The story of anaesthesia credit to *Dr HS Adenwalla*

When one goes through the history of the birth of anaesthesia one wonders why anaesthesia did not come to us as early as the year 1800- a good 50 years before it actually did!

In 1800 the celebrated English chemist, Sir Humphrey Davy had relieved the pain of an infected tooth by inhaling Nitrous Oxide. He even published a paper suggesting that this substance might be used to advantage during surgical procedures. No one took notice of this paper and Davy himself failed to follow up his observation.

In 1823 a young English physician named Henry Hill Hickman gave his patients Carbon dioxide which rendered them unconscious and came dangerously close to poisoning them. Carbon dioxide was of course unsuitable as an anaesthetic agent, but what prevented Hickman from trying other gases? It certainly would have been the logical thing to do.

Today we also know that in 1842 Dr. Crawford W. Long, a country doctor in Jefferson Georgia administered Ether to operate painlessly on several patients. It never occurred to this man that he had made an earth shattering discovery. He just went along with his quiet country practice. In 1844 Dr. E.R Smilie in Derby New Hampshire was treating a tubercular pastor for severe fits of coughing. Since Opium gave no relief, he tried a mixture of opium and ether. To his surprise not only did the coughing stop but the patient fell unconscious from his chair. Encouraged by this Smilie opened an abscess under the same mixture. The operation was painless. Smilie had every intention of a continuing with his experiment and publishing his findings. His friends however, dissuaded him from doing so. They told him that opium had been used for centuries; that there was nothing new that he was doing. They told him that he was just lucky for opium in those large doses could kill. No one including Smilie, no one gave thought to the fact that it was either that was doing the trick and not the opium. So Smilie too was on the verge of a great discovery but like the others he, so to say proverbially “missed the bus”.

In January 1845 John Collins Warren was lecturing in his operating theatre at the Massachusetts General Hospital Boston. At 11’O clock this master surgeon had finished speaking on trephinning of the skull as a treatment for head injuries. To the surprise of the audience he did not leave the theatre. In a vague, sarcastic tone he announced “there is a gentleman here a Mr. Horace Wells, a dentist from Hartford who claims that he has something which can make surgery pain free.” There was no case ready for the trial as the patient whose leg was to be amputated had refused the operation. Warren announced, “Gentlemen”, he said, “If there is anyone in the audience needed a tooth extracted and willing to give Mr. Well’s a try, he may step forward”. A volunteer stepped down and sat on Warren’s chair. Warren had meanwhile settled down in another chair like a skeptical aristocratic spectator in a theatre. Wells a timid and artless man came forward and announced that he had discovered that Nitrous oxide or laughing gas could make a man insensible to pain. He told the audience that he intended to demonstrate that he could remove this patient’s diseased tooth without pain. Wells, you must note, was quite open about what he was administering. He made the subject inhale nitrous oxide and when his jaw fell open he went with his forceps for the diseased tooth and pulled it out. The patient gave an agonising cry of pain and the audience started laughing and shouting. Humbug! Humbug! they shouted. Wells made an unceremonious and hasty exit from the theatre and Warren raised an imperious hand to quell the laughter and Cat Calls that prevaded the theatre.

No one knew that day that they had perhaps witnessed the debut of a new era in medicine. That this man Wells was the discoverer of anaesthesia. Neither did anyone know that his failure was because the patient was obese and an alcoholic, a poor subject for induction under nitrous oxide. Now where did Wells get the idea of using nitrous oxide? The forerunner of this failed experiment was a laughing gas show run by a man called Gardener Quincy Colton on the 10th of December 1844. All tickets were sold out. Wells was in the audience and noticed that a Samuel Cooley who was capering under nitrous oxide had hurt his shin badly, he had a deep cut which was bleeding but he felt no pain. In a fateful second Horace Wells had an insight. Hundreds before him had witnessed this at laughing gas parties and had not realised it, because they were not of the right background. Wells had fantasised that one day he would extract teeth without causing pain. He now had eyes only for Cooley. He left his wife and went and sat near Cooley and waited for him to come out of his semi stupors condition. He then asked him if he had any pain on his shin. Cooley said, “I did not realise it but now that you ask yes I do have pain”. He pulled up his pant to show a deep gash on his shin. Wells then made the profound statement, “I believe that a man can have a tooth pulled out or a leg amputated under the influence of this gas and not feel it”.

