Ohio History Journal

THE INTRODUCTION OF ANESTHESIA INTO OHIO

 

By HOWARD DITTRICK, M.D.

 

Since the practical application of anesthesia for the relief of

dental and surgical pain originated in the United States, it is not

strange that early Ohio practitioners followed closely along the

trails blazed by colleagues in the Eastern States and in foreign

centers of science.

Even the name anesthesia was coined by our own Dr. Oliver

Wendell Holmes directly following William Thomas Green Mor-

ton's historic demonstration in the Massachusetts General Hos-

pital on October 16, 1846. He grasped the significance of anes-

thesia, saying that it would be on the lips of every person of all

races who in time to come would dwell on this planet.

Previous experiment abroad had covered a considerable

period of time without practical application of the resulting knowl-

edge. Joseph Priestley, discoverer of oxygen, prepared the first

anesthetic to be later generally accepted. In 1776, he prepared

nitrous oxide, but his laboratory accomplishment remained merely

another experiment. In America, Horace Wells's demonstration

in 1844 failed through use of faulty apparatus.

Shortly before this, in 1842, ether had been used by Dr. Craw-

ford Long as a surgical anesthetic, but his experimental work was

not publicized until three years after Morton's successful dem-

onstration in Boston.

Upon the heels of the American introduction, Sir James

Simpson of Edinburgh did pioneer work in persuading the public

to accept the benefits of anesthesia, and experimented with a

variety of agents. His struggle against the prejudice of both

physicians and patients, who objected on religious grounds to any

mitigation of the pain of childbirth, needs no rehearsal. Not quite

so well known is the story that Sir Walter Scott devised an

escutcheon for Simpson which was designed around a new born

babe, and had for a motto "Does your mother know you're out?"

(338)

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OHIO MEDICAL HISTORY, 1835-1858                339

 

Returning to the use of anesthesia in early Ohio, reports in

our State medical journals of the period show that physicians were

following with hopeful caution the experiments and practices of the

rest of the United States and also those of Europe as they ap-

peared in digest form in our publications. That the adoption of

anesthesia was quick and wide-spread is evidenced by an editorial

in the Western Lancet (later Lancet-Clinic. Cincinnati, 1842-

1916. Vol. VI, 1847, p.53) stating that "the inhalation of sul-

phuric ether for the purpose of securing its letheon effects during

surgical operations, has rapidly extended throughout Europe and

America. . . . It is employed at this time not only in every city

and village in the United States, but it has likewise been intro-

duced into the principal cities of Europe." All this took place

within the year after the Morton demonstration, and the use far

and wide is the more remarkable because of the slow rate of all

communication at that time.

But Ohio, like the other states, really began its experiments

with anesthesia by means of the amusing sessions of "laughing

gas" inhalation in public exhibitions. The Warren (Ohio) Western

Reserve Chronicle of August 10, 1821 (see History of Trumbull

and Mahoning Counties. Cleveland, 1882. Vol. I, p.618) notes

the characteristic early use of gas in Warren, Ohio, in what later

came to be known as "ether frolics."

Dr. Brooks proposes to administer 10 to 15 doses of the protoxide of

azote, or the exhilarating gas, in the Warren Hotel on Tuesday next at

3:00 o'clock p. m. The sensations produced by this gas are highly pleas-

urable and resemble those in some degree attendant on the pleasant period

of intoxication. Great exhilaration, an irresistible propensity to laugh, dance

and sing, a rapid flow of vivid ideas, an unusual fitness for muscular

exertion, are the ordinary feelings it produces. These pleasant sensations

are not succeeded by any debilitating effects upon the system. A more full

account of this gas will be given on the evening of the exhibition. Tickets

of admission may be had at the printing office.

It will be recalled that, in 1844, in Hartford, Conn., C. Q.

