From coca leaves to laughing gas

From coca leaves to laughing gas

Evolution of anesthesia

Attempts at producing a state of general anesthesia can be traced throughout recorded history in the writings of the ancient Sumerians, Babylonians, Assyrians, Egyptians, Greeks, Romans, Indians, and Chinese. It is generally agreed that certain scientific discoveries in the late 18th and early 19th centuries were critical to the eventual introduction and development of modern anesthetic techniques.

PanARMENIAN.Net - Pain is not a disease or an injury; it is a symptom of an illness or physical damage. Throughout history there have been countless attempts at controlling, reducing and eliminating pain, both ordinary and severe enough to require surgery. The first attempts at general anesthesia were probably herbal remedies administered in prehistory. Alcohol is the oldest known sedative; it was used in ancient Mesopotamia thousands of years ago.

The Sumerians are said to have cultivated and harvested the opium poppy (Papaver somniferum) in lower Mesopotamia as early as 3400 B.C., though this has been disputed. The most ancient testimony concerning the opium poppy found to date was inscribed in cuneiform script on a small white clay tablet at the end of the third millennium BCE. This tablet was discovered in 1954 during excavations at Nippur, and is currently kept at the University of Pennsylvania Museum of Archaeology and Anthropology.

The Chinese developed acupuncture, now a 3,000-year-old healing technique of Traditional Chinese Medicine based on an ancient philosophy that describes the universe, and the body, in terms of two opposing forces: yin and yang. When these forces are in balance, the body is healthy. Energy, called "qi" (pronounced "chee") flows along specific pathways, called meridians, throughout the body. This constant flow of energy keeps the yin and yang forces balanced. However, if the flow of energy gets blocked, like water getting stuck behind a dam, the disruption can lead to pain, lack of function, or illness. Acupuncture therapy is said to release blocked qi in the body and stimulate function, evoking the body’s natural healing response through various physiological systems.

The Greeks and Romans primarily used alcohol, as the pain of surgery was torture. Celsus, a Roman physician, wrote around 100 AD: "Now a surgeon should be youthful or at any rate nearer youth than age; with a strong and steady hand which never trembles, and ready use the left hand as well as the right; with vision sharp and clear, spirit undaunted; filled with pity, so that he wishes to cure his patient, yet is not moved by his cries, to go too fast, or cut less than necessary; but he does everything just as if the cries of pain cause him no emotion."

Peoples of the ancient world found relief in numerous plant by-products, primarily from marijuana, mandrake, belladonna and jimsonweed, all of which could sedate, but not truly anesthetize, in preparation for primitive surgery.

Warriors carried small sacks of opium into battle, much the same way modern troops may carry syringes of morphine (a derivative of opium) when in danger of being wounded.

Africans induced numbing trances and drank or smoke potent mind-altering substances which made pain bearable.

American Indians relied on the bark of the willow tree, the original source of our modern-day aspirin. Inca shamans chewed coca leaves (which contain a mild natural version of cocaine) while drilling holes in the heads of their patients to release evil spirits, periodically spitting into the wounds they’d inflicted – the coca-resin spittle would keep the gash sufficiently numbed until the “operation” was concluded.

Some cultures believed bleeding a person to the point of faintness was an effective pain-killer. Ice was naturally and universally used to kill pain (except in tropical regions).

German pharmacist Friedrich Sertürner (1783–1841) first isolated morphine from opium in 1804; he named it morphine after Morpheus, the Greek god of dreams.

In 1799, a chemist and inventor named Humphry Davy started experimenting with nitrous oxide, the gas we now call “laughing gas.” He wanted to know what the gas might do to people, and to find out he started inhaling it himself, recording the sensation. He began to take the gas outside of laboratory conditions, returning alone for solitary sessions in the dark, inhaling huge amounts. Later in the year he would construct an “air-tight breathing box” in which he would sit for hours inhaling enormous quantities of the gas and have even more intense experiences, on more than one occasion nearly dying. A few months after he started the experiments Davy began to allow others to partake, at first his patients but then also perfectly healthy subjects chosen from his circle of family and friends. The gas became popular because it didn't have to knock people out to relieve pain.

In the early 1840s, Crawford W. Long, an American, became the first doctor to use a modern chemical anesthetic – ether – during major surgery. For a year or so, Long and his fellow physicians had been experimenting with the newly developed gas known as diethyl ether; however, their experiments were not taking place in laboratories, but at their homes during “vapour parties”.

Long observed that whenever one of his jolly intoxicated friends did something that normally would’ve caused much pain, such as falling down stairs, running into walls or getting into fights, none reported feeling the slightest pain. A few months later, Long used ether to painlessly amputate the diseased toe of a slave, and over the next several years performed other ether-induced operations.

In 1846, American physician and poet Oliver Wendell Holmes proposed in a letter that the new painkiller be named anesthesia, a Greek word meaning “no sensation of pain”.

A number of increasingly more effective local anesthetics were introduced in the early to mid-20th century, all derivatives of cocaine, including eucaine (1900), procaine, also known as novocaine (1905) and lidocaine (1943).

By the early twentieth century, huffing went out of fashion. Drugs could be administered more precisely through the injections. The first spinal anesthetic was performed in 1899 by German surgeon August Bier using cocaine.

Another family of anesthetic drugs known as “regional drugs” or “nerve blocks” emerged for use in anesthetizing larger portions of the body. The most well-known nerve blocking procedure, which first became available in the 1950s, was called an epidural, which numbs a woman’s body from the waist down during childbirth.

The most powerful family of painkilling drugs became known as “general anesthesia”, which induces deep sleep and immobilization during major surgery. Today, general anesthesia is most commonly administered via gas, an intravenous line or a combination of both.

Lusine Mkrtumova / PanARMENIAN.Net
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