In the 1830s, Scottish surgeon Robert Liston was renowned for his surgical speed. With medical students restraining the patient and onlookers eagerly awaiting, Liston would swiftly cut through his patient’s flesh, saw through their tibia and fibula, and complete an amputation within just a few minutes. This speed was crucial during a time when anesthesia was not widely used, forcing patients to consciously endure every moment of surgery.
The quest for anesthetics that could induce unconsciousness and enable more meticulous surgeries launched long before Liston. Around 200 CE, Chinese physician Hua Tuo described mixing alcohol with a powder of various ingredients to anesthetize patients. In the 13th century, Arab surgeon Ibn al-Quff described patients taking anesthetics, likely inhaling drugs like cannabis, opium, and mandrake, from saturated sponges.
By the end of the 1700s, many scientists were pondering chemistry’s medical applications. This led to a profusion of anesthetic advancements involving three main players: nitrous oxide, ether, and chloroform. In 1799, English chemist Humphry Davy began experimenting with nitrous oxide, or laughing gas, inhaling it himself and observing its effects on friends. Davy noted that its pain-relieving abilities might make it useful for surgical operations, but it would be decades before that happened. This was, at least in part, because some surgeons and patients were skeptical of the effectiveness and safety of anesthetic drugs.
In 1804, Japanese surgeon Seishū Hanaoka successfully removed a breast tumor from a patient anesthetized with a mix of medicinal herbs. However, the news stayed in Japan indefinitely. Meanwhile, ether started garnering medical attention. It was first formulated centuries before then came to be used recreationally. During the so-called “ether frolics” of the early 1800s, an American physician noted that the fall he suffered while using ether was painless. In 1842, he etherized a patient and successfully removed a tumor from his neck.
Scottish obstetrician James Simpson heard about an alternative anesthetic called chloroform. In 1847, he and two colleagues decided to try some themselves and promptly passed out. Soon after, Simpson administered chloroform to one of his patients during childbirth. It quickly gained popularity because it was fast-acting and thought to be side-effect-free, though we now know it’s harmful and probably carcinogenic. Chloroform came to be understood as a riskier, more toxic option and fell out of favor by the early 1900s.
Because anesthetics weren’t yet fully understood, they sometimes had lethal consequences. And some doctors held sexist and racist beliefs that dictated the amount of anesthesia they’d provide if any at all. American obstetrician Charles Meigs argued that the pain of childbirth was a form of divine suffering and was skeptical that doctors should interfere with it. Throughout the 1840s, American physician James Marion Sims conducted experimental gynecological surgeries without pain relief, primarily upon enslaved Black women.
By the late 19th century, those who could access anesthetics were undergoing increasingly complex operations, including some that were previously impossible. Alongside newer drugs, ether and nitrous oxide are still used today, but in modified formulations that are safer and produce fewer side effects, while doctors closely monitor the patient’s state. Thanks to these advances, speed is not always of the essence and, instead of acute agony, surgery can feel like just a dream.
Create a detailed timeline that traces the history of surgical speed and the development of anesthetics from the 1830s to the early 1900s. Include key figures such as Robert Liston, Hua Tuo, Ibn al-Quff, Humphry Davy, Seishū Hanaoka, and James Simpson. Use different colors or symbols to differentiate between advancements in surgical techniques and anesthetic discoveries.
Participate in a role-playing debate where you assume the roles of historical figures mentioned in the article. Debate the pros and cons of surgical speed versus the use of anesthetics. Consider the perspectives of surgeons, patients, and medical students from different time periods. This activity will help you understand the ethical and practical considerations of historical medical practices.
Conduct a research project on the modern use of anesthetics. Compare and contrast the anesthetics used today with those discussed in the article, such as nitrous oxide, ether, and chloroform. Present your findings in a multimedia presentation, including videos, images, and charts to illustrate how anesthetics have evolved and their impact on modern surgery.
Analyze a series of case studies that highlight the successes and failures of early anesthetic use. Discuss the medical, ethical, and social implications of each case. Reflect on how these historical events have shaped current medical practices and policies regarding anesthesia administration.
Engage in an interactive simulation that allows you to experience the challenges faced by surgeons and patients before the widespread use of anesthetics. The simulation should include scenarios where you must make quick decisions as a surgeon like Robert Liston or endure a procedure as a patient. This activity will provide a deeper appreciation for the advancements in medical science and the importance of anesthetics.
surgical speed – the ability to perform medical procedures quickly and efficiently in a surgical setting – The surgeon displayed remarkable surgical speed as he swiftly removed the patient’s appendix.
anesthesia – a medical state induced to eliminate pain and sensation during surgery or other medical procedures – The patient was administered anesthesia before the surgery to ensure a painless experience.
unconsciousness – a state of complete lack of awareness and sensation – The patient remained in a state of unconsciousness throughout the duration of the surgery.
meticulous surgeries – highly precise and careful medical procedures – The surgeon performed meticulous surgeries, paying attention to even the smallest details to ensure optimal outcomes.
nitrous oxide – a colorless and odorless gas used as an anesthetic – The dentist administered nitrous oxide to the patient to help alleviate anxiety during the dental procedure.
ether – a volatile liquid used as an anesthetic in the past – In the early days of surgery, ether was commonly used as an anesthetic.
chloroform – a colorless liquid with a sweet smell, formerly used as an anesthetic – The use of chloroform as an anesthetic declined over time due to its potential side effects.
medicinal herbs – plants or plant extracts used for their therapeutic properties – The ancient healers often relied on medicinal herbs to treat various ailments.
alternative anesthetic – a substitute for traditional anesthesia that can provide pain relief during medical procedures – The patient opted for an alternative anesthetic, such as acupuncture, to manage pain during the surgery.
discrimination in anesthesia administration – unfair or biased treatment in the distribution or administration of anesthesia – The study revealed a concerning pattern of discrimination in anesthesia administration, with certain groups receiving less effective pain management compared to others.
