Who invented anesthesia? The discovery of pain relief and the history of anesthesiology
Surgery and pain have always gone side by side since the first steps in the development of medicine. According to the famous surgeon A. Velpo, it was impossible to perform a surgical operation without pain; general anesthesia was considered impossible. In the Middle Ages, the Catholic Church completely rejected the very idea of eliminating pain, passing it off as a punishment sent by God to atone for sins. Until the mid-19th century, surgeons could not cope with pain during surgery, which significantly hampered the development of surgery. In the middle and end of the 19th century, a number of turning points occurred that contributed to the rapid development of anesthesiology - the science of pain management.
Emergence of anesthesiology
Discovery of the intoxicating effects of gases
In 1800, Devi discovered the peculiar effect of nitrous oxide, calling it “laughing gas.”
In 1818, Faraday discovered the intoxicating and desensitizing effects of diethyl ether. Devy and Faraday suggested the possibility of using these gases for pain relief during surgical operations.
First operation under anesthesia
In 1844, dentist G. Wells used nitrous oxide for pain relief, and he himself was the patient during tooth extraction (removal). Later, one of the pioneers of anesthesiology suffered a tragic fate. During public anesthesia with nitrous oxide, carried out in Boston by H. Wells, the patient almost died during the operation. Wells was ridiculed by his colleagues and soon committed suicide at the age of 33.
It should be noted that the very first operation under anesthesia (ether) was performed by the American surgeon Long back in 1842, but he did not report his work to the medical community.
Date of birth of anesthesiology
In 1846, the American chemist Jackson and dentist Morton showed that inhaling diethyl ether vapors turns off consciousness and leads to loss of pain sensitivity, and they proposed using diethyl ether for dental extraction.
On October 16, 1846, in a Boston hospital, 20-year-old Gilbert Abbott, a patient at Harvard University, had a tumor of the submandibular region removed under anesthesia (!) by Harvard University professor John Warren. Dentist William Morton narcotized a patient with diethyl ether. This day is considered the birth date of modern anesthesiology, and October 16 is celebrated annually as anesthesiologist's day.
The first anesthesia in Russia
On February 7, 1847, the first operation in Russia under ether anesthesia was performed by Moscow University professor F.I. Inozemtsev. A.M. also played a major role in the development of anesthesiology in Russia. Filomafitsky and N.I. Pirogov.
N.I. Pirogov used anesthesia on the battlefield, studied various methods of administering diethyl ether (into the trachea, blood, gastrointestinal tract), and became the author of rectal anesthesia. He said: “Ethereal steam is a truly great remedy, which in a certain respect can give a completely new direction to the development of all surgery” (1847).
Development of anesthesia
Introduction of new substances for inhalation anesthesia
In 1847, Edinburgh University professor J. Simpson used chloroform anesthesia.
In 1895, chlorethyl anesthesia began to be used. In 1922, ethylene and acetylene appeared.
In 1934, cyclopropane was used for anesthesia, and Waters proposed including a carbon dioxide absorber (sodium lime) in the breathing circuit of the anesthesia machine.
In 1956, halothane entered anesthesiological practice, and in 1959, methoxyflurane.
Currently, halothane, isoflurane, and enflurane are widely used for inhalation anesthesia.
Discovery of drugs for intravenous anesthesia
In 1902 V.K. Kravkov was the first to use intravenous anesthesia with hedonal. In 1926, hedonal was replaced by avertin.
In 1927, pernoctone, the first barbituric drug, was used for intravenous anesthesia for the first time.
In 1934, sodium thiopental was discovered, a barbiturate that is still widely used in anesthesiology.
Sodium oxybate and ketamine were introduced in the 1960s and are still used today.
In recent years, a large number of new drugs for intravenous anesthesia (methohexital, propofol) have appeared.
The occurrence of endotracheal anesthesia
An important achievement in anesthesiology was the use of artificial respiration, for which the main merit belongs to R. Mackintosh. He also became the organizer of the first department of anesthesiology at Oxford University in 1937. During operations, curare-like substances began to be used to relax muscles, which is associated with the name of G. Griffiths (1942).
The creation of devices for artificial lung ventilation (ALV) and the introduction of muscle relaxants into practice contributed to the widespread use of endotracheal anesthesia - the main modern method of pain relief during major traumatic operations.
Since 1946, endotracheal anesthesia began to be successfully used in Russia, and already in 1948 a monograph by M.S. Grigoriev and M.N. Anichkova “Intratracheal anesthesia in thoracic surgery.”