Colton in a lecture on popular science apparently hypnotized cer-

tain members of his audience by means of gesticulations. Mean-

while an associate engulfed the candidate in nitrous oxide to make

Colton's hypnotism effectual. Horace Wells, one of the audience,

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340   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

saw one of these individuals fall, hit his head and exhibit no sen-

sation of pain. During this demonstration he envisioned painless

dentistry and had a tooth of his own extracted next day under

"laughing gas." And in Ohio, in 1846, we find Horace Ackley

experimenting in Cleveland with operation under "magnetic

sleep." In the class notes of Abner Webb, student at Western

Reserve Medical College (MS. in Museum of Allen Memorial

Library, Cleveland), the following incident is reported:

On Nov. 25, 1844, Prof. Ackley in removing a tumor of an encysted

form, the result of a cancerous sore on the labium, which formed on the

under side of the inferior maxillary bone. This was cut out by dissecting

up the skin upon each side of the tumor and separating the skin from the

same; and by cutting down on each side of the tumor, and when he came

in contact with an artery, tied the same, and so went on till all the tumor

was dissected out. This was performed while the man was in a magnetic

sleep, so supposed.

Some incredulity must have been shown, for we read later in

the same notes--"On December 5, 1844, in Dr. Ackley's lecture, a

letter was read by Mr. Shreeve in respect of he being magnetized,

stating that it was true in his operation."

Was this an early use of the electro-magnetic current? The

only reference that we have found in local journals was this notice

three years later in Western Lancet, Vol. VI, 1847, p.258: It is

an abstract from the Dublin Medical Press (Dublin, 1839-59), and

it reads, "Our inventive neighbors, the French, have contrived a

new plan of procuring insensibility. M. Ducross . . . has commu-

nicated the results of his experiments in several letters to the

Academy of Sciences. The agent employed is the electro-magnetic

current. Individuals who have been subjected to the current have

been quite insensible to pricking or pinching at all parts of the

body, and teeth have been extracted without their knowledge."

Or was it a sort of hypnotism? That came out later in for-

eign literature and was noted in the Ohio Medical and Surgical

Journal (Columbus, 1848-78), Vol. XII, March, 1860, p.300, as

a late use of a principle written about (ca. 1842) by a Scotch sur-

geon named James Braid, whose book on the subject was entitled

Neurypnology; or, The Rationale of Nervous Sleep, Considered

in Relation to Animal Magnetism (London, 1843).

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OHIO MEDICAL HISTORY, 1835-1858            341

 

There is no evidence, so far as the author knows, that Ackley

or any other Ohio surgeon used magnetic sleep later as a con-

sequence of this experiment.

According to the History of Trumbull and Mahoning Coun-

ties (Vol. 1, p.290) Dr. Daniel B. Woods (b. 1816, graduated in

1840 from   Ohio Medical College, Cincinnati) who practised in

Warren from 1840,

was one of the first doctors in the West to use ether in surgical operations.

He used chloroform before it was manufactured for commerce or sold any-

where in the country. This was about ten years after its discovery by

Leibig in Germany. From the formula by Prof. Simpson of Edinburgh,

Dr. Woods, assisted by Daniel Jagger, a druggist in Warren, the first

chloroform used--at least in Northern Ohio--was made and administered

to a patient in October 1846.*  The experiment was repeated the spring

following. A few years later this valuable anesthetic came into general use

in this country.

By 1847, the wide-spread use of sulphuric ether made possible

a lengthy analysis of its benefits and its detriments as they had

been reported in the literature both here and abroad.       In the

Western Lancet (Vol. VI, p.53ff.) after enumerating its exten-

sive surgical use with satisfactory results, and noting that "crimi-

nals are now pleading for the somnific influence of ether to alle-

viate the terrors and pain of the guillotine and the halter," the

editor adds a detailed statement of caution in its use.    "In the

meantime the more cautious and prudent have looked with some

degree of apprehension to the results, but thus far no serious

accident has been reported; and when we contemplate the thou-

sands of instances in which the agent has been employed, and that,

too, in many cases by dentists and others who can claim but a very

limited acquaintance with physiological and pathological laws, it

must be confessed that the results are truly astonishing." Ad-

vising caution in its use, admitting some disasters may occur,

some secondary results become manifest, the editor yet believes

it should be used in surgery in spite of the few     fatalities that

may accrue.    He poses the question "whether the immediate

effects and the secondary consequences of the inhalation of ether

 

* The statement of the date involved is inaccurate. County histories are often

open to criticism regarding scientific data.

