Part 23

Baron Larrey, noticing the benumbing effect of cold upon wounded soldiers, suggested its introduction for anesthetic purposes, and Arnott, of London, systematized the practice, by recommending a freezing mixture of ice and salt to be laid directly upon the part to be cut. Other surgeons were accustomed to put their patients into a condition of either alcoholic intoxication or alcoholic stupor. Long-continued compression of a part was also practised by some, by which a limb could, as we say, be made to "go to sleep." A few others recommended to produce faintness by excessive bleeding. It was in 1776 that the arch-fraud Mesmer entered Paris and began to initiate people into the mysteries of what he called _animal magnetism_, which was soon named mesmerism, after him. Thoroughly degenerate and disreputable as he was, he nevertheless taught people some new truths, which many of them learned to their sorrow, while in the hospitals of France and England severe operations were performed upon patients thrown into a mesmeric trance, and without suffering upon their part. That a scientific study of the mesmeric phenomena has occupied the attention of eminent men in recent years, and that hypnotism is now recognized as an agent often capable of producing insensibility to pain is simply true, as these facts have been turned to the real benefit of man by scientific students rather than by quacks and charlatans.

In 1799, Sir Humphrey Davey, being at that time an assistant in the private hospital of Dr. Beddoes, which was established for treatment of disease by inhalation of gases, and which he called The Pneumatic Institute, began experimenting with nitrous oxide gas, and noticed its exhilarating and intoxicating effects; also the relief from pain which it afforded in headache and toothache. As the results of his reports, a knowledge of its properties was diffused all over the world, and it was utilized both for amusement and exhibition purposes. Davey even wrote as follows of this gas:

As nitrous oxide, in its extensive operation, appears capable of destroying physical pain, it may probably be used with advantage during surgical operations in which no great effusion of blood takes place.

It is not at all unlikely that Colton and Wells, to be soon referred to, derived encouragement, if not incentive, from these statements of Davey. Nevertheless, Velpeau, perhaps the greatest French surgeon of his day, wrote in 1839, that "to escape pain in surgical operations is a chimera which we are not permitted to look for in our day."

Sulphuric ether, as a chemical compound, was known from the XIII Century, for reference was made to it by Raymond Lully. It was first spoken of by the name of ether by Godfrey, in the Transactions of the London Royal Society, in 1730, while Isaac Newton spoke of it as the ethereal spirits of wine. During all of the previous century it was known as a drug, and allusion to its inhalation was made in 1795 in a pamphlet, probably by Pearson. Beddoes, in 1796, stated that "it gives almost immediate relief, both to the oppression and pain in the chest, in cases of pectoral catarrh." In 1815, Nysten spoke of inhalation of ether as being common treatment for mitigating pain in colic, and in 1816 he described an inhaler for its use. As early as 1812 it was often inhaled for experiment or amusement, and so-called "ether frolics" were common in various parts of the country. This was true, particularly for our purpose, of the students of Cambridge, and of the common people in Georgia in the vicinity of Long's home. It probably is for this reason that a host of claimants for the honor of the discovery appeared so soon as the true anesthetic properties of the drug were demonstrated.

There probably is every reason to think that, either by accident or design, a condition of greater or less insensibility to pain had been produced between 1820 and 1846, by a number of different people, educated and ignorant, but that no one had the originality or the hardihood to push these investigations to the point of determining the real usefulness of ether. This was partly from ignorance, partly from fear, and partly because of the generally accepted impossibility of producing safe insensibility to pain. So, while independent claims sprang up from various sources, made by aspirants for honors in this direction, it is undoubtedly as properly due to Morton to credit him with the introduction of this agent as an anesthetic as to credit Columbus with the discovery of the New World, in spite of certain evidences that some portions of the American continent had been touched upon by adventurous voyagers before Columbus ever saw it.

The noun "anesthesia" and the adjective "anesthetic" were suggestions of Dr. Oliver Wendell Holmes, who early proposed their use to Dr. Morton in a letter which is still preserved. He suggests them with becoming modesty, advises Dr. Morton to consult others before adopting them, but, nevertheless, states that he thinks them apt for that purpose. The word anesthesia, therefore, is just about of the same age as the condition itself, and it, too, deserves commemoration upon this occasion.

