ENGL 302 N04
AMRIN CHOWDHURY
THE HISTORY OF ANESTHESIA
Pain is an unpleasant sensation or
feeling that is usually associated with some internal damage such as
tissue damage. Pain can have an effect physically and emotionally, based
on the level of pain. Luckily, to get through this intolerable sensation,
the process of anesthesia was developed. This process worked to block the
perception of pain usually during any surgical procedures or other
procedures where patients are likely to experience severe or unbearable
pain.
The development of anesthesia was rather meant
to create a cultural change. The concept of pain was mostly
linked to the obstetric pain during the eighteenth century.
To endure that kind of pain and any other pain relative or
non-relative to obstetrics meant that a person had character
and was regarded highly within the community. Men who
tolerated pain were regarded with much more respect.
Gradually, a change took place when the idea of anesthetics
was favored. The development of anesthesia changed the
medical community of Western Europe and Americas, and
gradually spread to other parts of the world.
Dentists, not doctors, were the ones who were
credited for discovering anesthesia because they had better
everyday contacts with patients dealing with tremendous
amounts of pain. Doctors were more attentive on the rise of
new infectious diseases, researching, analyzing, and
observing patients more than operating on them. Horace Well
and William Thomas Green Morton were the two dentists known
to develop anesthesia, or better known as local anesthesia,
from a very peculiar crop, the coca leaf.
Coca leaf is best known today for its extraction to make the
drug cocaine, which is used in various ways in modern times. It was from
coca leaf that several chemists in Germany synthesized cocaine, with which
the first motives of anesthesia were encountered. Friedrich Gaedeke was
the German chemist, who discovered that coca leaves contained a molecule
known as alkaloid. Then, Albert Niemann isolated the substance and called
it cocaine. Cocaine was used and studied first by Thomas Moreno y Maiz, a
Peruvian surgeon, who found out that injecting this drug in rats, pigs,
and frogs caused sensitivity in them; hence, caused some local anesthetic
effects. Another observance with cocaine was led by a Russian physician,
Basil Von Anrep. He injected a small quantity of cocaine under his skin and felt nothing when
jabbing took place at that very site of the skin. Consequently, he did the same to his tongue
and felt no sensation when the tongue was jabbed the same way. Therefore, he concluded that
cocaine was a good candidate for surgical anesthetics. Finally, it was only after the
experiments and researched work of ophthalmologist Carl Koller from Vienna that cocaine was
named to be used as a regional and local anesthesia. Dr. Koller's work and research was based on
a patient who had glaucoma, who was the first person to have had a local anesthetic on an
operating table. The development of cocaine as anesthesia spread across United States and Canada
during the late nineteenth century.
Soon thereafter, Dr. Richard John Hall reported on the first successful nerve block of
a patient who was under the supplement of cocaine hydrochloride. It was him, Dr. Hall and Dr. William
Stewart Halsted who are credited for using the hypodermic syringe to infiltrate cocaine to the
sensory nerve. The development of the hypodermic syringe would further enhance local anesthesia. It
was an instrument carefully designed to administer substances into the human body, subcutaneously.
More and more elaborate designs of the syringe were being brought on by new innovators. It is
Alexander Wood, a surgeon from Edinburg, who we credit today for "employing the needle and the
syringe as a medical instrument." Eventually, medical professionals witnessed the development of
Pravaz's syringe, named after Charles Gabriel Pravaz, known as the "father of orthopedics." Pravaz's
syringe was the most advanced syringe, which drove more health professionals to the use of local
anesthesia due to its mechanism with the fine needle and the screw motion that allows a convenient
way to apply substances into the body.
After cocaine was well renowned, more drugs were being developed to be used for local anesthesia. The
most successful was novocaine, also known as para-amniobenzoic substances, discovered by Alfred Einhorn, a German
chemist. It was the safest, compared to other drugs, such as alypine and stovaine, two other drugs that were in the
market, and became the most popular anesthetic drug, although it appeared to cause allergic reactions in some
patients. In essence, more approaches were taken to search for alternate drugs. These drugs included lidocaine,
developed by Nils Lofgren and Bengt Lundquist, mepivacaine, bupivacane, pribocaine, and etidocaine. Today, the most
commonly used is the mepivacaine. In dentistry, lidocaine is the most common. Most of these solutions contain
adrenaline. It is a vasoconstrictor, which basically means it can constrict vessels and can prolong the effects of
the anesthetic.
Currently there is ongoing research in developing newer drugs that are more safe and effective.
Although anesthesia can have adverse effects such as toxicity to the heart, where it can cause arrhythmia or to the
brain, causing seizures, health professionals still find anesthetics to be a valuable and required part of any
surgical procedures for the dissipation of severe pain. It is for the benefit of both the patients and the medical
and health professionals to take advantage of such a powerful process because it only allows the completion of a
procedure without any complaints of pain.
I consulted our course revision checklist.
I used EndNote.
Calatayud, J. & Gonzalez, A. (2003). History of the
Development and
Evolution of Local Anesthesia since the Coca Leaf.
Anesthesiology, 98,
1503-1508.
Duce, M.A. & Hernandez, L. F. (1999). Origins of the
Hypodermic
Syringe and
Local Anesthesia. Their Influence on Hernia Surgery. Hernia,
3,
103-106.