Wells a simple, honest man had no intention of hiding his discovery, he went up to Colton and quite plainly told him what he thought of nitrous oxide and asked him to come to his office the following morning with a supply of nitrous oxide or laughing gas. They met on the 11th of December 1844 at 10’O clock in Well’s office. Wells was to be the subject of the experiment, Riggs, Well’s assistant was to extract the tooth. Colton and Colton’s brother were to administer the gas. The tooth came out without the slightest pain and Wells said “Gentlemen I felt no more than a prick of a pin”. When the others stared at him in disbelief he said, “This is the most wonderful discovery of our time”. The simple Wells now was obsessed with just one idea, and that was to make the world aware of his monumental discovery. If he could demonstrate this to John Collin Warren at the Massachusetts General Hospital, the world will know. Now you will see how fate conspired to get these three men together in this drama. His closest acquaintance in Boston was his former pupil Morton, a dentist who was now studying medicine. He presumed that Morton could get him into Warren’s theatre to demonstrate the effects of nitrous oxide. Morton suggested they go to Prof. Jackson who had studied at Harvard and at the Sorbonne. Jackson was a man of extraordinary learning and arrogance. He listened to Wells and Morton and ridiculed their claim about the effects of nitrous oxide. Somehow Wells got into Warren’s theatre, perhaps through Jackson’s influence, but as we have said before failed to demonstrate what he claimed for nitrous oxide. It is documented that Morton was present and witnessed Wells failure.

Now comes act two of this diabolical drama of deceit and intrigue. The scene is Warren’s theatre at the Massachusetts General Hospital, Boston the date the 16th of October 1846, exactly 21 months after Wells had been laughed out of Warren’s theatre. This time the amphi-theatre was full to capacity. Word had gone around that it was not Wells but another dentist, called Morton who was going to demonstrate a substance that would enable Warren to operate without causing pain. The stage was set; the patient was Gilbert Abbott, who had a tumor of the maxillary gland. “Gentlemen”, announced Warren “I propose to excise this tumor but for the second time we are told that we will be able to operated without causing pain.” Warren pocket watch in hand kept looking at the door- Morton had not come. At last Warren spoke in a mocking voice “Gentlemen as Dr. Morton has not arrived I presume he is otherwise engaged”. But at that very moment Morton appeared, he apologised, explaining that he was late because his instrument was not ready. He then made Abbott breath through a tube. The audience was just waiting to break into jeers. Then Morton said to Warren the historical sentence that all anaesthetist say to their surgeons; “Sir, your patient is ready”. Warren bent over his patient and made three lightening incisions as was his custom, he went deeper and deeper, and then Warren did something he had never done before in the middle of an operation. He stopped and looked at the patient’s face. There was not a trace of pain. The tumor was out, ligatures were applied and the bandages tied. Warren looked up at the audience and said “Gentlemen, this is no humbug”. The terse aloof unemotional surgeon, the great Warren had tears running down his cheek. No one then knew that Morton had used Sulphuric ether and not nitrous oxide. Unlike Wells he had no intention of revealing his secret which he had every intention of commercialising. Much later when Morton was forced to reveal that it was ether, the news spread to England. The surgeon who was to do the first operation under ether in England was Robert Liston. His anaesthetist was Squire the patient a Fredrick Churchill. The operation was an above knee amputation. Liston always the show man picked up his amputation knife “Time me gentleman” he said. The knife flashed one could hardly see his movements. Ransome the assistant tossed the limb in the saw dust. “Twenty Eight seconds sir”, Squire whispered. Liston looked at the patient in wonder and said in a voice unsteadily with emotion “This Yankee dodge gentleman beats mesmerism hollow”. The use of ether spread to the continent like wild fire. Dr. James Young Simpson gave it for painless delivery in Edinburg and created quite a stir among the clergy who believed that it was against God’s dictates to indulge in the sin of painless labour. Simpson paid no head to the criticism leveled against him. He said ether was good but was too irritant to the lungs and caused spasms of coughing he began to inhale other gasses in search of something better. On the night of November the 4th 1847 Simpson discovered the analgesic properties of a substance called chloroform Simpson realised that chloroform prepared from chloride of lime and alcohol was pleasant to smell and much quicker than ether in action, and above all it caused no coughing. The induction was smooth. Simpson’s researches revealed that a German chemist Justus Von Leibig and a Frenchman named Souberian had first produced chloroform simultaneously in the year 1831. Three years later Jean Baptista Dumar, made the first chemical analysis of this new volatile fluid and gave it the name chloroform.

