- Purpose
- Typical Anesthetic
Ether
"We have conquered pain," proclaimed a newspaper article in London late in the year 1846. The dispatch from Boston, dated Oct. 16, seemed too good to be true.
In the first successful public demonstration of diethyl ether's ability to render a patient unconscious during an operation, surgeon John Collins Warren had removed a tumor from the jaw of a fully anesthetized patient. When the patient, Gilbert Abbott, awoke a few minutes after the excision, he insisted he felt no pain during what might otherwise have been a horribly gut-wrenching experience.
Surgery in the 1840s was usually accompanied by the agonized yells and screams of a patient strapped to a table and writhing in pain. It is no wonder then that few people had the nerve to undergo major operations. When they did, it was often because they had no alternative.
Prior to the 1840s, only crude general anesthetics were available. Administering large doses of alcohol to a patient might render him or her insensible but had certain side effects--nausea, vomiting, and occasionally death. Hypnotism sometimes worked and sometimes not. Opium might dull the pain but could not prevent it. A stout surgeon might even try a knockout punch to the jaw or a hammer blow to the head. But these were brutal and unreliable techniques.
Ether inhalation therapy offered a remarkable alternative. At that first public demonstration in the surgical amphitheater of what is today called the Ether Dome at Massachusetts General Hospital, physicians and medical students witnessed an operation that held out hope that pain during surgery could be a thing of the past.
In January 1845, surgeon Warren, a founder of the New England Journal of Medicine, had taken part in another, less successful public demonstration of surgical anesthesia. As Warren stood by under the operating amphitheater dome, dentist Horace Wells encouraged a patient to inhale nitrous oxide fumes.
Wells had earlier seen a show in which stage volunteers inhaled nitrous oxide and experienced no pain when they fell down before the audience. He learned how to successfully use the gas in his dental practice and then thought to extend the use of nitrous oxide to general surgery. Wells convinced Warren to let him demonstrate the anesthetic before a group of doctors and medical students. But the effort failed: During the operation, the patient awoke in pain. Students and observers in the audience booed Wells and called him a "humbug" as he left the operating room in shame.
 COURTESY OF THE NATIONAL LIBRARY OF MEDICINE |
WAITING TO EXHALE This 19th-century engraving depicts Morton demonstrating the administration of ether at Massachusetts General Hospital on Oct. 16, 1846. |
ANOTHER DENTIST, 27-year-old William T. G. Morton, was successful in the administration of ether where Wells had failed with nitrous oxide. After consulting with Boston physician and chemist Charles T. Jackson, Morton chose to use ether vapors to eliminate pain during surgery.
At the time, ether already had a number of medical uses. Doctors would administer a few drops taken internally as a stimulant or to relieve spasms and convulsions. Medical students and their instructors also knew about ether's intoxicating effects. They occasionally used ether-filled balloons as social stimulants at "Ether Frolics" in the 1830s and 1840s.
For his public demonstration, Morton and his associates designed a glass reservoir with a hole toward the top and another on the side. For several minutes, Morton's patient inhaled through a pipe on one side of the glass as air passed through the hole toward the top and over ether-filled sponges.
While the initially skeptical group of surgeons and medical students again watched, patient Abbott passed out. In 10 minutes, surgeon Warren excised a congenital vascular tumor from Abbott's neck. While he appeared to be asleep the entire time, Abbott said later that he did not feel any pain but was aware of the operation.
This time the audience was impressed. When Warren finished the procedure, he is reported to have said, "Gentlemen, this is no humbug."
While a surgeon from Georgia, Crawford W. Long, claimed he used ether as early as 1841 in minor surgeries and for women in labor, he did not publicize the advance, publishing his work only in 1849. Morton moved more quickly. In November 1846, Morton took out a patent on the anesthetic, dubbed Letheon, and tried to cash in on the advance. Pure ether, which becomes a pungent volatile gas when exposed to air, could not be patented because it had been used for so long for other purposes. Letheon, however, contained aromatic oils and opium in addition to ether.
Surgeons criticized Morton for trying to keep such an important elixir secret. Within a year, he published an article on the proper way to administer ether. And though he tried for years to get the U.S. Congress to award him $100,000 for his patent, he died penniless in 1868.
Today, ether has been largely displaced by newer narcotics that have fewer side effects such as nausea and lung irritation. But cutting-edge medical practitioners in the late 1840s thought they had indeed found an elixir to conquer pain. Scotsman Robert Liston was the first surgeon in the British Isles to use ether. After painlessly sawing off a patient's leg, he said, "This Yankee dodge, gentlemen, beats mesmerism hollow." It was the beginning of a new era for surgeons and patients alike.—
