By Abdurrazzaq Abubakar
Have you ever wondered what practices ancient medical practitioners have to use in order to render their patients unconscious before surgery? Before the medical world achieved the delicate control of modern anesthesia, surgery was an agonizing, terrifying last resort. Medical Practitioners experimented with many potential solutions over the millennia before finding results that worked while also not killing their patients in the process, although they did more of the killing prior to finding a solution.
But before delving into these historical practices, lets quickly define what Anesthesia is; Anesthesia refers to the use of medications (called anesthetics) to prevent a patient from feeling pain during medical procedures. It involves inducing a controlled temporary loss of sensation or awareness by temporarily blocking sensory signals travelling from the nerves at the site of the procedure to the centers in the brain.
The Earliest attempts to achieve pain relief were as old as civilization itself, with early attempts documented as far back as 4000 BC. Sumerian artifacts depict the opium poppy, and ancient texts across the world describe using herbal mixtures and ethanol to ease pain during procedures.
Ancient cultures often relied on powerful plants for their sedative properties.
Opium and Hashish were common in Ancient Egypt and China for dulling sensation.
The Soporific Sponge, dating back to Arabic physicians and introduced to Europe around the 12th century, involved soaking a sponge in a cocktail of potent herbs including opium, hemlock, henbane, and mandrake. The dried sponge was rinsed in hot water and stuffed under the patient's nose where the fumes being intended to render them unconscious.
Later in the 13th-century, Theodoric Borgognoni from Italy refined early mixtures with opiates. Even earlier, the Chinese surgeon Hua Tuo who was the first verified figure known to have used a general anesthetic, developed mafeisan, a potent herbal anesthetic made from hemp and wine.
Local Anesthetics were used in the Inca civilization (modern day Columbia and Peru) where shamans used coca leaves, chewing and spitting the numbing saliva onto surgical wounds to act as a local anesthetic.
The major and recurring challenge with all these cures was that the amount of drug needed to successfully relieve the pain was often the same amount needed to fatally poison the patient.
When the herbal methods seem to fail, towards the 19th century, some practitioners turned to crude physical force. In China, records show doctors sometimes resorted to surprising their patients by whacking them over the head to knock them out before surgery, this alternative was often unreliable and dangerous.
In the 19th century, British physician Henry Hill Hickman attempted to bypass the brutality of blunt force by trying the method of controlled suffocation to induce unconsciousness. Hickman tested his theory on puppies, noting that after restricting air flow until breathing almost stopped, he could surgically remove an ear without the animal showing pain. Despite his observations, the fatal outcome for many of his test subjects was considered too risky, and his contemporaries universally rejected the method.
However, two major breakthroughs occurred that began to shift the paradigm, one that was tragically isolated and unknown to the rest of the world and the other that eventually changed the world.
In 1804, the Japanese physician Hanaoka Seishū became the first person to successfully perform surgery using general anesthesia. Drawing on both traditional Japanese and Dutch-imported European medicine, Hanaoka spent years developing a formula called tsūsensan from Korean morning glory and other herbs. His success became widely known in Japan, leading him to perform over 150 breast cancer operations and numerous amputations before his death in 1835. However, because Japan was closed off at the time, his ground-breaking invention never spread beyond the country, and the rest of the world remained unaware of this effective general anesthetic.
Meanwhile in the Western world, the gas nitrous oxide (which was unrelated to surgery at first) was discovered by English scientist Joseph Priestley in 1772. Though initially thought lethal, British chemist Humphry Davy experimented it on himself in 1799 and found it caused him to laugh, nicknaming it "laughing gas." Davy wrote about the potential of nitrous oxide to relieve pain during surgery in 1800, but his idea was not seriously pursued at the time.
The Ultimate Turning Point – Ether and Modern Surgery came on October 16, 1846. Dentist William Morton and surgeon John Warren made history at Massachusetts General Hospital by successfully using diethyl ether to prevent pain during surgery to remove a lump from a patient's jaw. This public success proved that painless surgery was possible and marked the true beginning of modern anesthesia.
Soon after, Scottish physician James Young Simpson promoted chloroform after observing its powerful effects. While it was successfully adopted in surgery, it quickly became popular for parties and was added to over-the-counter cough syrups. People thought that because the drug made them feel good, it was curing their sicknesses, but it was actually poisonous. Chloroform damaged the liver and kidneys, often causing a fatal reaction known as "sudden sniffer’s death." Because of these deadly risks, doctors eventually stopped using it.
Finally, the local anesthetic properties of the coca leaf used by the Incas were scientifically recognized when Cocaine was isolated and first used as an effective local anesthetic in eye surgery in 1884 by Karl Koller, marking the beginning of modern local pain relief.
The medical world has witnessed major changes over time to arrive at the much safer anesthetics used today. Of the first famous anesthetics, nitrous oxide is still widely used, but chloroform and ether were replaced by safer modern agents, and cocaine was replaced by more effective local anesthetics with less abuse potential. Today, specialist professionals called anesthesiologists are essential members of every surgical team, dedicated solely to ensuring safe and controlled pain management during medical procedures.
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