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342    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

may not be more prejudicial than the effects of pain during a

surgical operation.

The editor continues:

There is this difference in the two cases, the effects of pain are me-

chanical, and are confined to a depressing influence on the nervous system--

a shock; while in the other case, the ether produces a morbid or poisonous

influence, and probably more or less chemical action. And in tracing out the

same question, the idea very naturally occurs, whether the simple depression

of the nervous function consequent upon the pain of a surgical operation,

could be more directly and certainly remedied than the effects of a poison.

The one requires . . . nothing more than stimulants to sustain the system;

while the poisonous and chemical effects of the other would require we

know not what, and would probably receive nothing. It should be borne

in mind, that the object in employing ether is not merely to avoid the

temporary pain incident to a severe surgical operation; but it is rather to

obviate the secondary results--the shock which follows extensive and painful

operations. If, therefore, it should finally be ascertained that recoveries

were more tedious, or less certain, when ether had been inhaled, its continued

use would not be justified upon the less important consideration of allay-

ing pain.

The whole subject, it appears to us, is open for investigation; and

until something more definite is known, the questions to which we have

referred must remain, at least, as plausible objections.

The editorial concludes that only statistical observations by

those in extensive surgical practice will establish the truth con-

cerning the further use of anesthesia, whether it does in fact re-

lieve suffering humanity or contribute to augment mortality.

In the review section of the Western Lancet (Vol. VI, p.181)

some discussion found place concerning a pamphlet by Edward

Warren(₃d ed. Boston, 1847), entitled Some Account of the

Letheon; or, Who Is the Discoverer? It is worth noting that

this pamphlet including and discussing the Morton work on an-

esthesia only the previous year, was in its revised and enlarged

third edition a year later. Public interest must have been acute.

The editorial is here quoted.

Very extensive experience has now been obtained of the action of this

new agent; and its influence in the prevention of pain, when properly admin-

istered, is fully established. The failures which at first occurred in its

application seem to have been caused by the use of impure, unwashed ether,

or of an imperfect inhalating apparatus.

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OHIO MEDICAL HISTORY, 1835-1858                  343

 

It is asserted, in the present pamphlet, that "Dr. Morton himself, and

by his immediate agents has administered the ether to more than ten thou-

sand patients without a solitary accident." On the contrary, if we are to

believe the journals, other experimenters have not been so fortunate; and

among the great number of cases in which this agent has been used suc-

cessfully, for the prevention of pain in surgical operations, some have been

reported in which the patient never rallied again, but sunk, apparently under

the too powerful influence of ether, superadded to the shock of the opera-

tion. These unfortunate cases, however, have been remarkably few, in

comparison with the immense number of experiments which have been

made with it in all parts of the civilized world, by persons who had to feel

their way in its application, with inhalers of all descriptions, ether of

various degrees of purity, and on subjects of almost every idiosyncrasy.

They are, however, sufficiently numerous to inculcate great care in the use

of ether and to forbid its employment in every instance where the pro-

duction of insensibility to pain is not of paramount importance.

It is evident, therefore, that while it may be a great boon to suffering

humanity in proper hands, common prudence requires that its use should be

restricted to those who are competent to watch its effects and employ it

with all the possible precautions to prevent injury and death. . . .

Another fact, of interest to those who may wish to employ ether in-

halations, is that the various forms of inhaling apparatus, at first supposed

to be essential to the experiment, are now superseded by the simple sponge

soaked with ether held just above the nostrils of the patient. It is stated

in Mr. Warren's pamphlet, "that no sort of 'apparatus' whatever has been

used in Dr. Morton's office for the last three months, he having adopted

the use of the sponge altogether."

