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Retrospect

The defeat of pain

In 1846, ether began to be used officially in anesthesia

Pain was officially beaten on October 16, 1846. At 10 a.m. on that day, at the Massachusetts General Hospital, in Boston, United States, dentist William Thomas Green Morton anesthetized with ether the 17-year-old printer Gilbert Abbot, for surgeon John Collins Warren to remove a tumor from his neck. With the success of the procedure, the doctor addressed himself to the audience of doctors and medical students and to a reporter from the Boston Daily Journal and declared: “Gentlemen, this is no humbug”. It had been the first public demonstration of the use of anesthesia, which only failed to be photograph because the photographer felt queasy – in 1882, Robert Hinckley painted the picture that illustrates this page, reconstituting the historical moment.

“Until Morton’s demonstration, there had been a compartmentalization of information”, says José Luiz Gomes do Amaral, the chair professor of Anesthesiology, Pain and Intensive Medicine at the Federal University of São Paulo. “The Arabs, for example, had a lot of information about anesthetic substances back around the 10th century, but the texts were all in Arabic or Greek and only became better known around the 16th century.” The historical question of who discovered and used anesthesia for the first time was far from being ended in 1846.

Before that date, everything had been tried to carry out surgeries without pain: acupuncture, hypnosis, the sedative action of some plants, and alcohol. Only in 1773, the Englishman Joseph Priestley discovered nitrogen dioxide (NO2), although Humphry Davy, also an Englishman, had been the first to discover its anesthetic properties when breathing in the gas and perceiving that the toothache he had then had disappeared. It was the revered physician and chemist Michael Faraday who noticed that ether vapors had a similar effect to that of laughing gas. In 1841 – five years before the public presentation by Morton and Warren -, a doctor from Jefferson, United States, Crawford Williamson Long, was taking part in sessions of inhalation of ether with other youngster in nocturnal sprees known as ether parties or ether frolics.

More than once, under the effect of the substance, he hurt himself without feeling anything, and he had the idea of using ether in small surgical operations. Using ether, he extirpated two tumors from the nape of the neck of a friend, in the presence of several persons. In all, he operated eight patients under the same conditions, but authorities from his city made him to stop, fearing lest some patient might die in his hands. Long gave up the surgeries under the action of ether, and his pioneer work only became known after the demonstration in 1846. One year after the Long’s experiences, Horace Wells, a dentist from Hartford, United States, he himself inhaled laughing gas and asked a colleague to pull a tooth out, with success.

When he tried to do two public demonstrations with the gas, Wells failed – and, disheartened, quit his experiments and the profession. At that same time, Morton, who knew about the experiments with NO2 and ether, began to make his own attempts with animals, on himself, and with two students of dentistry. As he only achieved a partial success, he decided to consult a well-known professor of chemistry of the time, Charles Thomas Jackson, who advised him to abandon NO2 to experiment with pure sulfuric ether. Morton, who had not mentioned his work with ether to Jackson, understood the reason why he had failed in some experiments and convinced Warren to do the public demonstration. Shortly afterwards he created an inhaler for general anesthesia and requested a patent for the product, using the name of letheon, from the Greek lethes (forgetfulness), but was obliged by the doctors to reveal that he was using ether.

From then onwards, there was a great legal battle between Jackson and Morton for the primacy in the discovery. In the following years, other anesthetics appeared, as well as various methods for inducing anesthesia, besides inhalation. In Brazil, the first general anesthesia by ether was performed at the Rio de Janeiro Military Hospital by physician Roberto Jorge Haddock Lobo, on May 25, 1847, as told by Lycurgo Santos Filho, in his História geral da medicina brasileira [General history of Brazilian medicine].

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