I will be telling you my short little paper on the
History of Anesthesia. I will be telling what some
terms mean that will be used in anesthesia history.
Also I will be telling a some dates from years before
our time on how anesthesia came from and who was
there, and what drugs came out.
First I will be starting out with several definition
of the term anesthesia. The absence of normal
sensitiation, especially to pain, as induced by an
anesthetic substance or by hypnosis or as occurs with
traumatic or pathophysiologic damage to nerve tissue.
Anesthesia induced for medical or surgical purposes
may be topical, local, regional, or general and is
named for the anesthetic agent used, the method of the
procedure followed, or the area or organ anesthetized.
The people who are permitted to give anesthesia to a
patient is an anesthesiologist or a Certified
Registered Nurse Anesthetist (CRNA). (Mosby’s Pocket
Dictionary of Medicine, Nursing, and Allied Health)
There is also two different ways of describing
Anesthesia you could either call it anesthesia or
analgesic.
In the next couple paragraphs I will be going over
ways on how anesthesia would be given to a patient who
will be going under a surgery.
General anesthesia is the most common way that
anesthesia is given to a patient. The absence of
sensation and consciousness as induced by various
anesthetic agents, given by inhalation or intravenous
injection. Most of the time a general anesthesia is
given to the patient through an IV to the patient.
Local anesthesia is another common way of inducing a
patient. The administration of a local anesthetic
agent into tissues to induce the absence of sensation
in a small area of the body. Topical anesthesia is a
surface analgesia produced by application of a topical
anesthetic in the form of a solution, gel, or ointment
to the skin, mucous membrane, or cornea. Regional
anesthesia is an anesthesia of an area of the body by
injecting a local anesthetic to block a group of
sensory nerve fibers. Next one would be a caudal
anesthesia which would an injection of an agent into
the caudal part of the epidural space through the
sacral hiatus to anesthetize sacral and lower lumbar
nerve roots.

An epidural anesthesia is an injection A type of
regional


block in which a local anesthetic is injected into the
epidural space surrounding the dural membrane, which
contains cerebrospinal fluid and spinal nerves. The
last most common way of getting an anesthesia adjant
is inhalation. In halation is a surgical narcosis
achieved by the inhalation of an anesthetic gas or a
vapor.
The word anesthesia comes from a “Every body wants to
have a hand in a great discovery. All I will do is to
give you 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’ (from
the Greek word anaisthesia, ‘lack of sensation’). This
signifies insensibility ... The adjective will be
‘Anaesthetic’. Thus we might say the state of
Anaesthesia, or the anaesthetic state” (The American
Dictionary of English Words).
The best way for me to tell you about how anesthesia
came along I will tell you in a better way. The
history of anesthesia is pretty long. Alcohol, herbs,
hypnosis, acupuncture, and "the bullet" had been
around for centuries before the "discovery" of
anesthesia. Diethyl ether also had been around for a
while before its first documented use for anesthesia
in 1842 by Crawford Long, a rural physician in
Georgia. He removed some small masses in the neck of a



patient after administering ether via a towel. The fee
for this first surgical anesthetic was $2.25,
including the ether, amazingly close to today's rates!
Unfortunately, he didn't get around to reporting his
experience until 1849. By that time the well known
public demonstration by William Morton at MGH had
already taken place already. Psychopharmacology,
study of the relationship between drugs and brain
function, including mood, perceptions, and behavior.
Psychopharmacology is a branch of pharmacology, the
study of the action of drugs on living organisms.
Psychopharmacology is employed in psychiatry,
psychology, neurology, and in medical specialties
concerned with brain function. Throughout history,
almost every culture has sought ways to alter
consciousness by experimenting with plant substances
that yield many of the psychoactive drugs of today.
Important developments in ancient psychopharmacology
include the discovery and use of cannabis and alcohol,
and opium, in Europe and Asia and of caffeine,
nicotine, and cocaine, and hallucinogenic plants such
as peyote and psilocybin in the pre-Columbian
Americas. Developments in the 19th century include the
isolation of the potent analgesic morphine from opium;
the introduction of the anesthetics nitrous oxide,
ether, and choloroform and


the early use of cocaine as a stimulant. The first
sedative hypnotics, the barbiturates, were introduced
in the early 20th century, followed by the discovery
and use of amphetamines as psychostimulants in the
1930s.