Getting rid of pain has been the dream of mankind since time immemorial. Attempts to stop the suffering of the patient were used in the ancient world. However, the methods by which the healers of those times tried to relieve pain were, by modern standards, absolutely wild and themselves caused pain to the patient. Stunning with a blow to the head with a heavy object, tight constriction of the limbs, squeezing of the carotid artery until complete loss of consciousness, bloodletting to the point of brain anemia and deep fainting - these absolutely brutal methods were actively used in order to lose pain sensitivity in the patient.
There were, however, other ways. Even in Ancient Egypt, Greece, Rome, India and China, decoctions of poisonous herbs (belladonna, henbane) and other drugs (alcohol until unconsciousness, opium) were used as painkillers. In any case, such “gentle” painless methods brought harm to the patient’s body, in addition to a semblance of pain relief.
History stores data on amputations of limbs in the cold, which were carried out by Napoleon's army surgeon Larrey. Right on the street, at 20-29 degrees below zero, he operated on the wounded, considering freezing to be sufficient pain relief (in any case, he had no other options anyway). The transition from one wounded person to another was carried out even without first washing hands - at that time no one thought about the obligatory nature of this moment. Larrey probably used the method of Aurelio Saverino, a doctor from Naples, who back in the 16th-17th century, 15 minutes before the start of the operation, rubbed snow on those parts of the patient’s body that were then subjected to intervention.
Of course, none of the listed methods provided the surgeons of those times with absolute and long-term pain relief. The operations had to be carried out incredibly quickly - from one and a half to 3 minutes, since a person can withstand unbearable pain for no longer than 5 minutes, otherwise a painful shock would occur, from which patients most often died. One can imagine that, for example, amputation took place under such conditions by literally cutting off a limb, and what the patient experienced at the same time can hardly be described in words... Such anesthesia did not yet allow performing abdominal operations.
Further inventions of pain relief
The surgery was in dire need of anesthesia. This could give most patients who needed surgery a chance of recovery, and doctors understood this well.
In the 16th century (1540), the famous Paracelsus made the first scientifically based description of diethyl ether as an anesthetic. However, after the death of the doctor, his developments were lost and forgotten for another 200 years.
In 1799, thanks to H. Devi, a variant of pain relief using nitrous oxide (“laughing gas”) was released, which caused euphoria in the patient and gave some analgesic effect. Devi used this technique on himself during the eruption of wisdom teeth. But since he was a chemist and physicist, and not a physician, his idea did not find support among doctors.
In 1841, Long performed the first tooth extraction using ether anesthesia, but did not immediately inform anyone about it. Subsequently, the main reason for his silence was the unsuccessful experience of H. Wells.
In 1845, Dr. Horace Wells, who had adopted Devi's method of pain relief by using laughing gas, decided to conduct a public experiment: extracting a patient's tooth using nitrous oxide. The doctors gathered in the hall were very skeptical, which is understandable: at that time no one completely believed in the absolute painlessness of operations. One of those who came for the experiment decided to become a “test subject,” but due to his cowardice, he began screaming even before the anesthesia was administered. When anesthesia was finally carried out, and the patient seemed to pass out, “laughing gas” spread throughout the room, and the experimental patient woke up from a sharp pain at the moment of tooth extraction. The audience laughed under the influence of the gas, the patient screamed in pain... The overall picture of what was happening was depressing. The experiment was a failure. The doctors present booed Wells, after which he gradually began to lose patients who did not trust the “charlatan” and, unable to bear the shame, committed suicide by inhaling chloroform and opening his femoral vein. But few people know that Wells’s student, Thomas Morton, who was later recognized as the discoverer of ether anesthesia, quietly and imperceptibly left the failed experiment.
T. Morton's contribution to the development of pain management
At that time, Thomas Morton, a prosthodontist, was experiencing difficulties regarding the lack of patients. People, for obvious reasons, were afraid to treat their teeth, much less remove them, preferring to endure rather than undergo a painful dental procedure.
Morton perfected the development of diethyl alcohol as a powerful pain reliever through multiple experiments on animals and his fellow dentists. Using this method, he removed their teeth. When he built an anesthesia machine that was most primitive by modern standards, the decision to conduct public anesthesia became final. Morton invited an experienced surgeon to assist him, assigning himself the role of an anesthesiologist.
On October 16, 1846, Thomas Morton successfully performed a public operation to remove a tumor on the jaw and a tooth under anesthesia. The experiment took place in complete silence, the patient slept peacefully and did not feel anything.
The news of this instantly spread throughout the world, diethyl ether was patented, as a result of which it is officially considered that Thomas Morton was the discoverer of anesthesia.
Less than six months later, in March 1847, the first operations under anesthesia were already performed in Russia.
N. I. Pirogov, his contribution to the development of anesthesiology
The contribution of the great Russian doctor and surgeon to medicine is difficult to describe, it is so great. He also made a significant contribution to the development of anesthesiology.
