The First Dental Operation under Ether

Morton soon had an opportunity of making a practical experiment with the anæsthetic, for the same evening, about nine o’clock, a man named E. H. Frost called upon him suffering from a violent attack of toothache. “Can’t you mesmerise me?” asked the sufferer. “Upon which,” says Morton, “I told him that I had something better than mesmerism by means of which I could take out his tooth without giving him pain. He gladly consented, and saturating my handkerchief with ether, I gave it to him to inhale. He became unconscious almost immediately. It was dark, and Dr. Hayden held the lamp. My assistants were trembling with excitement, apprehending the usual prolonged scream from the patient while I extracted a firmly-rooted bicuspid tooth. I was so agitated that I came near throwing the instrument out of the window. But now came a terrible reaction. The wrenching of the tooth had failed to rouse him in the slightest degree. I seized a glass of water, and dashed it in the man’s face. The result proved most happy. He recovered in a minute, and knew nothing of what had occurred.”

First surgical operation under ether

Morton next appealed to Dr. John C. Warren, who was then Senior Surgeon at the Massachusetts General Hospital, and obtained permission to test his new anæsthetic on a patient about to undergo a surgical operation. The date fixed was Friday, October 16th, 1846, and at the appointed time a large number of medical men had assembled in the theatre. Morton administered the anæsthetic successfully, and the operation, which was for a congenital vascular tumour of the neck, in a young man named Gilbert Abbot, was completed in about five minutes without a groan from the patient. When it was finished, Dr. Warren exclaimed: “Gentlemen, this is no humbug!” The interest excited amongst those who witnessed the operation was naturally very great, and Dr. Henry J. Bigelow, who was present, said to a friend whom he met later in the day: “I have seen something to-day that will go round the world!” His prophecy proved correct.

Up to this time Morton had not disclosed the nature of the agent he employed, and nothing more was done until November 7th, when he expressed his willingness to reveal the secret. On this date two major operations were performed under ether, one by Dr. Hayward and the other by Dr. Warren.

From this time ether took its place as a general anæsthetic, and the practice of anæsthesia was firmly established.

The origin of the words “anæsthesia” and “anæsthetic”

Soon after the memorable 16th of October, a meeting was held in Boston, to choose a name for the new anæsthetic agent, and the word “letheon” was chosen by Morton himself; but, subsequently, Dr. Oliver Wendell Holmes suggested the name “anæsthesia” for the condition, and “anæsthetic” for the agent, which names have since come into general use.

Although it has never been very clearly established whether Morton or Jackson was the prime originator of the use of ether as an anæsthetic, the former was recognised by the United States Government as the discoverer, and received from it a handsome award. It seems most probable that Jackson supplied the inspiration, while Morton practically demonstrated it.

W. T. G. Morton

In reviewing the steps which led up to the discovery, it must not be forgotten that both Morton and Jackson were after all but followers of Collier, who first rendered himself unconscious with ether in the laboratory of University College, London, and forged one of the most important links in the chain of development.

Morton spent most of the remainder of his life in disputes about priority, and in efforts to secure recognition. He died bankrupt and broken-hearted on July 15th, 1868, before he had completed his forty-ninth year.

Curiously enough, Jackson, like Wells, became insane, and died in an asylum in 1880. When the friends of the rival claimants of the discovery of anæsthesia were proposing that monuments should be erected to each, Oliver Wendell Holmes characteristically suggested that all should unite in erecting a single memorial, with a central group symbolising painless surgery, a statue of Jackson on one side, a statue of Morton on the other, and the inscription underneath:—

TO E(I)THER

The news of the “ether process for removing pain,” as it was then called, spread rapidly. A private letter from Dr. J. Bigelow to Dr. Francis Boote, of Gower Street, carried the first news to England, and was communicated to the medical profession in London on December 17th, 1846. Two days later, Mr. James Robinson, a dentist, of Gower Street, performed the first dental operation under ether in England, the patient being a Miss Lonsdale, and the operation the extraction of a firm molar tooth.

On December 21st the first surgical operation under the new anæsthetic in England was performed by Robert Liston, in University College Hospital, London.

First surgical operation under ether in Great Britain

In the operating theatre, thronged with students, were the late Sir John Erichsen, the present Lord Lister, and many other famous surgeons. Mr. Barton relates an amusing incident which happened prior to the operation. Before the patient was brought in, the anæsthetist asked the students who crowded the benches in the theatre from floor to ceiling for some volunteer who would submit himself to be anæsthetised. A young man, Sheldrake, of very powerful build and a good boxer, at once offered to take the new anæsthetic, and came into the arena. “He lay on the table, and the anæsthetist proceeded to administer the ether. After the administration had proceeded for about half a minute, the subject of the experiment suddenly sprang up and felled the anæsthetist with a blow, and, sweeping aside the assistants in the arena, sprang shouting up the benches, scattering the students, who fled like sheep before a dog. He fell at the top bench, where he was seized and held down till he regained his senses. The whole scene hardly occupied a minute.”

An apparatus called “Letheon”

One of the earliest employed for the administration of Ether

New method of admini­stration

Before operating, Liston addressed a few words to those present as to the nature of the experiment about to be tried. The ether was administered by Mr. William Squire in an apparatus he had devised, which consisted of a large bell-shaped receiver containing the ether, to which was attached a long tube and mouthpiece. The patient, a middle-aged man, who was suffering from malignant disease of the skin and tissues of the calf of the leg, for which amputation of the thigh was deemed necessary, passed easily into complete insensibility, and Liston rapidly removed the thigh, the cutting operation being declared to have lasted only thirty-two seconds. In a few moments the patient completely recovered consciousness, and apparently did not know that the limb was off. When the towel was removed from the uplifted stump so that he could see it, he burst into tears and fell back on his pillow. Both surgeon and patient were much affected, and the scene in the theatre was most impressive. All appeared to see what an incalculable boon was in store for the human race, and Liston could scarcely command his voice sufficiently to speak.

A story of Liston

Some amusing stories are related of Liston, who was a very big, powerful man. His fine physique was often useful in the pre-anæsthetic days, when a patient’s nerve gave way at the last moment at the sight of the crowded theatre and the operating-table with its straps. It is said that on one occasion a patient, losing his courage at the last moment, rushed shrieking down the long corridor of the hospital, with Liston at his heels. The man locked himself in a room, but the surgeon with his shoulder broke in the door, and half-dragged half-carried the poor wretch back to the operating theatre, where the operation for stone was successfully performed.

First surgical operation under ether in Scotland

The practice of using ether was soon followed in other hospitals, and not only medical men but distinguished laymen crowded to witness its use. In Scotland, Dr. Moses Buchanan, Professor of Anatomy in Anderson’s University, was the first to have news of the event, and immediately after his lecture that day he experimented with ether inhalation. On the following day, in the operating theatre of Glasgow Royal Infirmary, a patient was placed under the anæsthetic and successfully operated on for fistula. So rapidly, indeed, did the practice spread from one centre to another, that by the end of the first quarter of 1847 the use of the new anæsthetic may be said to have become general in all operation cases.

Simpson proves value of ether in midwifery

The value of ether in midwifery practice still remained to be proved, and Sir James Simpson was the first to suggest and test its use in this department. On January 9th, 1847, he first administered ether to a patient in order to facilitate the operation of turning. The result, he reported, was most satisfactory and important, for it at once afforded evidence of the one great fact upon which the whole of the practice of anæsthesia in midwifery is founded, viz., that though the physical sufferings of the patient could be relieved by the inhalation of ether, yet the muscular contractions of the uterus were not interfered with.