Dr. Robbins came across this article recently, and thought you might enjoy it. Here is a portion of it…..

Medicine is about 18% of U.S. Gross Domestic Product, and surgery makes up a very substantial part of that. If surgery is a third of medicine on a dollar basis, a not unreasonable supposition, then it’s a trillion-dollar industry.

Only 200 years ago, there was little surgery except for amputations. Surgery caused unendurable pain. The greatest skill a surgeon could have was speed, as the strapped-down patient writhed and screamed under the scalpel. People were known to commit suicide rather than face the surgeon’s tools. To dull the pain at that time, there was only laudanum, which is opium dissolved in alcohol, or just large quantities of whiskey. But neither are anesthetics, just sedatives.

In the 1790s, things began to change, but only slowly. The great British chemist Humphry Davy experimented with a newly discovered gas, nitrous oxide. Davy nicknamed it “laughing gas,” as it could induce helpless giggles. It soon became a popular recreational drug; Davy thought it the equal of alcohol but without the hangover. He became addicted to it.

In his first important book, “Researches, Chemical and Philosophical,” published in 1800, Davy mentioned in passing that “as nitrous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations in which no great effusion of blood takes place.”

In January 1842, a medical student at the Berkshire Medical College in Massachusetts named William E. Clarke, a fan of ether frolics, administered ether to a dental patient, and a dentist then proceeded to extract a tooth painlessly. It was the world’s first medical procedure performed under anesthetic. But Clarke completely failed to understand the significance of what he had just done and did not pursue the technique any further.

In 1844, a dentist named Horace Wells attended a nitrous-oxide frolic in Hartford, Conn., where one of the participants injured a leg but reported that he felt no pain. Wells immediately grasped the significance and the next day experimented on himself. He had the organizer of the frolic administer nitrous oxide to him while another dentist extracted one of his molars.

Wells began to use nitrous oxide in his practice, and in 1845 gave a demonstration at Massachusetts General Hospital. It was a disaster.

But the following year, in the same room, Warren removed a tumor from a patient who was unconscious from diethyl ether. The patient was calm throughout and and afterward reported that he felt no pain.

Oliver Wendall Holmes Sr., the physician, poet, and father of the Supreme Court justice, suggested calling the new procedure “anesthesia,” from the Greek meaning “without sensation.”

The great British physician John Snow, the father of modern epidemiology, investigated and found there was a very narrow spread between an effective dose of chloroform and a toxic dose. He made anesthesia safe enough to administer to Queen Victoria during her last two confinements for childbirth.

It would be a few more decades before careful sterilization of physicians’ hands and instruments made abdominal surgery safe. But anesthesia was the first great step toward modern surgery.
November 24, 2014

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