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High-stakes performance -

In the 1830s, Robert Liston, a Scottish surgeon known for his incredible speed, performed operations like amputations within minutes. With medical students restraining patients and an audience watching, his swift work was necessary, as patients were fully conscious and suffered immensely without anesthesia.

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A painful reality -

Before the development of effective anesthetics, surgical procedures were terrifying and torturous experiences. Patients had to remain awake and endure every slice, cut, and break with full awareness, which made speed and efficiency critical qualities in a surgeon’s skill set.

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Early exploration into pain relief -

The search for ways to render patients unconscious during surgery began centuries before Liston’s time. Physicians across different cultures and eras sought any and all possible ways to dull pain or knock patients out, hoping to lessen suffering and improve the precision of surgeries.

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Ancient anesthetic formula -

Around 200 CE, Chinese physician Hua Tuo experimented with combining alcohol and a powdered blend of ingredients to create an early anesthetic. This mixture aimed to knock out patients prior to surgical procedures.

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Inhaled anesthetics -

In the 13th century, Arab surgeon Ibn al-Quff described a method for delivering anesthetics via sponges soaked with drugs like opium, cannabis, and mandrake. Patients likely inhaled these substances as a practical and somewhat sophisticated approach to reducing pain during operations.

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Chemistry of the Enlightenment -

By the late 1700s, scientific curiosity bloomed, especially around the use of chemistry in medicine. This period gave rise to numerous innovations in anesthesia, with chemists and doctors studying chemical compounds in search of effective, safe solutions for surgical pain.

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The laughter-inducing gas -

In 1799, English chemist Humphry Davy began self-experimenting with nitrous oxide, also known as laughing gas. After observing its euphoric and numbing effects on himself and his friends, he proposed that it might be useful for relieving pain during surgical procedures.

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Slow adoption -

Despite Davy’s insights, nitrous oxide did not quickly gain acceptance in medical practice. Skepticism about its reliability and safety (both from surgeons and patients) delayed its adoption for surgical purposes for several decades.

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A groundbreaking surgery -

In 1804, Japanese surgeon Seishū Hanaoka anesthetized a patient using a herbal concoction and successfully removed a breast tumor. But this notable medical achievement was isolated geographically, and knowledge of his work remained largely confined to Japan.

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Curious recreational beginnings -

Ether, a colorless chemical, had been synthesized centuries earlier but found a strange niche in early 1800's America through "ether frolics," social gatherings where people inhaled it for amusement. Over time, people started noticing ether’s pain-masking properties during accidents.

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A turning point -

In a major breakthrough, an American physician etherized a patient in 1842 and painlessly removed a tumor from the man's neck. This event demonstrated ether's medical potential and began to shift attitudes toward the use of anesthetics in professional surgery.

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Dentistry -

While physicians toyed with ether, dentists began to revisit nitrous oxide as a tool for painless tooth extraction. Despite its prior dismissal, nitrous oxide began carving out a role in dental procedures, and gained attention for its mild yet effective properties.

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The nitrous oxide mishap -

In an unfortunate public demonstration in 1845, a dentist attempted to extract a tooth from a nitrous oxide-sedated patient who screamed during the procedure. Likely caused by an insufficient dose, this incident is what led to public doubt about the drug’s reliability and safety.

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A return to ether -

Following the nitrous oxide debacle, dentists increasingly turned to ether, finding it to be a more reliable anesthetic for tooth extractions. It allowed for more consistent sedation and improved patient experience during procedures previously fraught with agony.

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Dramatic public success -

In October 1846, an American dentist successfully used ether to sedate a patient, and, just two months later, Robert Liston used ether during a leg amputation. The patient was so deeply anesthetized that he awoke after the operation, unaware it had already happened.

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A wave of global experiments -

Following these successes, surgeons worldwide (from India to Russia) began using ether in their practices. These positive outcomes accelerated its adoption, and shifted surgical priorities from speed to precision.

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Unpleasant drawbacks -

But despite its effectiveness, ether presented some challenges. Patients experienced unpleasant side effects, which often included nasty bouts of nausea and irritation. These drawbacks prompted the search for improved alternatives that could maintain efficacy without introducing discomfort or risk.

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Chloroform -

Scottish obstetrician James Simpson, intrigued by reports of a substance called chloroform, began experimenting with it in the 1800s. In 1847, he and two colleagues tested it on themselves and promptly lost consciousness.

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Introduction to childbirth -

Encouraged by his personal experience, Simpson used chloroform to anesthetize a patient during childbirth. The drug’s fast-acting nature and seemingly fewer side effects made it an instant favorite in obstetrics, particularly among women seeking relief from labor pain.

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The theology of pain -

Not everyone agreed with the use of anesthetics on pregnant women. American obstetrician Charles Meigs believed childbirth pain was a divinely ordained experience. He opposed the use of anesthetics during labor, and suggested that relieving women’s suffering went against nature and spiritual purpose.

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Rapid popularity -

Chloroform spread rapidly due to its speed and perceived safety. Many doctors preferred it to ether, believing it to be more manageable and less irritating. But this enthusiasm overlooked the long-term health risks that would become evident much later.

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The dark truth -

Though initially praised, chloroform was eventually found to be harmful, with toxic and even carcinogenic properties. These serious health risks weren’t immediately understood, which led to its continued use for years before being reevaluated and ultimately restricted.

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Fatal mistakes -

During this early era of anesthesia, the lack of understanding about proper dosing and side effects occasionally led to deadly consequences. The risks were real, and mistakes were sometimes fatal.

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Discriminatory practices -

Biases rooted in racism and sexism affected how anesthetics were administered. Some doctors selectively offered anesthesia based on their prejudices, limiting or denying pain relief to patients they deemed less deserving, such as women or enslaved people.

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Unethical gynecological surgeries -

In the 1840s, physician James Marion Sims conducted gynecological experiments on enslaved Black women without anesthesia. His work, now widely condemned, exemplifies how much of early medical research was built on racial exploitation.

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Anesthesia unlocks surgical potential -

By the late 1800s, access to anesthesia allowed surgeons to perform operations that were once deemed impossible. With patients safely sedated, doctors could take time to perform complex, life-saving operations.

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Falling out of favor -

As knowledge of chloroform’s toxic nature grew, it became clear the risks outweighed the benefits. By the early 20th century, it was largely phased out in favor of safer, better-understood alternatives that did not carry such serious health consequences.

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Modern anesthesia evolves -

Over time, new chemical formulations for anesthetics were developed that offered more reliable options for patients undergoing surgeries. Contemporary medicine still uses nitrous oxide and ether, but in refined forms that reduce the likelihood of side effects.

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Monitoring -

Advancements in medical technology also allow doctors to carefully monitor a patient’s vital signs and responsiveness during surgery. With effective anesthesia, surgeons are no longer forced to rush through procedures, and, instead of feeling like agony, surgery can feel like nothing more than a dream.

Sources: (TED-Ed) (The Public Domain Review) (Britannica)

See also: The major medical advances throughout history

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