Other Monuments to Inhalation Anesthesia

Journal of Oral and Maxillofacial Surgery, 2011

In this report, we explore the little known role of Dr Nathan Cooley Keep in the dissemination of ether anesthesia in Boston. Keep was a prominent Boston dentist who, for a short time, taught and employed both William Morton and Horace Wells. He used ether anesthesia for a variety of dental and other surgical procedures requiring pain control. Keep administered ether to anesthetize Henry Wadsworth Longfellow's wife during the delivery of their daughter. This was the first use of ether for obstetric anesthesia. Dr Keep was also the first Dean of the Harvard Dental School and convinced the Massachusetts General Hospital to appoint a dentist to the staff of the hospital for the first time.

The anesthesiology profession may one day serve as a cautionary tale of how power, politics and privilege can perturb science and progress. Previous anesthesia practitioners possessed a superior understanding of physiology and pharmacology, but overenthusiastic CO2 supplementation with inadequate monitors and machines caused asphyxiation disasters that were improperly attributed to CO2 toxicity. Dr. Ralph Waters founded the anesthesiology profession on the basis of a practical new anesthetic tech- nique that introduced elective intubation and hyperventilation to eliminate CO2 toxicity, but mechanical hyperventilation dangerously depletes CO2 tissue reserves and exag- gerates morbidity and mortality. The bene ts of CO2 supplementation were forgotten, and consequent CO2 confusion has derailed research, discouraged opioid treatment, damaged patient safety, and disrupted professional progress. Anesthesiologists can no longer claim to provide superior service, and hospital administrators are replacing them with nurses. Professional membership is in decline, and professional survival is in ques- tion. Modern machines have eliminated asphyxiation, and modern monitoring enables safe and bene cial hypercarbia that complements opioid treatment and minimizes sur- gical morbidity and mortality. CO2 reform promises revolutionary advance but faces formidable opposition.

Anesthesiology, 2010

Current Opinion in Anaesthesiology, 2012

Purpose of review Anesthesia for ambulatory surgery has come a long way since 1842 when James Venable underwent surgery for removal of a neck mass with Crawford W. Long administering ether and also being the surgeon. We examine major advances over the past century and a half. Recent findings The development of anesthesia as a medical specialty is perhaps the single most important improvement that has enabled advances in the surgical specialties. Moreover, improved equipment, monitoring, training, evaluation of patients, discovery of better anesthetic agents, pain control, and the evolution of perioperative care are the main reasons why ambulatory anesthesia remains so safe in modern times. The development of less invasive surgical techniques, economic factors, and patient preferences provided addition impetus to the popularity of ambulatory surgery. Summary Beyond the discovery in the mid-19th century that ether and nitrous oxide could be used to render patients unconscious during surgical procedures, subsequent developments in our specialty have added modestly, in a stepwise manner, to reduce mortality and morbidity associated with its use. These improvements have allowed us to safely meet the steadily increasing demand for ambulatory surgery.

Mending Bodies, Saving Souls: A History of Hospitals, 1999

This chapter depicts the “discovery” of ether anesthesia at the Massachusetts General Hospital within the context of Boston medicine, surgery and dentistry, discussing the local struggles for professional and cultural identity within an environment of sectarianism and professional secrecy. For this purpose, the narrative uses the story of Alice Mohan who actually became the first patient submitting to full ether inhalation for the amputation of her right leg. Mohan’s successful major surgery, performed on November 7, 1846, followed a prior, famous but brief attempt to remove Gilbert Abbott’s congenital neck tumor that forever put Boston and America on the list of pioneering surgical achievements. More than Abbott’s case, Mohan’s long pre-operative hospitalization and botched treatments provide a rare view into the state of contemporary medical therapeutics and the evolution of the Massachusetts General Hospital.

Best Practice & Research Clinical Anaesthesiology, 2005

Inhalational agents have played a pivotal role in anesthesia history. The first publicly demonstrated anesthetic of the modern era, diethyl ether, was an inhalational anesthetic. The attributes of a good agent, ability to rapidly induce anesthesia, with limited side effects has lead research efforts for over a hundred and fifty years. The explosion hazard was largely conquered with the development of the halogenated agents in the 1950s. Rapid emergence, with limited nausea and vomiting continue to drive discovery efforts, yet the 'modern' agents continue to improve upon those in the past. The future holds promise, but perhaps the most interesting contrast over time is the ability to rapidly introduce new agents into practice. From James Young Simpson's dinner table one evening to the operating suite the next day, modern agents take decades from first synthesis to clinical introduction.

