Dr. Oliver Wendell Holmes, who early proposed their use to Dr.
Morton in a letter which is still preserved. He suggests them with
becoming modesty, advises Dr. Morton to consult others before adopting
them, but, nevertheless, states that he thinks them apt for that
purpose. The word anesthesia, therefore, is just about of the same age
as the condition itself, and it, too, deserves commemoration upon this
occasion.
As one reads the history of anesthesia, which has been written up by
a number of different authors, each, for the main part, having some
particular object in view, or some particular friend whose claims he
wishes especially to advocate, he may find mentioned at least a dozen
different names of men who are supposed to have had more or less to
do with this eventful discovery. But, for all practical purposes, one
may reduce the list of claimants for the honor to four men, each of
whose claims I propose to briefly discuss. These men were Long, Wells,
Jackson and Morton. Of these four, two were dentists and two practising
physicians, to whom fate seems to have been unkind, as it often is,
since three of them at least died a violent or distressing death, while
the fourth lived to a ripe old age, harassed at almost every turn by
those who sought to decry his reputation or injure his fortunes.
Crawford W. Long was born in Danielsville, Ga., in 1816. In 1839
he graduated from the Medical Department of the University of
Pennsylvania. In the part of the country where Long settled it was a
quite common occurrence to have what were known as "ether frolics"
at social gatherings, ether being administered to various persons to
the point of exhilaration, which in some instances was practically
uncontrollable. Long's friends claim that he had often noticed that
when the ether effect was pushed to this extent the subjects of the
frolic became oblivious to minor injuries, and that these facts, often
noticed, suggested to his mind the use of ether in surgical operations.
There is good evidence to show that Long first administered ether
for this purpose on the 30th of March, 1842, and that on June 6th
he repeated this performance upon the same patient; that in July he
amputated a toe for a negro boy, but that the fourth operation was
not performed until September of 1843. In 1844 a young man, named
Wilhite, who had helped to put a colored boy to sleep at an ether
frolic in 1839, became a student of Dr. Long's, to whom Long related
his previous experiences. Long had never heard of Wilhite's episode,
but had only one opportunity, in 1845, to try it, again upon a negro
boy. Long lived at such a distance from railroad communication (130
miles) as to have few advantages, either of practice, observation or
access to literature. Long made no public mention of his use of ether
until 1849, when he published An Account of the First Use of Sulphuric
Ether by Inhalation as an Anesthetic in Surgical Operations, stating
that he first read of Morton's experiments in an editorial in the
_Medical Examiner_ of December, 1846, and again later; on reading
which articles he determined to wait before publishing any account of
his own discovery, to see whether anyone else would present a prior
claim. No special attention was paid to Long's article, as it seemed
that he merely desired to place himself on record. There is little,
probably no reasonable doubt as to Long's priority in the use of ether
as an anesthetic, although it is very doubtful if he carried it, at
least at first, to its full extent. Nevertheless Long was an isolated
observer, working entirely by himself, having certainly no opportunity
and apparently little ambition to announce his discovery, and having
no share in the events by which the value of ether was made known to
the world. Long's strongest advocate was the late Dr. Marion Sims, who
made a strong plea for his friend, and yet was not able to successfully
establish anything more than has just been stated. As Dr. Morton's
son, Dr. W. J. Morton, of New York, says, when writing of his father's
claim: "Men used steam to propel boats before Fuller; electricity to
convey messages before Morse; vaccine virus to avert smallpox before
Jenner; and ether to annul pain before Morton."
But these men are not generally credited with their introduction by
the world at large and, he argues, neither should Long or the other
contestants be given the credit due Morton himself. In fact, Long
writes of his own work that the result of his second experiment was
such as to make him conclude that ether would only be applicable in
cases where its effects could be kept up by constant use; in other
words, that the anesthetic state was of such short duration that it was
to him most unsatisfactory. Sir James Paget has summed up the relative
claims of our four contestants in an article entitled Escape from Pain,
published in the _Nineteenth Century_ for December, 1879. He says:
"While Long waited, and Wells turned back, and Jackson was thinking,
and those to whom they had talked were neither acting nor thinking,
Morton, the practical man, went to work and worked resolutely. He gave
ether successfully in severe surgical operations; he loudly proclaimed
his deeds and he compelled mankind to hear him."
Horace Wells was born in Hartford, Vt., in 1815. In 1834 he began to
study dentistry in Boston, and after completing his studies began to
practise in Hartford, Ct. He was a man of no small ingenuity, and
devised many novelties for his work. In December, 1844, he listened to
a lecture delivered by Dr. Colton, who took for his subject nitrous
oxide gas, the amusing effects of which he demonstrated to his audience
upon a number of persons who visited the platform for that purpose.
