A history of anesthesia

STANFORD T. SHULMAN, MD

aSpring 2000

The red U.S. stamp shows Dr. Crawford W. Long (1815–78) of Danielsville, GA, an 1839 graduate of the University of Pennsylvania. He and his friends in Georgia had participated in social gatherings, "ether frolics," and learned that injuries "under the influence" were painless. On March 30, 1842, he utilized ether inhaled from an ether-soaked towel to excise a cystic tumor from the neck of a friend who was fond of ether inhalations. This was pain-free, and Long utilized ether in at least eight additional operations by 1846. However, Long did not report his experiences until 1847 in the Southern Medical and Surgical Journal, after William Morton had done so in late 1846. Long’s claim for priority was largely ignored, and he died in obscurity.

William Thomas Green Morton (1819–68), shown on the tan and black stamp from Transkei, was born in Charlton, Massachusetts, the son of a shopkeeper, and trained originally in dentistry. He assisted his friend and former partner Horace Wells (1815–48), who utilized nitrous oxide on December 11, 1844, for a dental extraction. Wells arranged an ill-fated public demonstration at Massachusetts General Hospital with the prominent surgeon Dr. John Collins Warren. He was ridiculed when the anesthetic was removed prematurely, and the dental extraction was very painful. After an anesthetic fatality occurred, Wells quit practice and died in jail, of an apparent suicide. Morton had gone on to study medicine after dentistry, and he had used chloric ether in 1844 and sulfuric ether thereafter for dental procedures. He learned about ether and how to mask its smell from a well-known chemist, Charles Thomas Jackson, and Morton also arranged a public demonstration at Massachusetts General Hospital on October 16, 1846, for resection of a congenital superficial vascular tumor below the left mandible. This seems to be shown on the stamp from India. The next day, a fatty tumor on the shoulder was resected, and a report appeared November 18, 1846, in the Boston Medical and Surgical Journal (later the New England Journal of Medicine). Three days later, Oliver Wendell Holmes, MD, wrote to Morton and proposed the terms "anesthesia" and "anesthetic." Jackson claimed in vain that he deserved the credit for the discovery of anesthesia and died in an insane asylum. Morton, who received most of the credit, spent years quarreling over the patent rights and died in poverty.

The turquoise and brown Transkei stamp honors Sir James Young Simpson (1811–70), son of a Bathgate, Scotland, baker. He was appointed Professor of Midwifery at Edinburgh at the young age of 29 in 1840, and he carried out a systematic search for an ether substitute. He identified the colorless liquid chloroform and used it on November 4, 1847, to great advantage, reporting his experience one week later at the Edinburgh Medico-Surgical Society. This report dramatically transformed the field of Obstetrics. Simpson was responsible for several other innovations in his field, including wire sutures, the uterine sound and long forceps, and he emphasized the value of statistical analyses of operative outcomes. He received many honors, including knighthood, an honorary degree from Oxford, and was appointed physician to Queen Victoria in Scotland.

TWO FAMOUS PHYSICIANS
FROM MEDIEVAL SPAIN

Two of the most famous physicians of the 12th Century, close friends from Moslem Spain, are portrayed on the stamps from Syria and Spain. Avenzoar (Ibn Zuhr, 1113–62) was born in Cordova, spend his career in Seville, and was considered the greatest Moslem clinician of the Western Caliphate ("Famous Wise Man of Seville"). He was an empiricist who challenged the dogmatic teachings of Galen and Avicenna. His medical contributions included descriptions of the tiny itch-mite (probably scabies), making him the first parasitologist since Alexander of Tralles 600 years earlier; serous pericarditis, mediastinal abscess, pharyngeal paralysis, otitis media, and abdominal tumors. He utilized a silver feeding tube in cases of partial esophageal obstruction and delivery of nutrients per rectum (with some success) in complete esophageal obstruction. He, his father, and his friend and student Averroes were all persecuted by the fundamental Moslem rulers of Spain.

Averroes (Ibn Rushd, 1126–98) was also born in Cordova and died in Morocco, where he had become governor after having served as the chief magistrate of Cordova. He was noted more as a philosopher and free-thinker ("Prince of Philosophy") than as a physician.

Averroes’ sole contribution to medicine was to observe that smallpox did not attack the same person twice, suggesting immunity. His life work, however, was to interpret Aristotle, becoming a pantheist and free-thinker and, as a result, the great Moslem heretic of the 12th Century. Like his friend and teacher Avenzoar, he challenged Galen’s teachings and ultimately was persecuted by Moslem fundamentalists. Averroes’ philosophy was influenced by Jewish thought, and his most famous pupil was Maimonides, through whom he influenced subsequent Jewish philosophy.

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