However, it is of interest that a man called Samuel Guthrie an American of Scottish decent came very close to the discovery of chloroform. He was a chemist living at Sackets Harbour. His small daughter Harriet came upon a container of chloroform in his laboratory, enjoying the smell and the sweetish taste she both licked and inhaled the substance. Guthrie found her unconscious on the floor. He wrote a paper to say that chloroform could put children to sleep. He made no attempt to study the phenomena further. Shortly before his death in 1848 he read of Simpson’s discovery and fame on the other side of the Atlantic in Edinburgh. His thoughts are not recorded.

We must now digress to tell you the story of Queen Victoria’s confinement under chloroform, for that is what gave chloroform center stage for quite some time until its dangers of cardio-toxicity were detected. John Snow who already had a reputation for administering chloroform was summoned to the palace by the Prince Consort early in April 1853. The Prince had read Snow’s papers on the subject. Snow was also recommended to the Prince by a German Doctor friend by the nane of Baron Stockmar. The Prince asked Snow to stand in readiness for the Queen’s confinement. Charles Lock supported the decision, while the Queen’s personal physicians James Clerk was against giving the Queen chloroform. He was overruled. On the morning of April 7th 1853 in the presence of these three physicians John Snow administered chloroform to the Queen. After 35 minutes Prince Leopard was born. The labour was painless. Overnight John Snow became a famous man. No one then knew that Prince Leopard was born a haemophilic. If it was known then chloroform would have been blamed. Simpson’s critics would have construed it as a sign of Divine retribution for this intrusion into God’s natural process of birth, a sinful thing to do.

Dr. James Young Simpson was the only happy and successful man among the discoverers of anaesthesia. But success brought out the worst in this vain man. In all his success he forgot to acknowledge the man who first suggested chloroform to him, the Liverpool chemist David Waldic. Nor did he once disclaim the honor when the public hailed him as the discoverer of not only chloroform but of anaesthesia in general. Simpson died on the 8th of May 1870 of a coronary episode. The barefoot bakers boy had become Scotland’s most famous citizen. He was raised to a baronetcy and appointed physician to the Queen.

We are now left to tell you the story of the other three, Wells, Morton and Jackson who with Simpson claimed to have discovered anaesthesia. It is a story of greed treachery, dishonesty and deceit. Perhaps one of the most sordid stories in the annals of scientific history. Of the three well’s was perhaps the only man who showed some semblance of human decency.