Foremost among Ohio surgeons who reported work with an-

esthesia was Dr. R. D. Mussey, professor of surgery in the Ohio

Medical College in Cincinnati. In a report upon ether and chloro-

form  in the Ohio Medical and Surgical Journal (Vol. I, Sept.,

1848, p.86) his findings reflect the degree of incredulity with

which announcement of the wonderful effects of inhalation of

ether was received.     He stated, "Its employment was entered

upon with hesitation, and prosecuted with vigilance and care ....

It was only by cautiously feeling our way that some of us have

been established in the belief of its utility." "I have employed

etherization in the amputation of all the members belonging to

the human body, in operations for phimosis, in various applica-

tions of the actual cautery, in the excision of tumors, in lithotomy,

and in the reduction of dislocations."

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344   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

"In the great majority of the cases the sensibility was dimin-

ished; and in many of them it was suspended. And in a small

proportion of them, the sensibility, if not exalted, was evidently

not less than natural, while the patients were rendered less con-

trollable than ordinary, by the influence of ether. In most in-

stances no unpleasant effects followed the etherization. This could

not be said of two amputations of the thigh." These operations

he reported in detail. Evidently the patients were insensible to

pain during operation and for a subsequent half hour, after which

pain in the stump was acute from twenty-four to thirty-six hours.

In two cases of lithotomy pain was little diminished. In a case

of dislocated hip, ether inhalation resulted in sound sleep, and

relaxation was complete after a few minutes.

Reporting on chloroform, Mussey said he had used it in 38

surgical operations without any unpleasant sequel in a single

instance. He enumerated operations for removal of tumors, in

hydrocele, stricture of the rectum, fistula in ano, fistula in perineo,

strangulated hernia, in application of the actual cautery to cancer,

the same to vesicovaginal fistula, in castration and operations for

phimosis, in amputations of the larger limbs, the fingers and toes,

removing the toe nail, in plastic operations, and in lithotomy.

"In some of the fore-mentioned operations the pain is horribly

severe without some influence to diminish or suspend the sensi-

bility." Summing up his experience Mussey reported, "On the

whole I regard the inhalation of chloroform for surgical opera-

tions, administered with due precaution, as essentially safe; and

I look upon it as a boon of inestimable value, presented by chem-

istry to our profession under the guidance of a kind Providence."

The Editor's Table and Miscellany in the Ohio Medical and

Surgical Journal, Vol. I, Nov. 1848, p.201, sounds a warning

against the indiscriminate use of anesthetic agents, saying the

foreign journals especially were giving prominence to various

experiments with and accidents from chloroform and other an-

esthetic agents.

There is a reaction going on against the use of these agents which,

we are confident, will be productive of good. It cannot be that articles so

powerful can be used on every trivial occasion, and without discrimination,

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OHIO MEDICAL HISTORY, 1835-1858                   345

 

without occasionally producing the most disastrous results. . . . We have

been, for some time, among those who believe that neither ether nor chloro-

form should be used, unless in cases involving an operation or condition

which may endanger life, and then with great caution. This, we opine, will

ere long be the almost universal belief and practice of the profession. It

may be that we are too fearful; we hope we are. If used only in the

limited number of cases included in the above restriction, their discovery

must still be regarded as one of the greatest and happiest events of modern

times.

The editor then noted experiments abroad by Simpson, Nunnely

and Dr. Neil Arnott to induce local anesthesia by local application

of chloroform or frigorific mixture of ice and salt, and added,

"We shall endeavor to keep up with the progress of medical

opinion on this subject."

In neighboring Kentucky, whence came the inspiration of

many doctors in southern Ohio, the Western Journal of Medicine

and Surgery (Louisville, Ky., 1840-55. Vol. XVIII, no. 5, Nov.,

1848) reported upon the introductory lecture to the medical class

of Louisville by Prof. L. P. Yandell, M. D., professor of chemistry

and pharmacy. It sums up the quick acceptance and wide-spread

adoption of the Boston demonstration by Morton.