An account of the first use of Sulphuric Ether by
Inhalation as an Anaesthetic in Surgical Operations.
By C. W. Long, M.D., of Jefferson, Jackson Co.,
Georgia.
For nearly three years, the various medical journals
have contained numerous articles on the employment of
Sulphuric Ether by Inhalation, for the purpose of
rendering patients insensible to pain during surgical
operations.
The first notice I saw of the use of ether, or rather
of Dr. Morton's "Letheon," as an anaesthetic, was in
the editorial of the Medical Examiner for December,
1846, in which the editor gives the following extract
from a paper by Dr. H. J. Bigelow, contained in the
Boston Journal:--"The preparation (letheon) is inhaled
from a small two-necked glass globe, and smells of
ether, and is, we have little doubt, an ethereal
solution of some narcotic substance."
Having on several occasions used ether, since March,
1842, to prevent pain in surgical operations,
immediately after reading this notice of "letheon," I
commenced a communication to the editor of the Medical
Examiner, for publication in that Journal, to notify
the medical profession that sulphuric ether, when
inhaled, would of itself render surgical operations
painless, and that it had then been used by me for
that purpose for more than four years. I was
interrupted when I had written but a few lines, and
was prevented, by a very laborious country practice,
from resuming my communication, until the Medical
Examiner for January, 1847, was received, which
reached me in a few days after reading the December
number. It contained several articles, giving accounts
of different experiments in etherization, in which
surgical operations were performed without pain. On
reading these articles, I determined to wait a few
months, before publishing an account of my discovery,
and see whether any surgeon would present a clim to
having used ether by inhalation in surgical operations
prior to the time it was used by me.
A controversy soon ensued between Messrs. Jackson,
Morton and Wells, in regard to who was entitled to the
honor of being the discoverer of the anaesthetic
powers of ether, and a considerable time elapsed
before I was able to ascertain the exact period when
their first operations were performed. Ascertaining
this fact, through negligence I have now permitted a
much longer time to elapse than I designed, or than my
professional friends with whom I consulted advised;
but as no account has been published, (so far as I
have been able to ascertain), of the inhalation of
ether being used to prevent pain in surgical
operations as early as March, 1842. My friends think I
would be doing myself injustice, not to notify my
brethren of the medical profession of my priority of
the use of ether by inhalation in surgical practice.
I know that my interests have suffered from not making
an earlier publication, and I would not be persuaded
at this late stage of the ether controversy to present
my claim to being the first to use ether as an
anaesthetic in surgical operations, if I were not
fully satisfied of my ability to establish its
justness.
In the month of December, 1851, or January, 1842, the
subject of the inhalation of nitrous oxide gas was
introduced in a company of young men assembled at
night in this village, (Jefferson) and several persons
present desired me to prepare some for their use. I
informed them that I had no apparatus for preparing or
preserving the gas, but that I had a medicine
(sulphuric ether) which would produce equally
exhilarating effects; that I had inhaled it myself,
and considered it as safe as the nitrous oxide gas.
One of the company stated, that he had inhaled ether
while at school, and was then willing to inhale it.
The company were all anxious to witness its effects.
The ether was introduced: I gave it first to the
gentleman whom had previously inhaled it, then inhaled
it myself, and afterwards gave it to all persons
present. They were so much pleased with the
exhilarating effects of ether, that they afterwards
inhaled it frequently, and induced others to do so,
and its inhalation soon became quite fashionable in
this county, and in fact extended from this place
through several counties in this part of Georgia.
On numerous occasions I have inhaled ether for its
exhilarating properties, and would frequently, at some
short time subsequent to its inhalation, discover
bruised or painful spots on my person, which I had no
recollection of causing, and which I felt satisfied
were received while under the influence of ether. I
noticed, my friends, while etherized, received falls
and blows, which I believed were sufficient to produce
pain on a person not in a state of anaesthesia, and an
questioning them, they uniformly assured me that they
did not feel the least pain from these accidents.
These facts are mentioned, that the reasons may be
apparent why I was induced to make an experiment in
etherization.
The first patient to whom I administered ether in a
surgical operation, was Mr. James M. Venable, who then
resided within two miles of Jefferson, and at present
lives in Cobb county, Georgia. Mr. Venable consulted
me on several occasions in regard to the propriety of
removing two small tumours situated on the back part
of his neck, but would




