[XIII]
HISTORY OF ANAESTHESIA AND THE INTRODUCTION OF ANAESTHETICS IN SURGERY[10]
IN COMMEMORATION OF THE SEMI-CENTENNIAL OF THE INTRODUCTION OF ETHER AS AN ANAESTHETIC AGENT
Fifty years ago to-day—that is to say, on the 16th of October, 1846,—there occurred an event which marks as distinct a step in human progress as almost any that could be named by the erudite historian. I refer to the first demonstration of the possibility of alleviating pain during surgical operations. Had this been the date of a terrible battle, on land or sea, with mutual destruction of thousands of human beings, the date itself would have been signalized in literature and would have been impressed upon the memory of every schoolboy, while the names of the great military murderers who commanded the opposing armies would have been emblasoned upon monuments and the pages of history. But this event was merely the conquest of pain and the alleviation of human suffering, and no one who has ever served his race by contributing to either of these results has been remembered beyond his own generation or outside the circle of his immediate influence. Such is the irony of fate. The world erects imposing monuments or builds tombs, like that of Napoleon, to the memory of those who have been the greatest destroyers of their race; and so Cæsar, Hannibal, Genghis Khan, Richard the Lion-hearted, Gustavus Vasa, Napoleon and hundreds of other great military murderers have received vastly more attention, because of their race-destroying propensities and abilities, than if they had ever fulfilled fate in any other capacity. But the men like Sir Spencer Wells, who has added his 40,000 years of life to the total of human longevity, or like Sir Joseph Lister, who has shown our profession how to conquer that arch enemy of time past, surgical sepsis, or like Morton, who first publicly demonstrated how to bring on a safe and temporary condition of insensibility to pain, are men more worthy in our eyes of lasting fame, and much greater heroes of their times, and of all time,—yet are practically unknown to the world at large, to whom they have ministered in such an unmistakable and superior way.
This much, then, by way of preface and reason for commemorating in this public way the semi-centennial of this really great event. Because the world does scant honor to these men we should be all the more mindful of their services, and all the more insistent upon their public recognition.
Of all the achievements of the Anglo-Saxon race, I hold it true that 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.