In a few weeks after it was published in Boston, the letheon was tried

in London, Paris and Edinburgh, and the results of the practice by the

surgeons and physicians of those cities we had here in Louisville long before

the winter has passed away--results that read more like tales of fiction

than sober scientific realities. Patients have limbs amputated, and dislocated

limbs reduced; tumors, teeth, and the sensitive eye are exsected; the hot

iron is applied to the tender skin; in a word, all the procedures of surgery

which have been most dreaded by men, are now executed upon their persons

while they are asleep and lapped in pleasant dreams!

But this agent, wonderful as were the effects produced by it, was not

wholly unobjectionable. The sulphuric ether is unpleasant to inhale, and

leaves a persistent odor offensive to many; a long time is occasionally nec-

essary to bring the subject under its influence, and in some, its inhalation is

followed by headache. On account of these disagreeable qualities, it ap-

peared to practitioners desirable to find, if possible, some better anesthetic;

and since the last Introductory [lecture] was delivered in this room, Prof.

Simpson of Edinburgh has announced the discovery of a substitute more

pleasant, more efficient and only not quite so free from danger.

The discovery of anesthetics constitutes an era in our profession, for

their application, far from being limited to surgery, has already been ex-

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346    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

tended to all the healing arts, and we can only now regard them as just

fairly introduced. They have been applied with singular industry, and our

experience respecting them, considering that they have been in use less

than two years, is very great; but no one can esteem the practice as other-

wise than in its, infancy, and it would be idle to predict what it will grow to.

Chloroform, the substitute introduced by Prof. Simpson is a more

potent article, although a great majority of persons may inspire it long

enough to become intoxicated, without any unpleasant consequences. Of the

tens of thousands who have breathed it, only one, here and there, is reported

to have suffered from the practice. The wonder is, that an agent which

kills frogs, fish, newts, snails, and other small animals with the rapidity of

the hydrocyanic acid, should have been used indiscriminately by such num-

bers with impunity--not that a patient now, and another again, should have

died under its influence. It is a thing to excite our admiration, that a

vapor so deadly may be inhaled with safety by all but one in a million--

that, while anyone would be killed by it if it were pushed far enough, per-

haps every one may take it with safety to a limited, and for all practical

purposes, a sufficient extent.

A neighbor city, Cincinnati, early in the history of chloroform, fur-

nished an illustration of its fatal power. A woman, (Mrs. Simmons) died

last winter at a dentist's office under its influence. Other fatal cases are

already on record; but in the history of almost every case there is evidence

that the agent was improperly applied. Mrs. Simmons breathed the vapor

from an instrument which did not admit of a due admixture of atmospheric

air; she breathed it in a sitting posture, and made from twelve to fifteen

inspirations. Under the circumstances, this brought on syncope, which ended

in death. These cases will impress a salutary caution upon our profession,

all too prone, perhaps, to be led away by novelties; but experience has fully

demonstrated the fact that patients may be kept for a long time without

injury under the requisite influence of this powerful anesthetic, and that

they may employ it to an extent short of inducing insensibility, and short

of danger, but still with the effect of blunting sensibility to pain [analgesia].

Yandell suggests that chloroform might be employed as a

local anesthetic and also to relieve cramps in malignant cholera.

"May it not be administered," he says, "in such a way as to allay

the spasms, while other remedies are directed to the relief of the

disease, and at least prove, if nothing more, a euthanasial means

in cases where nothing avails to cure?"

Yandell reported a year later in the same journal (Western

Journal of Medicine and Surgery. Vol. XIX, no. 1, Jan., 1849,

p.33) "Up to the first of April, 1848, sixteen operations had been

performed on patients who had inhaled ether or chloroform with-

out a single fatality."

