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REVIEW ARTICLE
Year : 2007  |  Volume : 51  |  Issue : 6  |  Page : 472-478 Table of Contents     

The discovery of modern anaesthesia-contributions of Davy, Clarke, Long, Wells and Morton


1 M.D. Assistant Professor of Anaesthesia, Harvard Medical School, Anesthesiologist, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
2 M.D. Assistant Professor of Anesthesiology, University of Massachusetts Medical School, Anesthesiologist, Department of Anesthesiology, University of Massachusetts Memorial Healthcare Worcester, Massachusetts, USA
3 M.D., M.Sc., Professor & Head, Centre for Community Medicine, All-India Institute of Medical Sciences, New Delhi 110-029, India

Date of Acceptance21-Sep-2007
Date of Web Publication20-Mar-2010

Correspondence Address:
Sukumar P Desai
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
USA
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While many may argue as to who deserves the most credit for the discovery of modern anaesthesia, events in the late 18 th and early 19 th centuries led to the introduction and development of modern anaesthetic techniques.
English physicist and chemist Humphry Davy [1778-1829] first became aware of the sedative and analgesic properties of nitrous oxide in 1795. Although he never experimented with the drug during a surgical procedure, he was the first to suggest that it would be beneficial in relieving pain during surgical procedures. The mind-altering properties of nitrous oxide and ether were often abused for recreational purposes, and the term 'ether frolics' was coined to describe such use. While physician William Crawford Williamson Long [1815-1878] first used ether during general surgery, medical student William Edward Clarke [1819-1898] was the first to use ether for dental extraction in 1842. Dr. Long neglected to publicize his findings until 1849, thereby denying himself much of the credit he deserved. Dentist Horace Wells [1815-1848] successfully used nitrous oxide for dental procedures, but a public demonstration which he held in January 1845 turned out to be a fiasco. Medical student William Thomas Green Morton [1819-1868] was the first to publicly demonstrate the effectiveness of ether for general surgery on October 16, 1846. This article seeks to give rightful credit to each of these individuals for their unique contributions to the discovery of modern anaesthesia.

Keywords: Humphry Davy, WilliamT.G. Morton, Horace Wells, William Edward Clarke, Crawford Williamson Long, Discovery of Anaesthesia, Ether, Nitrous oxide


How to cite this article:
Desai SP, Desai MS, Pandav CS. The discovery of modern anaesthesia-contributions of Davy, Clarke, Long, Wells and Morton. Indian J Anaesth 2007;51:472-8

How to cite this URL:
Desai SP, Desai MS, Pandav CS. The discovery of modern anaesthesia-contributions of Davy, Clarke, Long, Wells and Morton. Indian J Anaesth [serial online] 2007 [cited 2014 Oct 20];51:472-8. Available from: http://www.ijaweb.org/text.asp?2007/51/6/472/61183


   Introduction Top


Few medical specialties can claim a history as colourful and controversial as anaesthesiology. Variously practiced before the mid-18 th century using alcohol, nar­cotics, hallucinogens, ischaemia, nerve compression, re­frigeration, or haemorrhagic shock, the first hint of an ef­fective analgesic was provided by Englishman Humphry Davy. Unfortunately, neither he nor his contemporaries followed up on his suggestion. It was only after nitrous oxide and ether enjoyed recreational use that their inevi­table use as anaesthetics would emerge. Modesty, igno­rance, and lack of assertiveness contributed to the con­troversy over the discoverer of anaesthesia.


