More on the History of Anesthesia and Sedation

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Over 25 years ago, I began learning about the use of music as an adjunct to anesthesia.  I didn’t know that much about anesthesia and sedation, but I knew that I didn’t want any more than I absolutely needed.  I knew that anesthesia was powerful stuff, so when I found out that I would be having a baby (over 40 years ago!) I knew that I wanted to have natural childbirth and not a “saddleblock” or any kind of spinal anesthesia.  Not only did I just not like the idea of someone putting a needle in my back, but I knew enough women at that time, who had utilized the LaMaze Method or the Bradley Method, that I knew it was quite possible with proper preparation, childbirth classes, and a willing husband, which I had!

In 1990, when I stepped into the field of Music Medicine, one of the things that fascinated me was the concept of music as a way to enhance minimal anesthesia usage and a way to tap into the powerof rhythmic entrainment.

Timeline of Progress in Pain Management during Surgery:

CA 4000 BCE Sumerian artifacts depicting the opium poppy

CA 1600 BCE Acupuncture being practiced in China, according to pictographs on bones and turtle shells

CA 1187 BCE In Homer’s “Odessey,” the Greek goddess Circe, uses deleriant herbs to brew a tea, turning Odysseus’ men into swine.

64 AD  Dioscorides, a Greek surgeon in the Roman army of Emperor Nero, recommends mandrake boiled in wine to “cause the insensibility of those who are to be cut or cauterized.”

CA 800-1300 After herbal mixtures including opium, mandrake, henbane, and/or hemlock are steeped into a soporific or sleep-bearing sponge (“spongia somnifera”), the sponge is dampened so that anesthetic vapors or drippings can be applied to a patient’s nostrils. These sponges were likely historical cousins to the so-called Roman or Arabic sponges (used during crucifixions, surgeries, and other painful events).

1540:  German physician and botanist Valerius Cordus (1515–1544), synthesizes diethyl ether by distilling ethanol and sulphuric acid into what he called “sweet oil of vitriol.”

1779:  Franz Anton Mesmer (1734–1815)—In Mémoire sur la découverte du magnétisme animal, he describes using magnets and hypnosis to cure many ailments.

1805:  Pharmacist Friedrich Sertürner (1783–1841)—Isolates a new substance from opium, which he later names “morphium” after Morpheus, the god of dreams.

1842: William Clarke (1819‐1908)—In Rochester, New York, a medical student etherizes a single patient for a dental extraction.

1842:  Dr. Crawford W. Long (1815-1878) etherizes James Venable for removal of neck cysts on March 30, 1842. Dr. Long would become honored as the 1st anesthesiologist on a US Postage stamp (1940) and as the inspiration for the 1st “National Doctors Day” on March 30, 1991.

1845:  Dr. Horace Wells (1815-1848)-After bravely volunteering to inhale nitrous oxide for his own dental extraction back in December of 1844, Dr. Wells demonstrates nitrous oxide anesthesia for a tooth extraction near Massachusetts General Hospital, but the partial anesthetic is judged a “humbug.”

1846: On October 16, William T. G. Morton (1819-1868) made history by being first in the world to publicly and successfully demonstrate the use of ether anesthesia for surgery. This occurred at what came to be called “The Ether Dome,” at Massachusetts General Hospital on patient Edward Gilbert Abbott. Surgeon John Collins Warren noted, “Gentlemen, this is no humbug.” Dr. Oliver Wendell Holmes, Sr. (1809-1894)-suggests the terms “anaesthetic” and “anaesthesia” in a letter to William T. G. Morton. News of Morton’s ether demonstration was carried by the paddle steamship Acadiafrom Boston to Dr. Francis Boott and then on to Dr. James Robinson (1813-1862), who extracted a tooth on December 19, 1846, under ether anesthesia. In 1847 Robinson authored one of the first textbooks on anesthesia: A Treatise on the Inhalation of the Vapour of Ether for the Prevention of Pain in Surgical Operations.* On December 21, Scottish surgeons in Dumfries, Scotland (Dr. William Scott) and in London (Dr. Robert Liston) amputate limbs of etherized patients- the first such surgical anesthetics in the British Isles. Liston commented, “This Yankee dodge beats mesmerism hollow.” Dr. Liston describes the surgery in a letter to Dr. Francis Boott, which is published in The Lancet. The WLM owns this letter.