He combined his developments on general anesthesia in 1847 with data previously obtained as a result of experiments conducted by other doctors. Pirogov described not only the positive aspects of anesthesia, but was also the first to point out its disadvantages: the likelihood of severe complications, the need for precise knowledge in the field of anesthesiology.
It was in the works of Pirogov that the first data appeared on intravenous, rectal, endotracheal and spinal anesthesia, which is also used in modern anesthesiology.
By the way, the first surgeon in Russia to perform an operation under anesthesia was F.I. Inozemtsev, and not Pirogov, as is commonly believed. This happened in Riga on February 7, 1847. The operation using ether anesthesia was successful. But between Pirogov and Inozemtsev there were complex, strained relations, somewhat reminiscent of the rivalry between two specialists. Pirogov, after a successful operation performed by Inozemtsev, very quickly began to operate, using the same method of administering anesthesia. As a result, the number of operations he performed noticeably overlapped those performed by Inozemtsev, and thus Pirogov took the lead in numbers. On this basis, many sources name Pirogov as the first doctor to use anesthesia in Russia.
Development of anesthesiology
With the invention of anesthesia, a need arose for specialists in this field. During the operation, a doctor was needed who was responsible for the dose of anesthesia and monitoring the patient’s condition. The Englishman John Snow, who began his activity in this field in 1847, is officially recognized as the first anesthesiologist.
Over time, communities of anesthesiologists began to appear (the first in 1893). Science has developed rapidly, and purified oxygen has already begun to be used in anesthesiology.
1904 - intravenous anesthesia with hedonal was performed for the first time, which became the first step in the development of non-inhalation anesthesia. It became possible to perform complex abdominal operations.
The development of drugs did not stand still: many drugs for pain relief were created, many of which are still being improved.
In the second half of the 19th century, Claude Bernard and Greene discovered that anesthesia could be improved and intensified by pre-administering morphine to calm the patient and atropine to reduce salivation and prevent heart failure. A little later, antiallergic drugs were used in anesthesia before the operation. This is how premedication began to develop as a medicinal preparation for general anesthesia.
One drug (ether) constantly used for anesthesia no longer satisfied the needs of surgeons, so S.P. Fedorov and N.P. Kravkov proposed a mixed (combined) anesthesia. The use of hedonal turned off the patient's consciousness, chloroform quickly eliminated the phase of the patient's excited state.
Now in anesthesiology, too, a single drug cannot independently make anesthesia safe for the patient’s life. Therefore, modern anesthesia is multicomponent, where each drug performs its own necessary function.
Oddly enough, local anesthesia began to develop much later than the discovery of general anesthesia. In 1880, the idea of local anesthesia was expressed (V.K. Anrep), and in 1881 the first eye surgery was performed: ophthalmologist Keller came up with the idea of performing local anesthesia using the injection of cocaine.
The development of local anesthesia began to gain momentum quite quickly:
- 1889: infiltration anesthesia;
- 1892: conduction anesthesia (invented by A.I. Lukashevich together with M. Oberst);
- 1897: spinal anesthesia.
Of great importance was the still popular method of tight infiltration, the so-called case anesthesia, which was invented by A. I. Vishnevsky. Then this method was often used in military conditions and in emergency situations.
The development of anesthesiology in general does not stand still: new drugs are constantly being developed (for example, fentanyl, anexate, naloxone, etc.), ensuring safety for the patient and a minimum of side effects.
Since ancient times, people have been thinking about how to relieve pain. The methods used were quite dangerous. Thus, in Ancient Greece, the root of mandrake, a poisonous plant that can cause hallucinations and severe poisoning, even death, was used as an anesthetic. It was safer to use “sleeping sponges.” Sea sponges were soaked in the juice of intoxicating plants and set on fire. Inhalation of the vapors put patients to sleep.
In Ancient Egypt, hemlock was used for pain relief. Unfortunately, after such anesthesia, few survived to the operation. The ancient Indian method of pain relief was more effective than others. Shamans always had an excellent remedy at hand - coca leaves containing cocaine. The healers chewed magic leaves and spat on the wounded warriors. Saliva soaked in cocaine brought relief from suffering, and shamans fell into a drug trance and better understood the instructions of the gods.
Chinese healers also used drugs for pain relief. Coca, however, cannot be found in the Middle Kingdom, but there were no problems with hemp. Therefore, the analgesic effect of marijuana has been experienced by more than one generation of patients of local healers.
Until your heart stops
In medieval Europe, methods of pain relief were also not particularly humane. For example, before an operation, a patient was often simply hit on the head with a mallet so that he would lose consciousness. This method required considerable skill from the “anesthesiologist” - it was necessary to calculate the blow so that the patient lost consciousness, but not life.