   Humphry Davy (1778-1829) Top


Born on December 17, 1778, in Cornwall, England, Davy had very modest beginnings. The son of a wood carver, he grew up in rural and industrial surroundings. He finished school at age 15 and was apprenticed to an apothecary-surgeon at 17. Davy was a good writer, and wrote many poems in both English and Latin. A self-taught man, he greatly admired Sir Isaac Newton. Achieving similar fame was his life's mission. He ex­perimented with the effects of inhaling nitrous oxide and, at Thomas Beddoes's urging, became an assistant and then superintendent of the Pneumatic Institute in Clifton, Bristol. Within a year, he published a book de­scribing the analgesic effect of nitrous oxide: 'As ni­trous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations [1] .He coined the term Laughing Gas for nitrous oxide. For half a century no one paid attention to his prophetic predic­tion. At 22, Davy accepted a post at the Royal Institu­tion in London. He was a brilliant lecturer and was able to instill in his audience respect and enthusiasm for science. His research focused on isolating and ex­amining the chemical and electrical properties of ele­ments such as sodium, potassium, chlorine and boron. He discovered that flames would not pass through metallic gauze and thereupon invented the miner's lamp. He was knighted in 1812 and elected President of the world's oldest scientific society, the Royal Society, in 1820. His meteoric rise from country boy to brilliant scientist did not go well in class-conscious England. Much admired but disliked, he died a lonely man in Geneva, Switzerland on May 29, 1829 at the age of 50.


   William Edward Clarke (1819-1898) Top


Born on February 22, 1819 in Lebanon, Connecti­cut, Clarke's father and both grandfathers were promi­nent physicians. His last name is occasionally spelt Clark and his middle name is sometimes listed as Edwin. While a student of chemistry, in Rochester, New York, he used ether recreationally as was common among city-folk throughout the United States. Wandering lecturers and demonstrators would hold gatherings where individuals from the audience were encouraged to inhale ether or nitrous oxide while providing much entertainment to on­lookers. One man who witnessed such use of ether, in Clarke's presence, was William T. G. Morton, the per­son most commonly credited with the discovery of ana­esthesia. In January 1842, while a student at Vermont Medical College, Clarke, in the presence of his precep­tor, Professor E. M. Moore, administered ether to Miss Hobbie, dentist Elijah Pope performed a dental extrac­tion. Miss Hobbie's first name has not been traced, but she was probably related to one of the two medical stu­dents known to Clarke - Joseph C. Hobbie or Allen Hobbey. (Hobbie has variously been spelt Hobbey and Hobby.) Professor Moore believed the patient had ex­perienced a hysterical attack and warned Clarke not to continue such treatments. Had Clarke not taken his ad­vice, he might have been recognized worldwide as the discoverer of anaesthesia. But Clarke also thought little of his accomplishment [2],[3] the episode only receiving indi­rect attention in 1850 [4] . After graduating from medical school in 1849, Clarke worked as a surgeon in Michigan and Chicago and entered military service in 1861. Two years later, he returned to civilian practice in Chicago as a surgeon and gynaecologist. He died in Chicago on October 6, 1894, unaware of his role in the discovery of anaesthesia.


   Crawford Williamson Long (1815-1878) Top


Born in Danielsville, Georgia on November 1, 1815, Long belonged to a wealthy family of plantation owners and merchants. He graduated from medical school at the University of Pennsylvania in 1839. Like many of those credited with discovering anaesthesia, Long was exposed to the recreational use of nitrous oxide and ether. After training in New York, he returned to Georgia and began medical practice in rural Jefferson. An acquain­tance, James Venable, suffered from two small tumors in the neck, a condition he wished could be treated sur­gically, but he was scared of the pain that would accom­pany such treatment. Considering the analgesic effects of ether and nitrous oxide, Long suggested that Venable undergo the procedure under the influence of ether. Long successfully administered ether and painlessly removed both tumors on March 30, 1842. Although he subse­quently administered ether to many of his patients, he did not foresee the need to publish his results until 1849 [5] . This delay allowed others to introduce the technique and claim credit as discoverers of anaesthesia. Long later said that he wished to be certain others who had used anaesthesia successfully were given a chance to make their claim. Long had a lengthy career in Georgia and died of a stroke in 1878 shortly after administering ether to a patient in labor.