postpone from time to time having the operations
performed, from dread of pain. At length I mentioned
to him the fact of my receiving bruises while under
the influence of the vapour of ether, without
suffering, and I knew him to be fond of, and
accustomed to inhale ether, I suggested to him the
probability that the operations might be performed
without pain, and proposed operating on him while
under its influence. He consented to have one tumour
removed, and the operation was performed the same
evening. The ether was given to Mr. Venable on a
towel; and when fully under its influence I extirpated
the tumour. It was encysted and about half an inch in
diameter. The patient continued to inhale ether during
the time of the operation; and when informed it was
over, seemed incredulous, until the tumour was shown
him. He gave no evidence of suffering during the
operation, and assured me, after it was over, that he
did not experience the slightest degree of pain from
its performance. This operation was performed on the
30th March, 1842.
The second operation I performed upon a patient
etherized was on the 6th June, 1842, and was on the
same person, for the removal of another small tumour.
This operation required more time than the first, from
the cyst of the tumour having formed adhesions to the
surrounding parts. The patient was insensible to pain
during the operation, until the last attachment of the
cyst was separated, when he exhibited signs of slight
suffering, but asserted, after the operation was over,
that the sensation of pain was so slight as scarcely
to be perceived. In this operation, the inhalation of
ether ceased before the first incision was made: since
that time I have invariably desired patients, when
practicable, to continue its inhalation during the
time of the operation.
Having so long neglected presenting my claim to the
discovery of the anaesthetic powers of ether; for the
purpose of satisfying the minds of all, of its
justness, I have procured, I conceive, a sufficient
number of certificates to establish the claim
indisputably. I present, first, the certificate of
James M. Venable, the patient on whom the first
experiments in etherization were made, and no comments
on it, I conceive, are necessary
(Southern Medical and Surgical Journal Vol. 5).


