Narcosis

Perhaps, no other discovery has influenced development of surgery as beneficially as the discovery of narcosis has. History of general anaesthesia is one of the most dramatic pages of medicine. It’ll be enough to say that in the Middle Ages a heavy wooden hammer was used instead of narcosis. Ether and nitrous oxide revolutionized surgery.

A German physician and scientist Paracelsus (1493–1541) described narcotic action of sulphuric ether as long ago as 1540. However, it was still far to the era of anaesthesia.

In 1799, an English chemist Humphry Davy (1778–1829) discovered an anaesthetic effect of nitrous oxide. After testing the gas on himself, he noted that inhalation provokes pleasant feelings and merry mood. The scientist called it “laughing gas” and suggested to use it in surgery. In 1818, another English scientist — a physicist Michael Faraday (1791–1867) — tested the soporific action of ether vapour on himself and published an article on this subject. Nevertheless, the papers of the chemist and physicist remained unnoticed.

The age of practical anaesthesia began in the middle of XIX century. In 1844, an American dentist Horace Wells (1815—1848) began to experiment with nitrous oxide for painless tooth extraction. After breathing in of “laughing gas”, he asked his colleague to pull his tooth out. Everything was done absolutely without pain before witnesses on December 11^th the same year. After this, in 1845, Wells gave a demonstration to medical students at the Massachusetts General Hospital. However, the gas was improperly administered and the patient cried out in pain. Because of this embarrassment, Wells was discredited in the medical community.

Despite this, the demonstration didn’t pass unnoticed: a physician and chemist Charles Jackson (1805–1880) has believed in the idea and shared it with his student William Morton (1819–1868). That was the beginning of their collaboration and … animosity of many years. Persistent and ambitious Morton started to experiment on ether secretly. He developed the inhaler (a bottle with a flexible tube), experimented on himself and on September 30^th, 1846 removed a tooth of a patient Eben Frost, who didn’t feel pain.

News of the dentist’s success reached a famous American surgeon, dean of Harvard Medical School professor John Warren (1778–1856). He offered Morton to assist him during an operation to prove effectiveness of ether narcosis. On October 16^th, 1846, at 10:15 a.m. the first operation with participation of an anaesthesiologist in the world was publicly performed. Morton etherized a 25-year old printer Gilbert Abbot with his apparatus, and Warren painlessly removed a tumour on his neck. After the operation finished he stated to his audience "Gentlemen, this is no Humbug". That October day is considered a birthday of anaesthesiology. By the way, the term “anaesthesia” (insensitivity to pain) was suggested by a surgeon Oliver Holmes, Warren’s successor.

Anaesthesia made lives easier for the humanity, but not for those who had invented it. The “ether anaesthetic litigation”, which has taken the rest of life of each claimant to priority of discovery, numerous trials has brought to them nothing but misery, waste of money and an early death. Wells committed suicide at the age of 33, Morton died in poverty when he was 48, and Jackson ended up in mental asylum, where he deceased at 75 years.

A year after the discovery of ether narcosis — November 4^th, 1847 — a Scotch obstetrician-gynaecologist James Simpson after experimenting on himself revealed narcotizing effect of chloroform.

In Russia, the first operation under ether narcosis was performed on February 7^th, 1847 by Feodor Inozemtsev (1802–1869). On February 16^th and 18^th, in St. Petersburg, a prominent surgeon Nikolay Pirogov (1810–1881) performed two difficult operations under such narcosis. In September 1847, during the siege of aul Salta in Dagestan Pirogov performed almost 100 interventions in the field. In Russia, he is considered a founder of general anaesthesia. It was the first time in history of wars when a surgeon didn’t hear moans of wounded.

Nowadays modern drugs and devices are used for general narcosis. Nevertheless, a general principle of immersion into a “chemical dream” is the same, deep down. Attempts to create a conceptually new narcosis haven’t succeeded yet.