2020

According to the definition of the International Association for the Study of Pain (IASP), pain is defined as: "Unpleasant subjective feeling and emotional experience associated with current or potential tissue damage of a particular localisation", which, as such, poses a challenge for epidemiological research to determine its frequency and prevalence. We have all heard the motto that surgery has experienced its unprecedented development on the wings of anaesthesia. This is most certainly the case, since it is precisely the pain that prevents any invasive procedure on the human body, hence the very elimination of pain has opened up the way for the application and development of surgery. For this reason, the skill and now the science of anaesthesia are epochal civilizational achievements, which is why it is worth remembering the attempts and successes of its application. The very beginning of mankind cannot be imagined without the humans facing some sort of pain. As long ag...

Journal of Anesthesia History, 2019

For millennia, mankind has sought a means of altering consciousness, often aided by naturally occurring elements. Psychotropic substances have been an integral part of spiritual, medicinal, and recreational aspects of life. The origin of anesthesiology stems directly from the use of recreational drugs; early inhaled anesthetics were first used as a means of entertainment. Hence, it is no surprise that many medications in the anesthesiologist's armamentarium are diverted for recreational use. In the 172 years following the first successful public demonstration of ether anesthesia, many drugs with abuse potential have been introduced to the practice of anesthesia. Although anesthesiologists are aware of the abuse potential of these drugs, how these drugs are obtained and used for recreational purposes is worthy of discussion. There are articles describing the historical and recreational use of specific drug classes. However, to the best of our knowledge, this is the first comprehensive review focusing on the breadth of drugs used by anesthesiologists.

Journal of Anesthesia History, 2015

News of the successful use of ether anesthesia on October 16, 1846, spread rapidly through the world. Considered one of the greatest medical discoveries, this triumph over man's cardinal symptom, the symptom most likely to persuade patients to seek medical attention, was praised by physicians and patients alike. Incredibly, this option was not accepted by all, and opposition to the use of anesthesia persisted among some sections of society decades after its introduction. We examine the social and medical factors underlying this resistance. At least seven major objections to the newly introduced anesthetic agents were raised by physicians and patients. Complications of anesthesia, including death, were reported in the press, and many avoided anesthesia to minimize the considerable risk associated with surgery. Modesty prevented female patients from seeking unconsciousness during surgery, where many men would be present. Biblical passages stating that women would bear children in pain were used to discourage them from seeking analgesia during labor. Some medical practitioners believed that pain was beneficial to satisfactory progression of labor and recovery from surgery. Others felt that patient advocacy and participation in decision making during surgery would be lost under the influence of anesthesia. Early recreational use of nitrous oxide and ether, commercialization with patenting of Letheon, and the fighting for credit for the discovery of anesthesia suggested unprofessional behavior and smacked of quackery. Lastly, in certain geographical areas, notably Philadelphia, physicians resisted this Boston-based medical advance, citing unprofessional behavior and profit seeking. Although it appears inconceivable that such a major medical advance would face opposition, a historical examination reveals several logical grounds for the initial societal and medical skepticism.

Anesthesiology, 2014

W E are delighted that AnEsthEsiology is publishing this special Edition, highlighting research at the harvard-affiliated departments. harvard Medical school (hMs) is unusual, perhaps unique, in that it has approximately 10,000 faculty appointees, including many physicians with additional appointments at multiple affiliated and financially independent academic hospitals that provide clinical training to hMs students, residents, and fellows, and also accommodate academic researchers. There are currently four academic hospitals with anesthesia departments that are affiliated with hMs: Boston Children's hospital, Brigham and Women's hospital, Beth israel Deaconess Medical Center, and Massachusetts general hospital (Mgh). here, we briefly review the history of the Department of Anesthesia (traditionally Anaesthesia) at hMs, essentially that of its affiliated hospital departments, and some of their collaborative initiatives that have influenced patient care, trainee education, and research. The hMs Department of Anesthesia officially came into existence with the unanimous approval of the faculty on october 16, 1969, the date chosen to coincide with Ether Day. 1 Before this, the hMs-affiliated hospitals had established autonomous anesthesia service groups, some functioning as academic departments. in 1936, Professor henry Knowles Beecher, M.D. (1904-1976) became the first anesthetist-in-chief at Mgh (established in 1811). subsequent chairs of the Mgh department have been Professor Richard