With a heavily researched and readable narrative, including a welcome dose of dry wit, Julie M. Fenster’s Ether Dayrecounts the mid-19th century origins of the use of surgical anesthesia, the first major medical discovery to be made in the United States. Fenster successfully transports the reader to a time when America was still developing its own distinct character, when the worlds of medicine and business were only cursorily acquainted with each other, and when, throughout the world, surgery was profoundly, and often mortally, painful.

Despite the fact that nitrous oxide and ether were well-known substances during the entire first half of the 1800s for personal and public entertainment, and several respected scientists had mentioned or written of the chemicals’ ability to desensitize individuals to pain (and even touched on their possible use in surgery), the terrifying practice of unanesthetized amputations, organ removal, and the like went on until the fateful day of October 16, 1846—Ether Day.

Fenster provides an interesting and informative (and, possibly, disturbing to the faint of heart) section on the dreadful nature of operations prior to anesthesia and their effects on patients and doctors, portraying surgery as a kind of black mark on the otherwise respected field of medicine. She then offers a telling—and at times almost scathing—counterpoint discussing the long delay in the medical use of nitrous oxide and ether. “For almost 50 years, the gas [nitrous oxide] was nothing more than chemistry’s plaything: a good laugh, the subject of dissertations, the headliner on playbills. . . . what had seemed like pain for patients was throughout that span violence—a kind of violence perpetrated by history.”

moregoodreading Tarnished Idol: William T. G. Morton and the Introduction of Surgical Anesthesia By Richard J. Wolfe Norman Publishing, 2001 We Have Conquered Pain: The Discovery of Anesthesia By Dennis Brindell Fradin Margaret McElderry, 1996 The Illustrated History of Surgery By Knut Hger; updated and edited by Sir Roy Calne Fitzroy Dearborn Publishers, 2000 The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900–1990 By Harry M. Marks Cambridge University Press, 1997

Most of the story is told through the intersecting lives of three absorbingly flawed individuals who all claimed credit for the discovery of the use of anesthesia. William Morton was a lifelong traveling con man turned Boston dentist (a position which, at that time, required only an apprenticeship rather than formal schooling) with “an excess of charm”. He was the one who successfully anesthetized a patient with ether on that October 1846 day at Massachusetts General Hospital for the removal of a tumor. Horace Wells, Morton’s dentistry mentor from Hartford, CT, had administered nitrous oxide to a surgical patient almost two years earlier, in a perceived failure to induce insensibility. And Charles Jackson, an ingenious chemist, physician, and geologist, with a contempt for most anything that took place outside the intellectual circles of France, offered some (or much) assistance to Morton in his efforts.

The book details how the three men became involved in such an important discovery, which had been waiting in the wings for years, and how they pushed it into a bitter controversy—fueled by greed, spite, and desperation—that ruined them all. Although the timeline sometimes appears a bit muddled as Fenster jumps from one character’s history to another, the overall effect is one of comprehensive clarity and very realistic personae.

Of possible interest to those involved in drug discovery is the view this book offers into the very early days of both clinical trials and drug patent issues in this country. William Morton’s initial surgical trial with ether happened only through a whim of the Massachusetts General chief of surgery, who did not even know the exact contents of Morton’s formulation (Morton had presented it as a secret mixture and tried to hide the ether scent with orange oil), in contrast to the massive amounts of research and paperwork necessary before experimentating on humans today. Morton (with the grudging co-applicant, Charles Jackson) applied for and received a patent for his ether/orange oil “discovery”. The patent infuriated most physicians, who considered themselves more serious practitioners than Morton and saw patents as unethical for anything that relieved disease or suffering—bringing to mind many pertinent modern-day issues. Morton’s moneymaking aspirations, however, led to the initial stages of commercialized medicine, which, of course, fuels today’s health care system.

One should not expect from this volume any detailed discussion of the technical issues of patent law in the 1840s, or more than cursory descriptions of the scientific concepts involved. This is a book about the all-too-human foibles that shaped the background of this immensely important medical discovery.

The World of Caffeine: The Science and Culture of the World’s Most Popular Drug
BENNETT ALAN WEINBERG AND BONNIE K. BEALER
Routledge, New York, 2001, 384 pp, $27.50 hardcover
ISBN 0-415-92722-6

If, as the bard Shakespeare once wrote, “music be the food of love,” then coffee is surely the food of work. Caffeine, whether in the form of coffee, tea, chocolate, or cola beverages, has clearly become the drug of choice throughout the world. The time it takes to walk between coffee shops in America is roughly the time it takes to empty a grande Kenya, black, one sugar.

The World of Caffeine is a study of how caffeinated beverages have affected societies.During the first few centuries of their recorded existence, coffee and tea (the two main topics) often played a role occupied by marijuana today. Outlawed at different times in different countries, the coffeehouses and teahouses that sprang up were seen by many governments as dens of sedition, a place for the common man to gather (women being predominantly excluded) and complain about the ruling classes.Vintners and brewers organized demonstrations against these market-invading potables and sponsored physicians to speak about their terrible toxic effects. At the same time, proponents spoke of the medicinal benefits of the two beverages, pointing out that they invigorated the body, allowed the body’s fluids to flow freely, and brought joy to the spirit.

Weinberg and Bealer break the narrative into five sections. Part I looks at the murky origins of coffee, tea, and cacao (aka cocoa), discussing the various myths and legends that have arisen. The authors take pains to dispel some of these stories, while leaving others open to interpretation.

moregoodreading Uncommon Grounds: The History of Coffee and How It Transformed Our World By Mark Pendergrast Basic Books, 2000 Buzz: The Science and Lore of Alcohol and Coffee By Stephan Braun Penguin USA, 1997

Part II presents the more recent history of coffee, tea, and chocolate as they swept across Europe like sequential tidal waves. The authors argue that the arrival of coffee changed the working philosophy of England and other countries.Previously, they propose, the beverage of choice was beer, and employees spent much of their days besotted, achieving little and working only until they had sufficient funds to return to the tavern. With the arrival of coffee—its acceptance being promoted by a mini-Ice Age sweeping through Europe—the workers rose earlier, stayed sober, and worked longer, changing the face of Europe forever.

Part III examines the roles of coffee and tea in Japanese and English culture. The authors contrast the civility of the various tea ceremonies with the more common coffeehouse experience. Where tea provided refreshment and protocol for the elite of such disparate societies, coffee provided a refuge for the common man.Parts IV and V discuss the fundamental aspects of caffeine, describing its natural history and what we are slowly starting to learn about its health and medicinal effects.

The book is well written and generously laced with amusing anecdotes in the words of the original authors.