Wells was one of these. Wells, moreover, noticed that another young
man, who bruised himself while under its influence, said afterward that
he had not hurt himself at all. Wells then stated to a bystander that
he thought that if one took enough of that kind of gas he could have a
tooth extracted and not feel it. He at once called upon a neighboring
dentist friend and made arrangements to test the anesthetic effects
of the gas upon himself the next morning. Accordingly Colton gave
him the gas, and Riggs, the friend, extracted the tooth; and Wells,
returning to consciousness, assured them both that he had not suffered
a particle of pain. He began at once to construct an apparatus for its
manufacture. Dr. Marcey, of Hartford, then informed Wells that while
a student at Amherst he and others had often inhaled nitrous oxide as
well as the vapor of ether, for amusement, and suggested to Wells to
try ether. After a few trials, however, it was found more difficult
to administer, and Wells accordingly resolved to adhere to gas alone.
This was in 1844, two years after Long's obscure experiments, of which,
of course, they were ignorant. In 1845, Wells visited Boston for the
purpose of introducing his discovery, and among others called upon his
former partner, Morton, trying to establish the use of the gas. He soon
became discouraged, however, and returned to Hartford, resuming his
practice. There he continued to use gas for about two years, but failed
to secure its introduction into general surgery, owing to prejudice and
ignorance on the part of dentists and physicians alike.
Wells's claims have been advocated by many of his fellow-citizens, and
in Bushnell Park, in Hartford, stands a monument erected by the city
and the state, dedicated to Horace Wells, "who discovered anesthesia,
November, 1844."
C. T. Jackson was born in Plymouth, Mass., in 1805. He graduated
in the Harvard Medical School in 1829, after which he went abroad,
where he remained for several years, made the acquaintance of the
most distinguished men, experimented in general science, electricity
and magnetism and even devised a telegraphic apparatus, similar to
that which Morse patented a year later. Returning, in 1835, he opened
in Boston a laboratory for instruction in analytical chemistry, the
first of its kind in the country. He also made quite a reputation
as a geologist and mineralogist and received official appointments
from Maine, Rhode Island, New Hampshire and other states. In 1845 he
discovered and opened up copper and iron mines in the Lake Superior
district. In 1846 and 1847 he was much aroused by Morton's experiments
with sulphuric ether, and claimed even that he had suggested the use
of ether to Morton, claiming also that he had himself been relieved
of an acute distress by inhalation of ether vapor, and that it was
from reflection on the phenomena presented in his own case that the
possibility of its use for relief of pain during surgical operations
suggested itself to him. This led to a triangular conflict for the
priority of discovery between Wells, Jackson and Morton, each claiming
the honor for himself. Wells health soon gave way. He went abroad and
got recognition from the French Institute and the Paris Academy of
Sciences, which did not, however, endorse his claim as discoverer nor
accept nitrous oxide as an anesthetic. Wells returned to find that
Morton was on the tide of popular favor, the public having endorsed
ether as the only reliable anesthetic. His mind became unbalanced, and
in a fit of temporary aberration he ended his own life in a prison
cell, in New York city in 1848.
Wells being out of the way, Jackson became Morton's most violent
opponent, and the two indulged in a most bitter fight and unseemly
discussion. A few years later, Jackson, who, as remarked, had an
extensive acquaintance abroad, visited Europe and presented his claim
to the credit of the discovery of ether before various individuals
and learned bodies, and so well did he work upon the French Institute
as to be recognized as the discoverer of modern anesthesia. A select
committee of the House of Representatives, to whom in 1854 Congress
referred the matter, announced the following conclusions:
"First, that Dr. Horace Wells did not make any discovery of the
anesthetic properties of the vapor of ether which he himself considered
reliable and which he thought proper to give to the world. That his
experiments were confined to nitrous oxide, but did not show it to be
an efficient and reliable anesthetic agent....
"Second, that Dr. Charles T. Jackson does not appear at any time to
have made any discovery in regard to ether which was not in print in
Great Britain some years before.
* * * * *
"Fifth, that the whole agency of Dr. Jackson in the matter appears to
consist entirely in his having made certain suggestions to aid Dr.
Morton to make the discovery."
In 1873, Jackson's mind gave way, and after seven years of confinement
in an asylum he died in 1880, at the age of 75, having been the
recipient of many honors from foreign potentates and learned societies.