   Horace Wells (1815-1848) Top


Born on January 21, 1815 in Hartford, Vermont, Wells completed dental studies in Boston, graduating in 1836. He established a dental practice in Hartford, Con­necticut. On December 10, 1844, he witnessed a dem­onstration by Gardner Quincy Colton of the analgesic effectsofinhaled nitrousoxide.Wellsinquired with Colton whether a tooth could be pulled painlessly from a patient under the influence of nitrous oxide. The very next day, Wells inhaled nitrous oxide provided by Colton while dentist John Riggs removed one of Wells's molars. En­couraged by this success and many others, Wells at­tempted to demonstrate his technique at Massachusetts General Hospital (MGH) in January 1845. He adminis­tered nitrous oxide, provided by a local manufacturer, during a dental extraction, but the patient moved and appeared to be in pain towards the end of the proce­dure. The patient later claimed to have felt no pain, but Wells was laughed out the operating room and thought to be a fraud. The concentration of nitrous oxide pro­vided by the Boston manufacturer was believed to be lower than what Wells usually administered in Connecti­cut, explaining why this attempt failed while earlier at­tempts were successful. After the failed demonstration in Boston, Wells returned to Hartford and continued us­ing nitrous oxide in his dental practice. By the end of 1846, Morton had already successfully publicly demon­strated ether anaesthesia at MGH, where Wells had failed. Wells was frustrated and angry about Morton's receiving credit for the discovery of anaesthesia and Morton's audacity in gaining financial advantage by se­curing a patent. Wells went to Europe for a few months and on his return tried to resume dental practice. By then, another anaesthetic, chloroform, was being used to relieve pain during labor and also for recreation. Wells began abusing chloroform and later moved to NewYork, attempting to build a successful practice there. While incoherent and under the influence of chloroform or other drugs, on January 22, 1848, he became upset at some prostitutes and threw sulphuric acid on them. Legal charges were brought in and Wells was imprisoned await­ing trial. He confessed to a prison physician that he had been delirious and later appeared quite remorseful. He was allowed by prison authorities to visit his home and collect personal belongings. Unknown to the guard, he also collected chloroform and a razor. He was found several days later in his prison cell, having committed suicide by lacerating his femoral artery after inhaling chloroform [6],[7],[8] .


   William Thomas Green Morton (1819-1868) Top


Born in Charlton, Massachusetts on August 19, 1819, Morton grew up in Massachusetts, where his family owned a farmland [9] . Morton had one characteristic that opened many doors for him. He exuded confidence and he had a knack for gaining the trust of people he dealt with. Early in his career, he was involved in many unsa­vory dealings, generally involving fraud and embezzlement of funds entrusted to him. His being wanted by the law in several jurisdictions did not prevent himfromstart­ing dental studies at Baltimore College of Dental Sur­gery in Baltimore, Maryland, in 1840 [8] . Restless by na­ture, he moved next to Hartford, Connecticut, to study under HoraceWells. He convinced Wells that they should move to Boston and market a dental prosthesis they had jointly designed. They sought and received, assistance and advice from Charles Thomas Jackson (1805-1880), a prominent physician and chemist. In March 1844, Morton began as a student at Harvard Medical School. While the partnership with Wells did not last, Morton had watched himadminister nitrous oxide and was present at Wells' unsuccessful demonstration at MGH in Janu­ary 1845. Morton was also aware of Clarke's use of ether during a painless dental extraction. Using his pow­ers of persuasion, Morton received permission to dem­onstrate the anaesthetic effects of his unidentified pain­killer. Though he was poorly prepared and late for his appointment, the demonstration was a success, and Morton received much acclaim and recognition for this achievement, from physicians and the press. After suc­cessfully demonstrating the anaesthetic properties of ether, Morton decided not to reveal the identity of his agent, merely referring to it as "Letheon." Ether's pun­gent odour could not conceal its identity for long, and its use spread in the United States and Europe. During the next two decades, Morton desperately tried to recoup financial rewards for his achievement, but without suc­cess. To receive financial rewards, he had to prove that he was the sole discoverer of anaesthesia. Without the distinction of graduating from dental or medical school, however, Morton was awarded an honorary M.D. by the University of Baltimore in 1852. For many years, Morton, Jackson, and Wells all tried to claim credit. Morton spent enormous amounts of energy and financial resources to influence the decision, apparently impoverishing himself, although evidence has emerged that he transferred at least some assets to his family to protect themfrom creditors [10] . Morton traveled to NewYork one particularly harsh sum­mer to meet with magazine editors who had incorrectly quoted surgeon John Collins Warren as stating that Jack­son ought to be given credit for the discovery of anaes­thesia.Whiletryingtosettle thisdispute, Morton wastaken ill and suffered fromheatstroke. On a carriage ride through New York's Central Park while delirious, he got into an argument with a bystander and landed in a pond. He died before arrangements could be made to transfer him to St. Luke's Hospital[11] .


