Science popular talk on

Discovery Of Anesthesia

Presented by:Karishma Das Purkayastha.

Roll no:06Dept of Life Science And

Bioinformatics.

Anesthesia Traditionally mean the condition of not having sensation (including the

feeling of pain) blocked or temporarily taken away. It is a

pharmacologically induced and reversible state of amnesia, analgesia,

loss of responsiveness, loss of skeletal muscle reflexes or decreased

stress response, or all simultaneously. An alternative definition is a

"reversible lack of awareness," including a total lack of awareness (e.g. a

general anesthetic) or a lack of awareness of a part of the body such as a

spinal anesthetic.

The Need for Anesthesia

• Relieve from painful surgery.• Need of unconsciousness.• Need of muscle relaxation.

Blast from the past

• In many surgeries, several burly men were needed to hold down patients and surgeons had to make themselves numb to patients pleas for mercy.

• Alcohol and opium were used at times, mandragora and some other herbs, which worked a little, but not terribly well. In large doses they had secondary problems.

Ether • The small organic molecule of ether was first created in

1275 by Spanish chemist Raymundus Lullius

• Later, in 1730, German scientist W.G. Frobenius changed the name of sweet vitriol to “ether.” And thus it remained until the early 1800s when gradually people realized that the vapors could generate a pleasant “high” as a recreational drug. But application as an anesthetic awaited four more decades.

Nitrous oxide

• In 1799 Humphrey Davy discovered anesthetic properties of nitrous oxide (N20)also known as "laughing gas.“

• A wide variety of reactions would come with the breathing of laughing gas a suffusion of insight, occasional grandiosity, sometimes belligerence.

The Discoverer(s) of Anesthesia• Four professionals later claimed to have

been the main one who discovered anesthesia! Their fight went all the way to Washington DC and to the French Academy, and various public figures and later historians tended to support this or that figure.

Crawford Williamson Long (1815-1878)

• He had apprentices four young gentlemen. Long being around 29 and they around 20. As was common, all held occasional nitrous oxide parties, and one time they had run out of nitrous and Long reminded them that ether might also serve as an intoxicant. This led to his noticing that high spirits during such frolics might result in injury without the person seeming to feel pain.

Horace Wells (1815-1848)• In 1844, Horace Wells attended an exhibition and witnessed a

participant injured his leg while under the influence of laughing gas. Told Wells that he didn't feel any pain.

• He tried nitrous oxide on himself: he had an impacted molar and asked a colleague to extract it, Wells first having inhaled deeply of nitrous oxide. so he tried it first on a patient, then several more. Emboldened, he spoke to Jackson, who ignored the idea, but nevertheless proposed to the nearby medical school that this substance could be a possible anesthetic.

Contd.• He claimed that nitrous is too shortacting, and one must

also inhale it for quite a while. Even then, possibly breaths need to be taken fairly frequently to maintain analgesia it wears of fairly rapidly, too. For whatever reason, this demonstration failed: The patient groaned and grimaced as the surgery neared completing, and the observers jeered. Wells was humiliated and left!.

William Morton • He trained predominantly under the guidance of

Horace Wells .• On the 30th of September 1846 a patient named

Ethan Frost came to his surgery for a painful wisdom tooth extraction and agreed to have it extracted under the influence of Ether.

Contd.

• On the 16th of October 1846 Morton gave the first ever public demonstration of anaesthesia using sulphuric ether.

Charles T. Jackson

• He may have been somewhat active in suggesting to both Wells and Morton the potential for anesthesia in these gases- he was in role to do this but he didn’t demonstrate it or write it up early

Who actually coined the term?

• The term anesthesia was coined by Oliver Wendell Holmes,Sr.

• He suggested the term to Morton.

Legal Disputes• Subsequently, all four of them or their surviving family

members and associates battled in congress and up to the Supreme Court as to who deserves official recogniton! Wells appealed to the French Academy. Money was a hoped for side benefit, the claimant wishing they could get something additional along with that recognition. It went on for years and various notables took sides.

Mischievious Morton

• So the dispute was never resolved & a few side issues of Morton was also there. He added a bit of artificial fragrance to ether & renamed it “ letheon”. He hoped to patent it but the chief of the hospital held out until he admitted that it was just simple ether.

Sad demise

• So, then, who is to get the credit?• It's really a rather sad story. Wells sought

justification, but interestingly, a few years later, discovered chloroform, which is a rather seductive substance, and became habituated. Wells went downhill, also using alcohol, and finally killed himself in jail! Morton and Jackson also struggled and also had unhappy ends. Long died of natural causes.

Pictures of surgeries using NO2 & ether

James Simpson• In January, 1847, James Young Simpson (1811-

1870) proposed that Ether, however, was by no means an ideal anesthetic. It tended to make people cough, could feel stifling and generate struggling in those who didn't trust the method, and sometimes made people throw up

Contd.• Finally he came upon chloroform, which he tried a few times not

only on himself, but also on some friends. He hit upon chloroform, which knocked him out, made his friends act weird, but it was a pleasant type of unconsciousness and it smelled better than ether.

• Simpson tried it on some patients and then on some obstetric patients. It became accepted in many circles because Simpson was associated with high status faculty and there didn't seem to be much problem. Again clergy and some doctors objected, but Simpson responded with reason and good arguments.

Contd..• An interesting thing about chloroform, though: It is good,

but not as safe as some originally thought. If there’s any adrenaline in the system, people tend to get cardiac arrest and die.

• Also, there are occasional late complications of severe and fatal toxicity to the liver, which leads to a distinctly uncomfortable death. Happens a bit more in kids.

John Snow

Dr. John snow use chloroform as anesthetics in 1853.

The use of chloroform became even more mainstream when Queen Victoria used it in 1853 to help with the birth of her son Leopold.

Technological Developments

• In the wake of the new technology of the gaseous anesthetics, a variety of inhalant systems were invented and revised in an attempt to promote the easiest, smoothest, most comfortable, most convenient, and in other ways a better way to use these substances

Hypodermic syringe

• Back to anesthesia: So now we have two types of anesthesia, inhalation of certain gases and hypodermic. A third route, intravenous, came with the continuing development of better needles, finer and more flexible, less likely to break off— and also the invention of the chemical, barbituate, and its derivatives.

• This is 21st century and science has given so much to people to enjoy & remorse. But back in those days before industrial revolution people had to struggle for surgery and pain. They were rather afraid of it. At any rate, regardless of who discovered anesthesia it was indeed a true breakthrough.

Summary

References • 1. Kuntz, L; Vera, A (2005). "Transfer pricing in hospitals and

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• 2. Small, MR (1962). Oliver Wendell Holmes. New York: Twayne Publishers. p. 55. ISBN 9780808402374. OCLC 273508. "In a letter to dentist William T. G. Morton, Holmes wrote: "Everybody wants to have hand in a great discovery. All I will do is to give a hint or two as to names—or the name—to be applied to the state produced and the agent. The state should, I think, be called 'Anaesthesia.' This signifies insensibility—more particularly ... to objects of touch.""

• 3. Powell MA (1996). "9: Wine and the vine in ancient Mesopotamia: the cuneiform evidence". In McGovern PE, Fleming SJ, Katz SH. The origins and ancient history of wine (Food and nutrition in history and anthropology). 11 (1 ed.). Amsterdam: Gordon and Breach Publishers. pp. 96–124. ISBN 9789056995522. ISSN 02755769. Retrieved 20100915.

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5. Booth M (1996). "The discovery of dreams". Opium: A History. London: Simon & Schuster, Ltd. p. 15. ISBN 0312206674. Retrieved 20100918.

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