Facts about Anaesthesia’s Past

The following passage comes from The American Heritage Dictionary of the English Language, 3rd edition, printed by Houghton Mifflin Company, Boston, 1992. Oliver Wendell Holmes, a physician-poet and the father of the Supreme Court justice of the same name, wrote the following on November 21, 1846:

“Every body wants to have a hand in a great discovery. All I will do is to give you a hint or two as to names—or the name—to be applied to the state produced and the agent. The state should, I think, be called ‘Anaesthesia’ (from the Greek word anaisthesia, ‘lack of sensation’). This signifies insensibility . . . The adjective will be ‘Anaesthetic’. Thus we might say the state of Anaesthesia, or the anaesthetic state.”

This citation is taken from a letter to William Thomas Green Morton, who in October of that year had successfully demonstrated the use of ether at Massachusetts General Hospital in Boston. Although anaesthesia is recorded in Nathan Bailey’s Universal Etymological English Dictionary in 1721, it is clear that Holmes really was responsible for its entry into the language. The Oxford English Dictionary has several citations for anesthesia and anesthetic in 1847 and 1848, indicating that the words gained rapid acceptance.

You may return to the directory at the top of this page.

The mandragora, or mandrake, plant has a long tap-root that is usually bifid (has a split root) and has a rough resemblance to that of a human form. The anthropological shape evidently was responsible for the superstition that it shrieked when it was uprooted and that its scream brought about the death of those who heard it, or, if it didn’t actually kill them, it caused them to go insane.

Because of the fear of death or insanity from pulling mandragora from the ground, the root was merely loosened by the collector and he/she attached a cord to the collar of his/her dog. With the dog’s struggle to get away, the root was freed from the earth. An old document declares, “Therefore, they did tye some dogge or other living beast unto the roots thereof with a corde ... and in the mean tyme stopped there own ears for fear of the terrible shriek and cry of the mandrake. In which cry it doth not only dye itselfe but the feare thereof killeth the dogge . . . .”

Mandragora was the most popular anaesthetic during the Middle Ages and in the Elizabethan Age it was still being used as a narcotic.

Medieval physicians analyzed symptoms, examined excreta, and made their diagnoses. Then they might prescribe diet, rest, sleep, exercise, or baths; or they could administer emetics and purgatives or bleed the patient. Surgeons could treat fractures and dislocations, repair hernias, and perform amputations and a few other operations. Some of them prescribed opium, mandragora, or alcohol to deaden pain. Childbirth was left to midwives, who relied on folklore and tradition.

The mandrake has long been known for its poisonous properties. In ancient times it was used as a narcotic and an aphrodisiac, and it was also believed to have certain magical powers. Its forked root, seemingly resembling the human form, was thought to be in the power of dark earth spirits. It was believed that the mandrake could be safely uprooted only in the moonlight, after appropriate prayer and ritual, by a black dog attached to the plant by a cord.

Human hands were not to come in contact with the plant. In medieval times it was thought that as the mandrake was pulled from the ground it uttered a shriek that killed or drove mad those who did not block their ears against it. After the plant had been freed from the earth, it could be used for “beneficent” purposes, such as healing, inducing love, facilitating pregnancy, and providing soothing sleep.

Dioscorides (A.D. 40-90), a Greek physician and pharmacologist whose work was the foremost classical source of modern botanical terminology and the leading pharmacological text for sixteen centuries.

Dioscorides’ travels as a surgeon with the armies of the Roman emperor Nero provided him an opportunity to study the features, distribution, and medicinal properties of many plants and minerals. Excellent descriptions of nearly 600 plants, including cannabis, colchicum, water hemlock, and peppermint, are contained in his De materia medica. Written in five books around the year 77, this work deals with approximately 1,000 simple drugs.

The medicinal and dietetic value of animal derivatives such as milk and honey is described in the second book, and a synopsis of such chemical drugs as mercury (with directions for its preparation from cinnabar), arsenic (referred to as auripigmentum, the yellow arsenic sulfide), lead acetate, calcium hydrate, and copper oxide is found in the fifth book. He clearly refers to sleeping potions prepared from opium and mandragora as surgical anesthetics “to such (people) as shall be cut, or cauteried .... For they do not apprehend the pain because they are overborn (overcome) with dead sleep .... But used too much they make men speechless.”

Although the work may be considered little more than a drug collector’s manual by modern standards, the original Greek manuscript, which was copied in at least seven other languages, describes most drugs used in medical practice until modern times and served as the primary text of pharmacology until the end of the 15th century.

You may return to the directory at the top of this page.

A Synopsis of Conquering Pain with Anaesthetics

• A doctor’s first duty is often to find relief for a patient’s pain and this is usually done with a sedative drug.
• Early records indicate that two of the first pain-relieving remedies to be used were mandragora (now known as mandrake) and Indian hemp (hashish).
• The Egyptians believed that mandragora was the special gift to medicine from the god Ra, their Sun-God.
• The Roman herbalist and physician Dioscorides gave instructions for its use, “Boil the roots in wine to a third part, and preserve the juice thus procured and give one cyathus of it to cause the insensibility of those who are to be cut or cauterized.”
• The mandragora or mandrake plant has a long tap-root split into two parts so that it roughly resembles a human figure.
• Mandrake was the most popular anesthetic during the Middle Ages and in the Elizabethan Age it was still being used as a narcotic, as indicated by the following lines from Shakespeare:

• Mandrake (Mandragora officinarum) is a plant related to the potato family.
• Hashish is also from the distant past as shown when Herodotus wrote that it was not only eaten but that it was sometimes inhaled, and if this statement is correct, hashish inhalation must be looked upon as being the first of all the inhalation anesthetics.
• Opium is also a very ancient narcotic drug and it was introduced into medicine by the Chinese.
• Dioscorides referred to the taking of an alcoholic extract of mandragora before an operation and this suggests that it was normal for Greek surgeons of ancient Rome to decrease the pain of an operation by giving their patients sedative drugs.
• Apuleius, in about A.D. 200, wrote, “If anyone is to have a member mutilated, burned or sawed let him drink half an ounce with wine, and let him sleep till the member is cut away without any pain or sensation.” (K. Walker, The Story of Medicine)
• For some reason, the practice of drugging people before operating on them was discontinued during the Middle Ages.
• That special branch of medicine now known as anaesthetics may be said to date from the day on which Sir Humphry Davy, the inventor of the miner’s lamp, discovered the anaesthetic properties of “laughing gas” or nitrous oxide.
• Davy discovered that a compound of nitrogen and oxygen (nitrous oxide) caused unusual results.
• At first, when Davy inhaled the gas, it produced a soaring euphoria, which soon passed into uncontrollable outbursts of laughter and sobbing, until it made him unconscious by the substance he unhesitantly called “laughing gas”.
• A passage written on November 21, 1846, by Oliver Wendell Holmes, a physician-poet and the father of the Supreme Court justice of the same name, provides us with evidence of when the words anaesthesia (anesthesia) and anaesthetic (anesthetic) became a part of the English language.
• The use of anesthetics to relieve pain during surgery was pioneered by U.S. dentists.
• According to the Reader’s Digest Book of Facts, Horace Wells (1815-48), a Connecticut dentist, was the first man to successfully use nitrous oxide (“laughing gas”) as an anesthetic when in 1844 he performed tooth extractions using the gas.
• Another version, in Kenneth Walker’s The Story of Medicine, “The first man to employ nitrous oxide for anaesthetic purposes was Dr. Riggs.”
• Based on his personal experiences (having one of his own teeth pulled by Dr. Riggs) with nitrous oxide as an anaesthesia, Dr. Horace Wells gave several demonstrations to his colleagues and in a comparatively short time the great value of the gas was established.
• The problem with nitrous oxide is that its effect didn’t last very long and so it was not suitable for long medical operations.
• Dr. William Morton, a Boston dentist and former partner of Dr. Horace Wells was one of the first to use ether as an anesthesia.
• In 1846, just two years after Horace Wells’ anesthetic success with nitrous oxide, Dr. William Morton (1819-68), constructed the first anesthetic machine.
• Morton’s simple device was a glass globe housing an ether-soaked sponge so all the patient had to do was merely to inhale the vapor through one of two outlets.
• Morton’s invention was put to the test on October 16, 1846, in the surgical amphitheater of the Massachusetts General Hospital in Boston when a twenty-year-old man was successfully anesthetized so a tumor could be painlessly removed from what one source said was his neck and another indicated was from his jaw.
• The history of the two anaesthetics, nitrous oxide and ether, was the same in that the anaesthetic properties of the two had originally been discovered in England but no further use was made of them.
• Americans were the ones who found practical uses for the gasses as anesthetics.
• Dr. James Simpson (1811-70), “a well-known Edinburgh (Scotland) gynaecologist”, was first to use ether in his obstetric practice.
• Simpson considered ether to be too unstable for his gynaecological work so he looked for other anaesthetic properties.
• After much experimentation, Simpson decided to use chloroform as a better anesthesia than either nitrous oxide or ether.
• Many in Scotland protested that the use of chloroform in child-labor was contrary to biblical teaching, for didn’t God say to Eve, “in sorrow thou shalt bring forth children”?
• Dr. James Simpson was the first man to use chloroform to relieve the pain of childbirth because he was dissatisfied with ether, not only because it irritated the eyes, and was highly inflammable, but also because there was no assurance that its use was safe.
• Simpson first administered chloroform in 1847 by simply sprinkling it on a handkerchief and placing it over the patient’s mouth and nose so that she could inhale the vapors.
• One mother was so delighted by the painless delivery that she named her child Anaesthesia.
• In 1853, Queen Victoria was given chloroform during the birth of her eighth child, Prince Leopold.
• The announcement of this in the press was received with amazement, grief, and criticism.
• Yet the “good Queen” participated in this form of anaesthesia and what the good Queen did was generally accepted.
• After Queen Victoria allowed the use of chloroform during her next birth, it became known in Great Britain as “anaesthesia a la Reine”.
• The use of chloroform in childbirth became fashionable and what was fashionable soon became moral and acceptable.
• Chloroform is more potent and more toxic than ether. Its use as an anaesthetic decreased with increased experience and knowledge of its dangers.
• Cocaine is another example of a tool for medical usage which came from a primitive and ancient source.
• It was the Incas of Peru who regarded the coca-plant with great religious devotion and made offerings of its leaves to their Sun God.
• The story of anaesthesia is closely linked with medical progress in the “New World”, particularly in the United States (according to British writer, Kenneth Walker in his The Story of Medicine).
• We also owe to the Incas of Peru a preparation which is now being used on a big scale in conjunction with anaesthetics, the drug called curare.
• Curare has the special property of paralyzing the nerve endings in the muscles and when the anaesthetist found it impossible to obtain good muscular relaxation by his anaesthetic alone, he gave the patient an injection of this drug.
• Curare was used long ago by the old hunters of Peru who dipped their arrow heads in the poison because they found that by using it they didn’t lose as many arrows when the wounded prey tried to escape.
• The poison, curare, was absorbed from the wound into the animal’s blood stream and it quickly brought about the paralysis of its muscles.
• The use of an anaesthetic has now become so complicated that it is recognized as a speciality in medicine.
• Awareness of dosage is essential to the safe use of anaesthetics.
• The advancements in surgery could never have been made if parallel advances weren’t made in the speciality of anaesthesia.

You may return to the directory at the top of this page.