A World of Pain
Anaesthesia was a word coined by the ancient Greeks, meaning "absence of sensation". The celebrated Greek physician Pedanius Dioscorides (c. 40-90AD) experimented with a wide range of early medicines, including a preparation derived from the mandragora (or mandrake) plant. This potion could dull pain sensation in a patient and Dioscorides used it with some success during his years as a physician in the Roman army. Native south American physicians used extracts of the coca plant to ease the pain of wounds. Ancient Chinese doctors employed acupuncture to help release the body's own painkilling agents.
None of the ancient methods could remove pain entirely or spare patients the trauma of being awake during a bloody operation. But knowledge of even these basic pain-control methods faded during the Middle Ages. As late as the first half of the 19th century, patients were lucky if they got a swig of alcohol before being operated on. You didn't want a surgeon who would mop your brow and comfort you. Instead, you prayed for a cold heart and a steady hand. Surgeons depended on their dexterity and speed to minimise blood loss and shock during an amputation. The best of them could have your leg off in under 30 seconds...
Breathe Deeply, Please
Throughout the early years of the 19th century, scientists were experimenting with the sedative properties of diethyl ether (commonly known as ether). On October 16, 1846, at the Massachusetts General Hospital in the U.S. state of Boston, dentist William Morton presided over the successful removal of a tumour from the jaw of an unconscious patient who had been anaesthetised after inhaling ether. The age of anaesthetics had dawned at last. For the first time, surgeons no longer had to work at speed. They could take their time and perform more delicate operations on the abdomen, the chest or even the head. Anaesthetics weren't just making patients more comfortable. They were helping to push back the boundaries of medical knowledge.
More Deep Breaths
News of Morton's ether demonstration soon spread to Britain. In January 1847, Edinburgh obstetrician James Simpson was the first to administer an ether anaesthetic in Britain. By the end of that year, Simpson had moved on to chloroform - easier to use and more effective than ether. Unfortunately, chloroform could trigger heart problems and liver damage. Surgeons and dentists were also experimenting with nitrous oxide, a relatively weak anaesthetic known as laughing gas because of the euphoric state it could induce.
The Big Sleep
Modern anaesthetists have come a long way since 1846. They use a carefully controlled mixture of substances - including nitrous oxide and sophisticated ether derivatives - to anaesthetise the patient, relax the muscles and administer pain relief. Before a general anaesthetic is administered, the patient will often have a sedative followed by an intravenous injection to put them to sleep calmly and quickly. But, even today, anaesthesia is an imprecise science. Researchers estimate that between one and three patients out of every thousand experience some level of awareness during an operation. Most do not experience pain but the experience can nevertheless be traumatising. Perhaps we are not so very far from the Victorian operating theatre, after all...