The First Recorded Anesthesia Case the first
demonstration of ether anesthesia was in the Etherdome
of the Massachusetts General Hospital on October 16th,
1846. The patient, Gilbert Abbott, had a tumor on his
neck. W.T.G. Morton, a dentist who would give the
anesthetic, held a glass of ether up to his face. The
surgeon was Professor John Warren. This the first
demonstration of "Ether" Day painting by Hinckley
which commemorates the first demonstration of ether
anesthesia in the Etherdome of the Massachusetts
General Hospital on October 16th, 1846. The patient,
Gilbert Abbott, has a tumor on his neck and reclines
on a chair in the center of the painting. W.T.G.
Morton, a dentist who would give the anesthetic, holds
the glass ether vaporizer and the surgeon, Professor
John Warren, stands above the patient. When the
surgery was completed Professor Warren turned to the
gallery and, with tears in his eyes, said "Gentleman
this is no humbug." On that day the infant specialty
of anesthesia was born. The first ether anesthetic had
actually been given on March 30th, 1942 by Dr.
Crawford Long a General Practitioner from Jefferson
Jackson County, Georgia but for an unexplained reason
he did not record it.
Before then, what did doctor's use? Surgeon's were
rated for their speed, not precision. Patients were
terrified of surgery or dental work because the doctor
came marching in the operating room with two bottles
of whiskey-one for the patient and one for him-so he
could endure the patients screams. In an estimation,
anesthesia was ready to take on cardiac surgery in
about 1942 for by that time oxygen and ether had been
shown to be a reliable safe anesthetic, the blood
pressure cuff and stethoscope had been used for about
forty years to monitor the safety of patients under
anesthesia and the Cambridge Simplitrol portable ECG
machine, although cumbersome, was being recommended
for perioperative use. The latter had been introduced
by Dr. Wayne Smith, a general practitioner from
Providence, Rhode Island. The endotracheal tube was in
general use, blood banks had been established and Dr.
Harold Griffith had introduced Curare into the
practice of anesthesia which made controlled
ventilation in light anesthesia possible.
Since then, medicine has progressed rapidly. An
estimated 25 million anesthetics are administered each
year in this country. Anesthesiologists and CRNAs
provide or participate in more than 90 percent of
these anesthetics. In the operating room, they are
responsible for the medical management and anesthetic
care of the patient throughout the duration of the
surgery. In the recovery room, while safety is of
course the foremost priority during surgery, it is
also of utmost concern that the patient be monitored
and continually assessed while fully regaining
consciousness. In most cases, the anesthesiologist
decides when the patient has recovered enough to be
sent home following outpatient surgery or has been
stabilized sufficiently to be moved to a regular room
or ward in the medical facility.
Today, anesthesia covers a broad spectrum of medical
treatment. Anesthesiologists specialize in techniques
such as cardiac catheterizations, pediatric, pain
medicine, critical care, trauma medicine and
angioplasty procedures for emergency airway management
or resuscitation if necessary.
Now in the next couple pages I will be telling about
a dateline and give you some years to remember about
how anesthesia came about.
In 1844 nitrous oxide used by Wells to produce dental
anesthesia. 1846 Diethyl ether is used publicly by
Morton to produce surigical anesthesia. 1847
Chloroform popularized for surgical anesthesia in
England. 1854 Hollow metallic needles invented by
Wood. 1856 Chloroform administered by John Snow, MD.
to Queen Vicoria for the birth of Prince Leopold.
Also John, Snow, MD. was the first known
anesthesiologist ever. 1868 Administration of
nitrogen oxygen introduced by Andrews. 1871 cylinders
of nitrogen oxygen introduced by Brothers. 1884
cocaine used by Koller to produce topical anesthesia.
1885 nerve block and infiltration anesthesia by
injection of cocaine introduced by Halsted. In that
same year Corning introduced epidural anesthesia.
1893 Spinal anesthesia introduced by Bier. 1904
Buchanan appointed first professor of anesthesia in
the USA at New York, Medical College. In 1905
Procaine synthesized by Einhorn, and Long Island
Society of Anesthetists founded by Erdmann. Then 6
years later Long Island Society of Anesthetist becomes
the New York society of Anesthetists. 1914 The
American Journal of Anesthesia and Analgesia first
published as a quarterly supplement to the American
Journal of Surgery. 1917 Oxygen mask developed by
Poulton. 1920 Guedel published data on signs of ether
anesthesia. 1922 The Journal, current researchers in
anesthesia and analgesia first published. 1923 Mary
A. Ross, MD. becomes the first postgraduate trainee in
anesthesiology in the USA. 1924 National Anesthesia
Research Society becomes the International Anesthesia
Research Society. 1926 American Journal of Anesthesia
and Analgesia ceases publication. 1927 Waters
appointed as the first university professor of
anesthesia in the United States British Journal of
Anesthesia first published also. 1930 circle
anesthesia breathing and carbon dioxide absorption
system described by Sword. 1932 Association of
Anaethetists of Great Britian and Ireland founded.
1933 Cyclopropane used by Waters to produce surigical
anesthesia. 1934 Thiopental used by Lundy for
induction of anesthesia because the main part was just
inhaled. 1935 Rovenstine organized a department of
anesthesia at Bellevue Hospital in New York. 1936 New
York Society of anesthesia becomes the American
Society of Anesthesia. 1938 American Board of
Anesthesiology is founded. In 1942 Tubocuraine used
by Giffith T. Johnson, and in 1943 Lidocaine was
synthesized by Lofgren. 1947 Succinylcholine used
clinically by Phillips and Fusco. Succinylcholine is
an muscle relaxer.
The 1950’ thru the 1990’s is where anesthesia finally
picks up. 1956 Halothane used clinically by Johnson.
1959 Methoxyflurane used clinically by Artusio and Van
Pozma. 1968 Society of Academic Anesthesia founded.
1972 Enfluran used clinically in the medical field.
1973 the journal of critical care medicine first
published ever in the US. 1975 in training
examination in anesthesiology inated. 1981 Isoflurane
was clinically use in the work field. 1985 The
Anesthesia Patient Safety Foundation was established.
1986 Foundation for Anesthesia Education and Research
established. 1989 Propofol used clinically in the
work field. 1990 Pulse Oximetry added to the
standards for basic monitoring when it comes to an
anesthestized patient. 1992 Desflurane was finally
made that it could be used clinically. Desflurane is
one the anesthesia drugs that must be heated because
it is unsable in room temperature. 1994 Sevoflurane
also was passed to be used in a clinically stable
medical field. 1995 House of Delegates of the ASA
approves Practice Guidelines for Preoperative
Transesphageal Echocardiography. 1996 End trial
carbon dioxide monitoring added to the standards for
basic monitoring. End trial carbon dioxide can also
be used as EtCO2. Also in this year the Bispectral
Index Monitoring System approved for Clinical use.
House of the ASA approves Practice Guidelines for
Office Based Anesthesia. Last thing in this year
Rapacuronium used clinically and it is also always
known as a IV drug.
















Page 13


WORK CITIED

The American Heritage Dictionary of the English
Language, 3rd. Edition. 21 November 1846

Longnecker, David E., Murphy, Frank L. Introduction to
Anesthesia. Copyright 1997

Dorsch, Jerry A., Susan E. Understanding Anesthesia
Equipment Construction, Care, and Complications (3rd.
Edition). Copyright 1993

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