1847:  Prof. James Y. Simpson (1811-1870)-Scottish obstetrician begins administering chloroform to women for pain during childbirth. Chloroform quickly becomes a popular anesthetic for surgery and dental procedures as well. Chloroform was discovered independently in 1831 by the USA’s Samuel Guthrie, France’s Eugène Soubeiran, and Germany’s Justus von Liebig.

1853:  Drs. Charles Pravaz (1791-1853) and Alexander Wood (1817-1884)-These men independently invented the hollow hypodermic needle, which will be attached to an earlier invention, the syringe popularized in 1845 by Ireland’s Francis Rynd.

1884:  Dr. Karl Koller (1857-1944)-Viennese ophthalmologist and colleague of Sigmund Freud, introduces cocaine as an anesthetic for eye surgery.

1898:  Dr. August Bier (1861-1949)-Conducts the first spinal anesthetic using cocaine; 10 years later, he popularized the intravenous regional (“Bier”) block.

1902:  Dr. Mathias J. Seifert of Chicago coins the words “anesthesiology” and “anesthesiologist.” He asserted that an “ANESTHETIST” is a technician and an “ANESTHESIOLOGIST” is the scientific authority on anesthesia and anesthetics.

1923: Dr. Isabella Herb administers the first ethylene-oxygen surgical anesthetic. She demonstrated the remarkable trance-like state that low-dose ethylene could induce in human subjects.

1929:  The Anaesthetists’ Travel Club is organized by Dr. John S. Lundy, who will popularize use of the intravenous anesthetic thiopental (Pentothal) and will become the ASA President in 1946. The popularity of thiopental-as a swift-onset intravenous agent for inducing general anesthesia-will pave the way for other totally unrelated intravenous induction agents, such as ketamine, etomidate, and propofol.

1941:  Henry K. Beecher, MD- After his appointment to the USA’s first endowed chair in anesthesiology as Harvard’s Henry Isaiah Dorr Professor of Anaesthesia Research, Prof. Beecher will pioneer understanding of medical ethics, patient consent, clinical trials, the placebo effect, and “brain death.”

Dr. Robert Hingson develops Continuous Caudal Anesthesia, an innovation in obstetrical anesthesia that provides continuous pain relief for prolonged or difficult labor. In 1958, Dr. Hingson starts Brother’s Brother, a nonprofit charity for supplying medical, educational, and agricultural supplies worldwide. His needle-free “Peace Guns” would mass-immunize millions by jet injection and would be featured as the “Hypospray” in Star Trek and many science fiction films

1960:  Drs. Joseph Artusio, Alan van Poznak et al. begin human trials of the inhalational anesthetic methoxyflurane.

1999: In its report To Err is Human, the Institute of Medicine lauds the efforts of anesthesiologists in improving patient safety

By 1999, I was well on the road to trying to figure out how music could be used as an adjunct to anesthesia, in order to create a safer surgical experience by decreasing the amount of anesthesia, as well as anxiety and pain medication, before, during and after surgery!

The rest is history!!  For more information on this, please visit https://www.woodlibrarymuseum.org/history-of-anesthesia/

 

 

 

 

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About the Author:

Dr. Alice Cash is one of the world’s few clinical musicologists. Based in Louisville, Kentucky, USA, she brings to her work over 40 years of professional experience as a college professor, clinical therapist, solo and chamber music performer and composer. Since 1990, Dr. Cash has been in the field of Music Medicine and conducted clinical research at the University of Louisville School of Medicine, under the guidance of Dr. Joel Elkes, Dr. Leah Dickstein, and Dr. Rif El-Mallakh. Her clinical work at the University of Louisville lead to her career in music medicine. In addition to her work with the University of Louisville, Dr. Cash lead the development of using music a hospital setting at Baptist East Hospital, Louisvile, KY. She has founded 3 companies: Healing Music Enterprises, Surgical Serenity Solutions and Crescent Hill Counseling.

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