As one reads the history of anesthesia, which has been written up by a number of different authors, each, for the main part, having some particular object in view, or some particular friend whose claims he wishes especially to advocate, he may find mentioned at least a dozen different names of men who are supposed to have had more or less to do with this eventful discovery. But, for all practical purposes, one may reduce the list of claimants for the honor to four men, each of whose claims I propose to briefly discuss. These men were Long, Wells, Jackson and Morton. Of these four, two were dentists and two practising physicians, to whom fate seems to have been unkind, as it often is, since three of them at least died a violent or distressing death, while the fourth lived to a ripe old age, harassed at almost every turn by those who sought to decry his reputation or injure his fortunes.

Crawford W. Long was born in Danielsville, Ga., in 1816. In 1839 he graduated from the Medical Department of the University of Pennsylvania. In the part of the country where Long settled it was a quite common occurrence to have what were known as "ether frolics" at social gatherings, ether being administered to various persons to the point of exhilaration, which in some instances was practically uncontrollable. Long's friends claim that he had often noticed that when the ether effect was pushed to this extent the subjects of the frolic became oblivious to minor injuries, and that these facts, often noticed, suggested to his mind the use of ether in surgical operations. There is good evidence to show that Long first administered ether for this purpose on the 30th of March, 1842, and that on June 6th he repeated this performance upon the same patient; that in July he amputated a toe for a negro boy, but that the fourth operation was not performed until September of 1843. In 1844 a young man, named Wilhite, who had helped to put a colored boy to sleep at an ether frolic in 1839, became a student of Dr. Long's, to whom Long related his previous experiences. Long had never heard of Wilhite's episode, but had only one opportunity, in 1845, to try it, again upon a negro boy. Long lived at such a distance from railroad communication (130 miles) as to have few advantages, either of practice, observation or access to literature. Long made no public mention of his use of ether until 1849, when he published An Account of the First Use of Sulphuric Ether by Inhalation as an Anesthetic in Surgical Operations, stating that he first read of Morton's experiments in an editorial in the _Medical Examiner_ of December, 1846, and again later; on reading which articles he determined to wait before publishing any account of his own discovery, to see whether anyone else would present a prior claim. No special attention was paid to Long's article, as it seemed that he merely desired to place himself on record. There is little, probably no reasonable doubt as to Long's priority in the use of ether as an anesthetic, although it is very doubtful if he carried it, at least at first, to its full extent. Nevertheless Long was an isolated observer, working entirely by himself, having certainly no opportunity and apparently little ambition to announce his discovery, and having no share in the events by which the value of ether was made known to the world. Long's strongest advocate was the late Dr. Marion Sims, who made a strong plea for his friend, and yet was not able to successfully establish anything more than has just been stated. As Dr. Morton's son, Dr. W. J. Morton, of New York, says, when writing of his father's claim: "Men used steam to propel boats before Fuller; electricity to convey messages before Morse; vaccine virus to avert smallpox before Jenner; and ether to annul pain before Morton."

But these men are not generally credited with their introduction by the world at large and, he argues, neither should Long or the other contestants be given the credit due Morton himself. In fact, Long writes of his own work that the result of his second experiment was such as to make him conclude that ether would only be applicable in cases where its effects could be kept up by constant use; in other words, that the anesthetic state was of such short duration that it was to him most unsatisfactory. Sir James Paget has summed up the relative claims of our four contestants in an article entitled Escape from Pain, published in the _Nineteenth Century_ for December, 1879. He says:

"While Long waited, and Wells turned back, and Jackson was thinking, and those to whom they had talked were neither acting nor thinking, Morton, the practical man, went to work and worked resolutely. He gave ether successfully in severe surgical operations; he loudly proclaimed his deeds and he compelled mankind to hear him."

Horace Wells was born in Hartford, Vt., in 1815. In 1834 he began to study dentistry in Boston, and after completing his studies began to practise in Hartford, Ct. He was a man of no small ingenuity, and devised many novelties for his work. In December, 1844, he listened to a lecture delivered by Dr. Colton, who took for his subject nitrous oxide gas, the amusing effects of which he demonstrated to his audience upon a number of persons who visited the platform for that purpose. Wells was one of these. Wells, moreover, noticed that another young man, who bruised himself while under its influence, said afterward that he had not hurt himself at all. Wells then stated to a bystander that he thought that if one took enough of that kind of gas he could have a tooth extracted and not feel it. He at once called upon a neighboring dentist friend and made arrangements to test the anesthetic effects of the gas upon himself the next morning. Accordingly Colton gave him the gas, and Riggs, the friend, extracted the tooth; and Wells, returning to consciousness, assured them both that he had not suffered a particle of pain. He began at once to construct an apparatus for its manufacture. Dr. Marcey, of Hartford, then informed Wells that while a student at Amherst he and others had often inhaled nitrous oxide as well as the vapor of ether, for amusement, and suggested to Wells to try ether. After a few trials, however, it was found more difficult to administer, and Wells accordingly resolved to adhere to gas alone. This was in 1844, two years after Long's obscure experiments, of which, of course, they were ignorant. In 1845, Wells visited Boston for the purpose of introducing his discovery, and among others called upon his former partner, Morton, trying to establish the use of the gas. He soon became discouraged, however, and returned to Hartford, resuming his practice. There he continued to use gas for about two years, but failed to secure its introduction into general surgery, owing to prejudice and ignorance on the part of dentists and physicians alike.