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OHIO MEDICAL HISTORY, 1835-1858            347

 

Dr. E. C. Bidwell of Keene, Ohio, reported in detail his ex-

perience with the use of chloroform in labor in September, 1849

(Ohio Medical and Surgical Journal. Vol. II, 1850, p.203). At

a stage when instrumental aid was indicated, and no forceps were

available, he administered "the unusual quantity, near half an

ounce" of chloroform, with inhalation at intervals to keep up

anesthesia. After one and a half hours a large living child was

delivered, and the patient was found to have been suffering from

hour-glass contraction of the uterus. A previous child of the

patient could not be delivered following twenty-four hours of

labor, and had been subjected to cephalotomy. He concluded: "The

action of chloroform in this case, gives it, and me, a new value

in obstetrical practice, raises it in my estimation to a higher rank

than that of a mere assuager of pain, to that of an actual pro-

moter of the process. I know of no other means, at the same

time so pleasant and harmless, from which to expect, in the acci-

dent in question, such prompt and efficient assistance."

In the Ohio Medical and Surgical Journal (Vol. II, Sept.,

1849, p.77) an editorial review of Simpson's book, Anesthesia; or,

the Employment of Chloroform and Ether in Surgery, Midwifery,

etc. (Philadelphia, 1849), treated with amazed scorn the author's

use of twenty pages of the text to refute religious objections ad-

vanced against the employment of any means for the relief or

abrogation of the pains and perils of childbirth. The editor re-

gretted inclusion of these chapters and adds, "If anesthesia prove

so great a blessing to the human family as he predicts, we appre-

hend Dr. Simpson himself may see the day when his arguments

for the overthrow of his religious (?) antagonists will be looked

on as literary curiosities, equally ridiculous and out of place with

the religious objections themselves urged with so much vehemence

against employment of vaccination."

L. M. Whiting, M. D., of Canton, Ohio, in the Ohio Medical

and Surgical Journal (Vol. I, March, 1849) reported the use of

chloroform anesthesia as a last resort to control a case of delirium

tremens, not controlled by fifty grains of opium and a large quan-

tity of strong camphor, julep and Hoffman's anodyne in the pre-

ceding eight hours. During the next nine or ten hours the patient

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348   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

had been given digitalis, antimony tartrate and morphine sulphate,

with no improvement. "One or two inhalations of chloroform

from a well charged sponge elicited only a few hearty curses and

resulted in increased excitement, but presently he sank into a

sound sleep lasting four hours, from which he awoke rational."

The patient alternated between sleeping, awakening and eating for

forty-eight hours, after which he went about his business com-

plaining only of a heavy feeling about the head. Whiting asserted

he would not permit another case of the kind to proceed to such

extremity without a trial of this powerful agent.

Mussey reported (Ohio Medical and Surgical Journal. Vol.

II, March, 1851, p.353) refracture of a young woman's leg under

chloroform. "Miss K., having been placed under the influence of

chloroform, was wholly unconscious of pain during the operation,

and occupied herself all the while in singing sacred songs and

holding celestrial conversation . . . finding herself coming to earth

again (while bandage and splint were being applied) she en-

treated most earnestly for more chloroform, to prolong ecstatic

illusion." Incidentally there was an excellent result following this

operation.

Mussey's experience is further noted in a discussion of an-

esthesia appearing in the Ohio Medical and Surgical Journal

(Vol. IV, July, 1852, p.481). The discussion took place in a

Philadelphia meeting.  Dr. Bell said that Mussey, his former

colleague in the Ohio Medical College and Commercial Hospital

of Cincinnati, "uniformly made use of a mixture of ether and

chloroform for the subjects on whom he operated, and without,

it is believed, in any case sinister results."

Again, in an editorial reviewing Mussey's introductory lecture

(Ohio Medical and Surgical Journal. Vol. IV, July, 1852, p.534)

he was quoted as having called the anesthetic agent "a priceless

boon, recently handed down to us by a kind Providence to dis-

arm surgery of its terrors. . . . In my practice," he continues,

"ether and chloroform have been used without injury in over six

hundred operations." On the preceding page of the same volume

is expressed the belief that, "in dislocations, anesthetic agents will

probably take the place of copious bleedings, nauseating doses, and

the extreme warm bath."