In spite of his failed experiment in Warren’s theatre at the Massachusetts general Hospital, Horace Wells may be considered as the first to have discovered the concept of anaesthesia. Unlike Jackson he had every desire to reveal to the world the nature of the substance that he was using, money was never a question with Wells, but it is natural that he craved for the fame of being the first to discover anaesthesia. In this endeavor he migrated to New York, took rooms at 140 Champers street and set up a laboratory there. Having left his wife and child behind he started experimenting with various gases and in the process he became an addict. He fell in with a young man of dubious character who borrowed some acid from him to throw on his lover from whom he had for some reason became estranged. Wells saw him do this, it must have left a strange impression on his deranged mind. A couple of days later coming out of a drunken stupor he did the same thing threw acid on another woman in the street without any reason. It was obvious that he was going out of his mind. Wells was arrested, tried and imprisoned. On the morning of January the 23rd 1848 the Jail attender who opened the door found Wells sitting on his bed, back to the wall, a flask of chloroform at his side, a handkerchief soaked in chloroform tied round his nose and with a razor in hand he had cut his left femoral artery. Wells was found dead with a pathetic note of remorse and frustration left at his bedside. The note was addressed to his wife and child whom he loved dearly. Wells had become an addict, he was not insane, but he was not in control of his actions, he had even lost his memory. That was the tragic end of Horace Wells.

Now how did Morton stumble upon ether?

It is recorded that William Green Morton was in the audience at the Massachusetts General hospital when his teacher Horace Wells failed in his demonstration. Morton was a clever scientist, dishonest and greedy for money. He had a sneaking feeling that Wells had something up his sleeve. He thought it might be worth his while to pursue Wells research. So Morton went to a man called Jackson whom they had both met before, seeking his help to demonstrate in Warren’s theatre. Jackson had then ridiculed Wells’s idea. Jackson was not in his laboratory. Morton borrowed from his assistant a rubber blades such as Wells had used to administer nitrous oxide. As he was leaving he met Jackson by chance. “What are you doing with that?” asked Jackson,”I am going to administer nitrous oxide to a patient and then hypnotize him to pull out his tooth”. Jackson laughed at him and said, “Don’t be a fool, you saw what happened to Wells”. “But, he said if you really want a show why don’t you try sulphuric ether”. “Sulphuric ether?” Morton asked “what is that?””you ignoramus” said Jackson, “it is a liquid which vaporises when it comes in contact with air, but I don’t think it is going to put your patient to sleep. Since you don’t have nitrous oxide you might as well get some ether”. Morton then asked Jackson, “Is it safe?” “Yes”, said Jackson and asked him to buy it from Burnett’s pharmacy for they were the only ones who made rectified sulphuric ether. Jackson himself had no idea what ether could do, nor did Morton.

Morton took him seriously and purchased a consignment of ether. A couple of days later a man called Eben H Frost came to Morton’s clinic. His face was badly swollen he asked Hayden and Tenney Morton’s assistants if his tooth could be pulled out without pain. Morton was informed. He decided to do it himself under ether. Frost’s tooth came out without any pain. Morton realised that he had stumbled on to something great, better and faster than nitrous oxide. In the twinkling of an eye Morton realised that he was in for big money if he commercialised the product. He made Frost write a statement about his experience and had the document countersigned by his two assistants. Next day it made headlines, in the Boston Daily journal and he obtained a patent for his new discovery. Morton unlike Wells never thought of the benefits to mankind, he only thought of this fame and the money he would make. Now ether was known to chemists since 1450, was used as a solvent and as a palliative for asthma. So Morton began to mix perfumes in it to change its odor so that no one could identify the substance he was using.