   Conclusion Top


Before the development of anaesthesia, surgery was viewed by patients with fear and trepidation. Pa­tients rarely submitted to surgery willingly. Indications for surgery included wens (sebaceous cysts), hernias, hemorrhoids, bladder calculi, abscesses, boils, obstetri­cal conditions and a variety of injuries incurred in battle or civilian life. Poor dental hygiene meant most people needed dental extraction some time during their lives. These procedures were short and amenable to trial with analgesic treatment. It is therefore not surprising that dentists and dental procedures played such an important role in the discovery of anaesthesia. We propose that each be recognized for his unique contribution to the dis­covery of anaesthesia. Sir Humphry Davy, as the man who first suggested that nitrous oxide had analgesic prop­erties that could be employed during surgical procedures. Next, William Edward Clarke, as the first person to use ether as a general anaesthetic during dental extraction. Crawford Williamson Long should be recognized for the first to use of ether for a general surgical operation and Horace Wells for the first use of nitrous oxide for dental extraction. William Thomas Green Morton, the person who has received widest recognition as the discoverer of anaesthesia, should be recognized for the first public demonstration of ether as an anaesthetic agent during general surgery and for promoting the concept and use of anaesthesia.

The birth of our specialty occurred amidst recreational use of nitrous oxide and ether. Dental procedures were common and readily amenable to experimental use of new analgesic treatment. Over four years, Clarke, Long, Wells, and lastly Morton successfully used these drugs as anaesthetic agents. Due to vagaries of their personalities and the circumstances surrounding their use of these agents, Morton has received maximum credit as the discoverer of anaesthesia, although most of this recognition occurred posthumously.[Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5]

 
   References Top

1.Davy H. Researches, chemical and philosophical; chiefly con­cerning nitrous oxide, or dephlogisticated nitrous air, and its respiration. London: J. Johnson; 1800.  Back to cited text no. 1      
2.Lyman Henry M. The discovery of anesthesia. Virginia Medi­cal Monthly 1886;13:369-92.  Back to cited text no. 2      
3.Lyman Henry M. Biography of eminent American physicians and surgeons. Indianapolis: Carlton & Hollenbeck 1894.  Back to cited text no. 3      
4.Richmond PA. Was William E Clarke of Rochester the first American to use ether for surgical anesthesia? "Scrapbook," The Rochester Historical Society 1850 ;1:11-3.  Back to cited text no. 4      
5.Long C W. An account of the first use of sulphuric ether by inhalation as an anesthetic in surgical operations. Southern Medical and Surgical Journal 1849;5:705-13.  Back to cited text no. 5      
6.Anonymous. Distressing case of suicide. New York Tribune 1848 Jan 25;2.  Back to cited text no. 6      
7.Anonymous. Distressing case of suicide. New York Herald 1848 Jan 25;2.  Back to cited text no. 7      
8.Fenster JM. Ether Day. New York: HarperCollins; 2001.  Back to cited text no. 8      
9.Rice NP. Trials of a public benefactor. New York: Pudney and Russell; 1859.  Back to cited text no. 9      
10.Wolfe RJ. Tarnished idol. San Anselmo, California: Norman Publishing; 2001.  Back to cited text no. 10      
11.Unknown. The death of Professor Morton. New York Herald 1868 Jul 17;5.  Back to cited text no. 11      


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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    Abstract
    Introduction
    Humphry Davy (17...
    William Edward C...
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    William Thomas G...
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