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Annmedhistv1n4winyr1917toc.Pdf (9.666Mb) NUMBER 4 ANNALS OF MEDICAL HISTORY n FRANCIS R' PACKARD 'M 'D ' EDITOR [PHILADELPHIA] PUBLISHED QUARTERLY BY PAUL - B - HOEBER 67-69 EAST FIFTY-NINTH STREET - NEW YORK CITY Entered aa second class matter June 2,1917, at the post office at New York, N. Y „ under the Act of March 3,1879. Yearly Subscription 86.00. Single numbers 82.00. ANNALS OF MEDICAL HISTORY Volume i Winter 1917 N umber 4 THE FIRST PRINTED DOCUMENTS RELATING TO MODERN SURGICAL ANESTHESIA1 By SIR WILLIAM OSLER, M.D., F. R. S. Oxford, England. HE story of surgical perspective and a failure to realize just anaesthesia illustrates what priority means in the case of a great how long it takes an discovery. idea to become effect­ Why do we not give the credit to Dios­ ive. The idea of pro­ corides, who described both general and ducing insensibility local anaesthesia, or to Pliny, or Apuleius to pain during a cut­ or to Hiotho, the Chinaman, who seems ting operation is of to be next in order, or to the inventor of great antiquity, e. g., in Chapter II, 21, of the spongia somnifera, or to Master Mazzeo the Book of Genesis. Nor is the word Montagna, in Boccaccio, or to any one of anaesthesia modern, as is sometimes said, the score or more of men in the Middle and invented by Oliver Wendell Holmes. It Ages who are known to have operated on occurs, Withington tells me, first in Plato patients made insensible by drugs or vapors? (Timaeus) and is used by Dioscorides in Why do we not give the credit to Davy, the modern sense. who had the idea, or to Hickman, who had The extraordinary controversy which has both idea and practice, or to Esdaile, who raged, and which re-rages every few years, operated on hundreds of patients in the on the question as to whom the world is hypnotic state, or to Elliotson, who did indebted for the introduction of anaesthesia, the same; or to Wells, who, in 1844, oper­ illustrates the absence of true historical ated under nitrous oxide, or to Long, who frequently practised ether anaesthesia? 1 Remarks made on presenting Morton’s original papers to the Royal Society of Medicine, London, Why? Because time out of mind, patients May 15, 1918, had been rendered insensible by potions 330 Annals of Medical History or vapors, or by other methods, without In the same journal for December 9th, any one man forcing any one method into Dr. J. Collins Warren (Primus) gives an general acceptance, or influencing in any account of the first operation at the Massa­ way surgical practice. chusetts General Hospital. These four Before October 16, 1846, surgical anaes­ papers stand out in the literature of sur­ thesia did not exist— within a few months gical anaesthesia as fundamental, and truly it became a world-wide procedure; and the epoch-making. full credit for its introduction must be Morton called the drug letheon and given to William Thomas Green Morton, applied for letters patent to secure his who, on the date mentioned, demonstrated rights— not an unethical procedure in the at the Massachusetts General Hospital dental profession of America. This led the simplicity and safety of ether anaes­ to the publication of his first pamphlet thesia. On the priority question let me called “ Letheon,” the bibliography of quote two appropriate paragraphs— “ He which some one should undertake. “ The becomes the true discoverer who estab­ medium through which Dr. Morton com­ lishes the truth; and the sign of the truth municated the results of experiments on is the general acceptance. Whoever, there­ etherization to the public, was a ‘circular’ fore, resumes the investigation of neglected which he had printed, at his own expense, or repudiated doctrine, elicits its true almost every week. It was at first, as its demonstration, and discovers and explains name imports, a mere letter of advice; the nature of the errors which have led but, as it became the receptacle of news­ to its tacit or declared rejection, may paper articles, and correspondence from certainly and confidently await the acknowl­ every portion of the Union, announcing the edgements of his right in its discovery.” success of etherization, it was necessarily (Owen, “ On the Archetype and Homologies enlarged into a large and closely-printed of the Vertebrate Skeleton,” p. 26.) “ In sheet of four pages. Soon this ‘Circular’ science the credit goes to the man who became a pamphlet, and of this five differ­ convinces the world, not to the man to ent editions were published, under Dr. whom the idea first occurs” (Francis Dar­ Morton’s immediate supervision, embody­ win, The Eugenics Review, 1914). Morton ing a digest of all the authentic information, convinced the world: the credit is his. both from Europe and America, on Morton’s original essays are among the Anaesthesia.” (Rice, “ Trials of a Public rarissima not existing, so far as I can Benefactor,” 1859, p. 114.) ascertain, in any of the general or special The Index Catalogue of the Surgeon libraries of this country. I have been General’s Library only mentions a four­ looking for them in vain for many years. teen-page pamphlet, 1846, printed by In a parcel of his father’s papers recently Dutton and Wentworth, Boston. The early received from William J. Morton of New form of the circular may be seen on the York there were duplicates of “ Letheon” back page of The Boston Medical and and “ Remarks on the Proper Mode of Surgical Journal, for December 9th. In Administering Sulphuric Ether by Inhala­ the number for November 18th with Bige­ tion,” which I have great pleasure in pre­ low’s paper, there is only an advertisement senting to the Library. Also a duplicate of Morton’s courses of instruction in dentis­ copy of The Boston Medical and Surgical try. The circular appeared first November Journal of November 18, 1846, which 26th, and is copied on pages 14-15 of the contains the first printed account of the Letheon pamphlet, fifth edition. This new procedure, by Dr. Henry J. Bigelow. pamphlet is made up of more than eighty First Printed Documents Relating to Modern Surgical Anesthesia 3 3 1 short articles from medical journals and by Inhalation,” and after referring to the newspapers, and is of special value in early cases of Warren and of Hayward at giving the popular first-hand impressions the Massachusetts General Hospital, he relating to the great discovery. There is gives fuller details of the dental cases which very little of Morton’s— only the circular he had seen with Dr. Morton. No small already referred to, and on page 16 the share. of the early confidence inspired in terms for the “Apparatus, a bottle of the the profession is due to this temperate Preparation, instruction, etc.” statement by Dr. Bigelow, who fully realized In 1847 Morton published a forty-four the enormous value of the discovery. page pamphlet on “The Proper Mode of In the literature of anaesthesia these are Administering Sulphuric Ether by Inha­ the three fundamental contributions. With lation,” Boston, Dutton and Wentworth, them should be placed Collins Warren’s printers, in which the original apparatus account of the first operation, The Boston (now a treasured relic at the Massachusetts Medical and Surgical Journal, December General Hospital) is described. In the early 9th, and Vol. x x x v of this publication, part of April he found that a sponge would which contains some twenty-two papers on serve the same purpose and was less danger­ the subject, illustrating the rapid spread of ous. The greater part of the pamphlet is the practice. taken up with general directions, the out­ The opportunity here offers to suggest come of the author’s experience. the arrangement of certain subjects in our The claims of Morton were very fully libraries on an educational basis. For stated in a pamphlet published in Paris example, why should not the members of in 1847 with the title “ Memoire sur la the Section on Anaesthesia of this Society decouverte du novel emploi de I’ether undertake to collect and classify their Sulphurique.” literature on historical lines? Start with In 1859 he published a small work the documents that magnetized into life “ On the Physiological Effects of Sulphuric an antique practice, these pamphlets of Ether and its Superiority to Chloroform,” Morton, Bigelow’s paper, Warren’s paper, Boston. So far as I can ascertain, this is and Volume xxxv of The Boston Medical his complete output on the subject of and Surgical Journal. Put these together— anaesthesia, except a posthumous pam­ all in vellum and lettered in gold!— as the phlet on “The Use of Ether as an Anaes­ blastoderm from which the enormous litera­ thetic at the Battle of the Wilderness.” ture has developed, which might be ar­ (Journal of the American Medical Asso­ ranged on the shelves in ten or more ciation, April 23, 1904.) sections. The Index Catalogue of the Sur­ The third item is No. 16 of Vol. xxxv geon General’s Library has a good classi­ of The Boston Medical and Surgical Journal fication, but for my own collection I have (then as now, issued weekly) for November used the following: 18th, which introduces to the profession I. The general story, as given in such modern surgical anaesthesia. Henry J. Bige­ publications as the Jubilee numbers of the low, the distinguished surgeon, had been British Medical Journal and The Boston interested in Morton’s private dental cases, Medical and Surgical Journal; and the and read a paper before the American text books in which the history of the Academy of Sciences, November 3rd, and subject is well given, as Snow, Foy, and so at the Boston Society of Medical Improve­ forth.
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