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OHIO MEDICAL HISTORY, 1835-1858            349

 

On June 14, 1852, Dr. Alexander Dunlap, of Ripley, Ohio,

assisted in an operation to remove a multilocular cyst (Western

Journal of Medicine and Surgery. Vol. XXVIII, no. 3, Sept.,

1853, p.¹⁸⁶). The patient was subjected to the influence of chloro-

form, not sufficient to induce profound sleep, but to annul pain.

You will note that there is nothing new about analgesia except the

name. The pulse in this patient did not vary ten to the minute

from the commencement of the operation till six hours after it

was completed. "The patient had a quick recovery without a

single unpleasant symptom. The operation required twenty-four

minutes. Six weeks afterward the young lady who had been for

twelve years burdened with the tumor was riding about returning

calls."

In the July issue of the same journal a short editorial, on

chloroform and Queen Victoria, states that the Lancet denied that

chloroform was used to assuage the pain of childbirth. "On in-

quiry we were not at all surprised to learn that on her late con-

finement the Queen was not rendered insensible by chloroform or

any other anesthetic agent." Their information had been erro-

neous, needless to say. But the editor marveled at its successful

use in obstetrics. "Why, in all the multiplied instances of its

administration to parturient females, in natural as well as in diffi-

cult labor, not one casualty has occurred, while so many patients

have died in the dentist's chair or on the surgeon's table, may be

impossible to explain, but it is certainly a curious and interesting

fact."

Dr. M. B. Wright, professor of obstetrics and of diseases

of women and children in the Medical College of Ohio, analyzed

briefly the advantages of letheon and chloroform in obstetrical

practice (Western Lancet. Vol. VIII, 1855, p.84). He referred

to the argument publicly expressed that if mothers suffered no

pain they would have no strong affection for the child, a sub-

version of the curse, "In sorrow shalt thou bring forth children."

He reported several cases and his use of long forceps, as well as

use of letheon. "The child belched letheon," but he praised its

advantages nevertheless.

Following an announcement of the use of a new anesthetic

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350    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

agent, vapor of amylene, by John Snow (Ohio Medical and Surgi-

cal Journal. Vol. IX, March, 1857, p.332), editorial comment is

made to this effect:

In regard to all our anesthetic agents, as a journalist, we have said

but little calculated to encourage general use. That they have a place in

practice there is no question. This, however, involves such a nice, such a

thorough investigation of all the circumstances, peculiarities, etc., connected

with the case in which their powers are about to be invoked, that we think

them safe in the hands of but very few. Better suffer a little pain, than

not to be perfectly satisfied that there is no possible thing or circumstance

present which might not only render the agent injurious, but convert it

into a cause of fatality.

When the Committee on Surgery reported to the Ohio State

Medical Society at its session at Sandusky in June, 1857, through

its chairman, John Dawson, M. D. (Ohio Medical and Surgical

Journal. Vol. IX, March, 1857, p.126), a comprehensive analysis

was made of the current opinions of surgeons on anesthesia.

The use of anesthetics in surgery, although instituted for a different

purpose at first, has lately been suggested as having an influence over oper-

ation mortality. Simpson has put himself to the trouble to collect statistics

on amputations of the thigh, with and without the use of anesthetics. He

comes to the conclusion that the use of such agents in this operation, saves

about eleven per cent. We have no comments to make on this conclusion.

It comes from an ardent and able advocate of anesthetics whose limit to

their application is almost undefined. Preserving a patient from pain while

an operation is going on, may rob the procedure of some of its dangers, as

well as of its terrors. The pain occasioned by operations exhausts in

several ways; and simply the removal of this, saying nothing about the

increased facilities afforded to the surgeon by the passive state of the

patient, may increase the chances of recovery.

Since the period under discussion, 1835-1858, anesthesia has

gone a long way in adaptation of new anesthetic agents to pur-

pose desired and to conditions to be combated. We have not yet

attained, nevertheless, the goal set forth in the vision in Revela-

tions, "there shall be no more death, neither sorrow nor crying--

neither shall there be any more pain."

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