Wells's claims have been advocated by many of his fellow-citizens, and in Bushnell Park, in Hartford, stands a monument erected by the city and the state, dedicated to Horace Wells, "who discovered anesthesia, November, 1844."

C. T. Jackson was born in Plymouth, Mass., in 1805. He graduated in the Harvard Medical School in 1829, after which he went abroad, where he remained for several years, made the acquaintance of the most distinguished men, experimented in general science, electricity and magnetism and even devised a telegraphic apparatus, similar to that which Morse patented a year later. Returning, in 1835, he opened in Boston a laboratory for instruction in analytical chemistry, the first of its kind in the country. He also made quite a reputation as a geologist and mineralogist and received official appointments from Maine, Rhode Island, New Hampshire and other states. In 1845 he discovered and opened up copper and iron mines in the Lake Superior district. In 1846 and 1847 he was much aroused by Morton's experiments with sulphuric ether, and claimed even that he had suggested the use of ether to Morton, claiming also that he had himself been relieved of an acute distress by inhalation of ether vapor, and that it was from reflection on the phenomena presented in his own case that the possibility of its use for relief of pain during surgical operations suggested itself to him. This led to a triangular conflict for the priority of discovery between Wells, Jackson and Morton, each claiming the honor for himself. Wells health soon gave way. He went abroad and got recognition from the French Institute and the Paris Academy of Sciences, which did not, however, endorse his claim as discoverer nor accept nitrous oxide as an anesthetic. Wells returned to find that Morton was on the tide of popular favor, the public having endorsed ether as the only reliable anesthetic. His mind became unbalanced, and in a fit of temporary aberration he ended his own life in a prison cell, in New York city in 1848.

Wells being out of the way, Jackson became Morton's most violent opponent, and the two indulged in a most bitter fight and unseemly discussion. A few years later, Jackson, who, as remarked, had an extensive acquaintance abroad, visited Europe and presented his claim to the credit of the discovery of ether before various individuals and learned bodies, and so well did he work upon the French Institute as to be recognized as the discoverer of modern anesthesia. A select committee of the House of Representatives, to whom in 1854 Congress referred the matter, announced the following conclusions:

"First, that Dr. Horace Wells did not make any discovery of the anesthetic properties of the vapor of ether which he himself considered reliable and which he thought proper to give to the world. That his experiments were confined to nitrous oxide, but did not show it to be an efficient and reliable anesthetic agent....

"Second, that Dr. Charles T. Jackson does not appear at any time to have made any discovery in regard to ether which was not in print in Great Britain some years before.

* * * * *

"Fifth, that the whole agency of Dr. Jackson in the matter appears to consist entirely in his having made certain suggestions to aid Dr. Morton to make the discovery."

In 1873, Jackson's mind gave way, and after seven years of confinement in an asylum he died in 1880, at the age of 75, having been the recipient of many honors from foreign potentates and learned societies.

