History of Anesthesiology – Anesthesiology Basics

00:00 So how did anesthesia develop? Well, it's all thanks to the dentists. Doctors can't take any credit for it.

00:05 Prior to 1846, there was no known way to provide anesthesia to those undergoing surgery. The whole process of surgery was extraordinarily painful, bloody and dirty. Surgeons were praised for the speed, not skill, and their successful completions of operations. Surgical procedures were really either very superficial, drainage of abscesses, a removal of small skin lesions, or major amputations of limbs, cesarean section, all without any anesthesia.

00:41 The Massachusetts General Hospital, at the time that this whole event occurs, was the busiest surgical site in North America. It provided surgical procedures to an average of five patients a week. After 1846, after 1846 longer, more complex surgical procedures developed and the field of surgery exploded. Now, over a hundred procedures are done at Massachusetts General Hospital a day and new surgical procedures are being developed at a very rapid pace.

01:17 So the first dentist we are going to talk about is Doctor Horace Wells. He's the real father of anesthesiology, although the term's been used on many individuals. Yes, he was a dentist.

01:29 In 1844 he went to a party. It was a nitrous oxide party, where people gathered, enjoyed themselves and breathed nitrous oxide usually out of a big paper bag. And one of the things he noticed, was a woman smashed her leg very hard against the bench and ended up with a large laceration on her leg, which should have been extremely painful. She had no sense of pain whatsoever from it. And from this observation, he then went about using nitrous oxide in his dental practice. He had his own tooth extracted under nitrous oxide anesthesia and had very little discomfort.

02:11 And in 1845 he demonstrated nitrous oxide for surgical anesthesia at the Massachusetts General Hospital. Unfortunately, as you're going to learn in this course, nitrous oxide is not a strong anesthetic, and it was a dismal failure. And he was shamed before all the physicians in Massachusetts and the dentists. Nitrous oxide provides good analgesic, good pain control, but cannot provide full anesthesia.

02:41 So the patient cried out during the surgery, Wells was humiliated and he ultimately committed suicide. This was a typical advertisement in those days for a laughing gas party, nitrous oxide party. So you can see: laugh, sing, dance, speak or fight.

02:59 All those wonderful things you could do with nitrous oxide on board. So the next dentist to come along was Doctor William Morton, also in Massachusetts. He'd actually been pre-dated by Doctor Crawford Long in Great Britain, who did do surgery under ether anesthesia, but didn't bother publishing his results. So the first described and known event in general anesthesia occurred on October 16 1845. Doctor Morton provided anesthesia to a young man having a tumor removed from his neck under ether anesthesia. And the chief surgeon turned to the crowd in the room and said, in the very pompous way of that Victorian era: "Gentlemen, this is no humbug!" and Morton's name was made. Morton was a bit of a scamp unfortunately, and he tried to make more out of this than he was able to, by coloring ether orange and then tried to patent it as orange ether claiming it was superior to regular ether, that had actually been around as a solvent and cleaning agent for centuries.