Origins of anesthesia a turning point in surgery

One can argue about what was the most important discovery in the evolution of surgery, not just ophthalmology. I suggest that Oct. 16, 1846 was the date when one of the most important events occurred.

The location The operating room of Massachusetts General Hospital.

The attendees Students, invited faculty, and staff.

The event The operating room at Massachusetts General was packed. The principals arrived. All in attendance were anxiously waiting for the event to begin.

Horace Wells (1815-1848) was a dentist who practiced in Hartford, CT and was the partner of Dr. Morton. In 1845, he had a poor result in his demonstration of the effects of nitrous oxide in performing painless dental extractions. Would this present demonstration be a repeat performance?

The patient, Abbott, was fearful about pain. Dr. Warren calmed the patient's fear and Abbot agreed to participate in the experiment.

Dr. Warren spoke to the audience about his wishes to be able to perform painless surgery and that he looked forward to the possible success of this surgical procedure.

The surgery was scheduled for 10 a.m. and as the hour arrived, Dr. Morton was still not in attendance.

At 10:10, Dr. Warren was prepared to proceed in the usual manner with a number of attendants restraining the patient strongly. Just as his knife was preparing to cut, Dr. Morton arrived.

He immediately began instilling the ether by using an inhaler that he had worked throughout the night to build. Under normal circumstances, ether was administered on a pocket-handkerchief or cloth.

As Dr. Warren began his administration, a still overwhelmed the audience. Abbott closed his eyes; Dr. Morton told Dr. Warren that he could proceed.

As the knife was applied to the skin most people expected a cry of pain to emerge from Abbott's mouth, but not a sound occurred. Another cut, and another-still silence. The surgery took 30 minutes.

Abbott awoke and told the audience that he experienced no pain. Dr. Warren looked at the audience and said "gentlemen, this is no humbug."

Further tests Following this initial experiment the crucial test was to come: could Dr. Morton prevent pain from occurring during an amputation?

On Nov. 7, 1846 Alice Mohan, a 21-year-old who had tuberculosis of the knee joint, was prepared to be the patient. After Dr. Morton administered anesthetic, a smooth and painless amputation took place.

This treatment using anesthesia was now to become standard treatment; painless surgery had arrived and as such, great strides were to occur in surgery. The operating room at Massachusetts General Hospital has from that time been referred to as the Ether Dome. Within 2 months news reached Europe where Robert Liston (1794-1847), professor of surgery at the University College Hospital in London, agreed to test the use of ether on his patients.

On Dec. 21, 1846 a number of dental extractions were performed, all successfully. Two days later, Dr. Liston agreed to perform an amputation, an operation that he had perfected and for which he had developed special surgical knives. Dr. Liston was acknowledged as the greatest surgeon in London at the time.

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