William T. G. Morton was born in Charleston, Mass., in 1819. After a disastrous experience in business he was sent to Baltimore in 1840 and began the study of dentistry. In 1841 he entered the dental office of Horace Wells as student and assistant, becoming a partner in 1842. In 1843 partnership was dissolved, Wells removing to Hartford, as before stated. Morton, ambitious for a medical degree, entered his name as a student in the office of Charles T. Jackson, in 1844, and the same year matriculated in the Harvard Medical School, though he never graduated. Having learned through Wells of the latter's successful use of nitrous oxide gas, but not knowing how to make it, he sought the advice of Dr. Jackson, who informed him that its preparation entailed considerable difficulty, and inquired for what purpose he wanted it. On Morton's replying that he wished to use it to make patients insensible to pain, Jackson suggested the use of sulphuric ether, as Marcey had suggested it to Wells two years previously, saying that it would produce the same effect and did not require any apparatus. Jackson also told Morton of the ether frolics common at Cambridge among the students. That same evening, September 30, 1846, Morton administered ether to a patient and extracted a tooth for him without pain. The next day he visited the office of a patent lawyer, for the purpose of securing a patent upon the new discovery. This lawyer ascertained that Jackson had been intimately connected with its suggestion, and came to the conclusion that a patent could not safely issue to either one independently of the other. But Jackson being a member of the State Medical Society, against whose ethical code it is to patent discoveries that pertain to the welfare of patients, and fearing the censure of his colleagues, agreed at once to assign his right over to Morton, receiving in return a 10 per cent. commission upon all that the latter made out of it. Morton, as a dentist, having no more compunction then than dentists have now upon the securement of a patent,--in other words, being actuated by no fine ethical scruples,--secured the patent, and then called upon Dr. J. Mason Warren, one of the surgeons in the Massachusetts General Hospital. Warren promised his coöperation and appointed the 16th of October, 1846, for the first public trial. Upon this occasion the clinic room was filled with visitors and students, when Morton placed the young man under the influence of his "letheon," as he called it then; after which Warren removed a tumor from his neck. The trial was most successful. Another took place on the following day, and on November 7th an amputation and an excision of the jaw were made, both patients being under the influence of letheon and oblivious to pain. At this time the nature of the anesthetic agent was kept a secret, the vapor of ether being disguised by aromatics, so as not to be recognized by anyone present.

True to the highest traditions of their craft, the staff of the Massachusetts General Hospital now met and declined to make further use of a drug whose composition was thus kept secret. It was then that Morton revealed the exact nature of it as sulphuric ether, disguised with aromatic oils. In a report made by the commissioner of patents, it was set forth that:

"For many years it had been known that the vapor of sulphuric ether, when freely inhaled, would intoxicate as does alcohol when taken into the stomach, but that the former was much more temporary in its effects. But notwithstanding the records of its effects to this extent, which were familiar to so many, no surgeon had ever attempted to substitute it for the palliatives in common use previous to surgical operations. That, in view of these and other considerations, a patent had been granted for the discovery."

In 1846 an English patent was obtained.

Morton soon began the attempt to sell office rights, as do the dentists of to-day, while the medical profession was then, as ever, antagonistic to patents, holding them to be subversive of general good. His patent was soon opposed and then generally infringed upon. Litigation followed without end, and the government stultified itself by refusing to recognize the validity of the patent issued by itself. And so, without any compensation to the discoverer, ether soon came into general use in this country as abroad. While receiving many congratulations from friends and humanitarians, Morton's success aroused the jealousy of some of his professional brethren, among them one Dr. Flagg, who commenced a terrible onslaught upon the new application of ether and its promoter. By his machinations a meeting of Boston dentists was called and a committee of twelve appointed to make a formal protest against anesthesia. This committee published a manifesto in the _Boston Daily Advertiser_, in which all sorts of untoward effects and unpleasant results were attributed to the new anesthetic. This proclamation was spread broadcast, and did Morton, for the time, very much harm. Equally obstreperous was Dr. Westcott, connected with the Dental College in Baltimore. He made fun of Morton's "sucking bottles," as his inhalers were dubbed; and in various of the medical and secular journals of the day, bitter, often foolish and absurd, attacks were made. The editors of the _New Orleans Medical and Surgical Journal_ said:

"That the leading surgeons of Boston could be captivated by such an invention as this, heralded to the world under such auspices and upon such evidences of utility and safety as are presented by Dr. Bigelow, excites our amazement. Why, mesmerism, which is repudiated by the savants of Boston, has done a thousand times greater wonders, and without any of the dangers here threatened. What shall we see next?"

These and similar statements created a very strong prejudice against Morton, who, in December, 1846, sent to Washington, to a nephew of Dr. Warren, to endeavor to urge upon the government the advantages of employing ether in the army during the Mexican war, then in progress. The chief of the Bureau of Medicine and Surgery reported that the article might be of some service for use in large hospitals, but did not think it expedient for the department to incur any expense by introducing it into the general service; while the acting surgeon-general believed that the highly volatile character of the substance itself made it ill-adapted to the rough usage it would necessarily encounter upon the field of battle, and accordingly declined to recommend its use.

In January of 1853, Morton demonstrated at the infirmary in Washington, before a congressional committee and others, the anesthetic effect of ether, which he continued through a dangerous and protracted surgical operation. This was the result of a challenge to compare the effects of nitrous oxide and those of ether, the advocates of the former not putting in an appearance.