Guest post by Rowena Fletcher-Wood

Some discoveries are made after hunting hard for the answer, some come to you when you need them most, and some just turn up at parties. Such was the discovery of modern anaesthetics.

Method of administering nitrous oxide used by Samuel lee Rymer in London, 1863
Credit: Wellcome Library, London. Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0

The concept of anaesthetics and their application to relieve pain during surgery was not wholly new. The Mesopotamians used alcohol (and its use persisted in resource deprived times such as war as late as 1812) and the ancient Chinese used acupuncture. The Sumerians may have used opium and Egyptians mandrake, and around a similar time, juniper and coca were put the the same use.

A popular anaesthetic in England between ~1200 and 1500 was Dwale – a mixture of varying composition containing opium and hemlock as well as lettuce, bile and bryony. Mandrake roots were chewed, extracting the active ingredients in doses that varied with chewing time or vigour. This was a risky business: low doses were often insufficient to fully mask the pain of surgery or put the patient to sleep, but at doses not much higher, many of these substances would become fatally toxic. Enough to make you numb just thinking about it.

However, these drugs have pronounced differences from the ones we are now familiar with. Most were applied locally, by rubbing a paste into the skin.

Because of the suffering and associated risks, many patients would choose not to undergo surgery, even in the face of otherwise certain death. The best surgeons were the fastest surgeons and although anaesthetics were administered, they were normally considered unreliable and untrustworthy. There was also the problem of testing new products – animal testing had limited feedback, and many drugs were piloted during dental operations or other painful, low-risk medical procedures. Even as late as the early 1800s, Henry Hill Hickman was busy gassing animals with carbon dioxide, trying to achieve the perfect balance between loss of sensation and death, where he might amputate one of their limbs without objection.

Luckily there was a good resource of keen volunteer test subjects just waiting to be tapped into: Party goers.

During the late 18th century, chemists as we now know them started to emerge. Amongst their many exploits was the extraction and characterisation of many of the active ingredients found in ancient remedies. Opium was found to contain morphine, a narcotic pain reliever, and the active components of the mandrake root are atropine and scopolamine – two alkaloids that, similar to coniine, the hemlock ingredient, produce varying effects from respiratory paralysis to heart palpitations. In coca, cocaine acts as a stimulant, and in juniper, terpinen-4-ol is simply a diuretic. Purifying these products allowed better dose control, understanding of the mechanism behind the active drug, and the classification of groups of compounds, allowing potential new products to be identified and developed. In particular, a new theory of gases was developed accompanying the discovery of dozens of new kinds of air, work pioneered by the gas giant Joseph Priestley, discoverer of oxygen, ammonia, hydrogen chloride and, in 1772, nitrous oxide, which he formed by combining iron metal and nitric acid, then collecting the bubbles of gas this produced.

Later, in 1799, Sir Humphrey Davy realised that nitrous oxide, or NO2, could be breathed by humans, and that breathing it produced a rather interesting result – it made you laugh. Nicknaming his discovery ‘laughing gas’, Davy went on to demonstrate the hilarious effects of nitrous oxide at the Royal Society, and several parties, where the habit took on. Alongside laughing gas, breathing ether became popular, and all the best parties had them.

It was whilst under the influence of one of these favourite party boosters that one man literally stumbled upon scientific enlightenment. At an 1844 event, Horace Wells looked on as a man seriously damaged his leg, but carried on with his activities regardless. When questioned about his lack of regard for the bleeding appendage, he told Wells he couldn’t feel any pain from it. Wells quickly realised that the laughing gas had altered the man’s perception of pain – a pain he would wake to when the effect of the nitrous oxide wore off.

Along with other fathers of modern anaesthesia, Horace Wells turned party time into serious science – as painlessly as possible. Through understanding of circulation, dosage and patient idiosyncrasy, the general anaesthetic was realised, and surgery revolutionised, NO contest.

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Painless party time, 5.5 out of 10 based on 2 ratings
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