Morton then through Dr. Bigelow, Warren’s first assistant wangled another demonstration in Warren’s theatre with Warren himself presiding. As mentioned earlier the experiment was a great success. Morton however, refused to disclose the nature of the preparation he was using. The doctors in Boston including Warren thought that Morton’s behavior was most unethical. Then started that fatal relationship between Morton, Jackson and Wells which ultimately destroyed all three of them. Morton with all possible dispatch started the commercial exploitation of ether, he not only started amassing large sums of money but also claimed that he was the sole discoverer of the art of painless surgery. Morton was of course well aware that it was Jackson’s suggestion that made him try ether, he did not even know that such a substance existed. He also knew that his teacher the benign and honest Wells was the originator of the idea of inhalation of gases to produce a state in which one could operated without pain. Morton also then knew that someday Wells would speak up so would Jackson who was more dangerous than Wells. Morton then tried to buy Wells off by offering him a share of his earnings from ether. Wells refused. He then tried to buy Well’s assistant Riggs to give false evidence against Wells, and after Wells death he offered 50,000 dollars to Wells’s wife if she made no claims for Wells. She refused so did Wells faithful assistant. Before he died Wells made an attempt to stake his claim through the scientific society of France which proclaimed that he was the first to discover a method of painless surgery. But by that time the deranged Wells had committed suicide. Now that Wells was out of the way, there resumed a battle between Morton and Jackson. Each man stooped to the lowest level of degradation by blatantly lying, bribing and cheating. Jackson more for fame, Morton more for money.

Jackson who never believed that ether nitrous oxide or ether could anaesthetise and who had half in jest suggested that Morton try ether, now wrote a paper that it was he who had discovered ether and used it successfully, and that he had sent Morton as his emissary to demonstrate to Warren at the Massachusetts General Hospital. It was a cleverly written paper full of lies. He gave convincing facts and figures of experiments he had never performed and he sent this paper off to a friend one of the foremost French scientist in Paris. This man’s name was Elie de Beaumont. The French academy of science accepted this paper and France declared that Jackson was the man who had discovered anaesthesia. Jackson then perfectly timed an appearance before the American Academy of Science and made a similar presentation. This turned the tables against Morton in America too. Wells to whom belonged the credit and the crown was completely forgotten.

For 15 years this so called “ether war” raged, which divided country. Some were for Jackson others for Morton. Both these men went all out; employed lawyers and writers and politicians to fight for them. Ultimately the cause went to the Congress of the United Stated. Congress sided with Morton and decided to recognize him as the discoverer of anaesthesia and award him a congressional prize of a hundred thousand dollars. Matters were dropped for a time. Again in 1863 Congress again voted in favor of Morton and this time decided to grant him 200,000 dollars as a prize for the discovery of anaesthesia. But on both occasions a brilliant and brave senator by the name of Truman Smith introduced Wells’ forgotten account and undeniable dame. The senator insisted that no decision be taken by Congress in favor of Morton or Jackson until Wells’ claim be properly investigated. The congress then in sheer desperation threw the case back to the law courts. Morton now impoverished was a dejected and defeated man and began to show severe symptoms of paranoia. He was found driving his carriage helter skelter like a mad man through central park. One day he was found unconscious in the park and was admitted to St. Luke’s hospital where he died the next day at the age of 48 years.

The cleverer Jackson outlived Morton for many years. He became a strange and angry man, showed grandiose symptoms of megalomania. It was obvious that he too was slowly becoming insane. In 1873 he was certified and committed to the Mc Lean mental asylum in Somerville, a suburb of Boston. For 7 years he survived there a raving lunatic claiming for himself all the great discoveries of the world. A husk of the brilliant scientist that he had once been. On August 28th 1830 he died the last of the three unfortunates who had conferred on the world one of its greatest blessings. Till this day the debate goes on as to who should be given the credit for this great discovery.

At the time of Jackson’s death, anaesthesia, as Oliver Wendell Holmes called it, had already become the common property of the entire world and the great age of surgery was on the march. Men like Semmelweis, Pasteur, Lister and Fleming pushed it to greater and greater heights of endeavor. All three body cavities were now laid open by the surgeon with impurity while just a few years ago surgeons feared to open the abdomen. Anaesthsia, Asepsis and Antibiotics have become the clarion call of the new age of surgery the wonders of which man is heil to today. We need to remember and honor these benefactors of mankind who suffered so that we may have a better chance in life.

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