Bloodletting was also quite popular among doctors of that time. The patient's veins were opened and they waited until he lost enough blood to faint.
Since such anesthesia was very dangerous, it was eventually abandoned. Only the speed of the surgeon saved the patients from painful shock. For example, it is known that the great Nikolay Pirogov spent only 4 minutes amputating a leg, and removed the mammary glands in one and a half minutes.
Laughing gas
Science did not stand still, and over time, other methods of pain relief appeared, for example, nitrous oxide, which was immediately dubbed laughing gas. However, initially nitrous oxide was not used by doctors at all, but by traveling circus performers. In 1844, a magician Gardner Colton He called a volunteer onto the stage and let him inhale the magic gas. A participant in the performance laughed so hard that he fell off the stage and broke his leg. However, viewers noticed that the victim does not feel pain, as he is under anesthesia. Among those sitting in the hall was a dentist Horace Wells, who instantly appreciated the properties of the wonderful gas and bought the invention from the magician.
A year later, Wells decided to demonstrate his invention to the general public and staged a demonstration tooth extraction. Unfortunately, the patient, despite inhaling laughing gas, screamed throughout the entire operation. Those who gathered to look at the new painkiller laughed at Wells, and his reputation came to an end. Only a few years later it became clear that the patient was not screaming from pain, but because he was terribly afraid of dentists.
Among those present at Wells' disastrous performance was another dentist - William Morton, who decided to continue the work of his unlucky colleague. Morton soon discovered that medicinal ether was much safer and more effective than laughing gas. And already in 1846 Morton and the surgeon John Warren performed an operation to remove a vascular tumor using ether as an anesthetic.
And again coca
Medical ether was good for everyone, except that it only provided general anesthesia, and doctors also thought about how to obtain a local anesthetic. Then their eyes turned to the most ancient drugs - cocaine. In those days, cocaine was widely used. They were treated for depression, asthma and stomach upset. In those years, the drug was freely sold in any pharmacy along with cold remedies and ointments for back pain.
In 1879, a Russian doctor Vasily Anrep published an article on the effects of cocaine on nerve endings. Anrep conducted experiments on himself, injecting a weak solution of the drug under the skin, and found out that this leads to loss of sensitivity at the injection site.
The first person who decided to try Anrep’s calculations on patients was an ophthalmologist Karl Koller. His method of local anesthesia was appreciated - and the triumph of cocaine lasted for several decades. Only over time, doctors began to pay attention to the side effects of the miracle drug, and cocaine was banned. Koller himself was so amazed by the harmful effect that he was ashamed to mention this discovery in his autobiography.
It was only in the 20th century that scientists managed to find safer alternatives to cocaine - lidocaine, novocaine and other drugs for local and general anesthesia.
By the way
One in 200 thousand planned operations - this is the probability of dying from anesthesia today. It is comparable to the probability of a brick accidentally falling on your head.
The history of pain management is inextricably linked with the history of surgery. Elimination of pain during surgery dictated the need to search for methods to solve this issue.
Surgeons of the ancient world tried to find methods of adequate pain relief. It is known that compression of blood vessels in the neck and bloodletting were used for these purposes. However, the main direction of searches and the main method of pain relief for thousands of years was the introduction of various intoxicating substances. In the ancient Egyptian Ebers Papyrus, which dates back to the 2nd millennium BC, there is the first mention of the use of pain-relieving substances before surgery. For a long time, surgeons used various infusions, extracts of opium, belladonna, Indian hemp, mandrake, and alcoholic beverages. Probably, Hippocrates was the first to use inhalation anesthesia. There is evidence that he inhaled cannabis vapor for pain relief. The first attempts to use local anesthesia also date back to ancient times. In Egypt, Memphis stone (a type of marble) with vinegar was rubbed into the skin. As a result, carbon dioxide was released and local cooling occurred. For the same purpose, local cooling with ice, cold water, compression and constriction of the limb was used. Of course, these methods could not provide good pain relief, but for lack of anything better, they were used for thousands of years.
In the Middle Ages, “sleeping sponges” began to be used for pain relief; it was a kind of inhalation anesthesia. The sponge was soaked in a mixture of opium, henbane, mulberry juice, lettuce, hemlock, mandrake, and ivy. After that it was dried. During the operation, the sponge was moistened and the patient inhaled the vapor. There are other ways to use “sleeping sponges”: they were burned, and patients inhaled the smoke, sometimes chewed it.
In Rus', surgeons also used “ball”, “afian”, “medicinal glue”. “Rezalnikov” of that time could not be imagined without “uspic” means. All these drugs had the same origin (opium, hemp, mandrake). In the 16th-18th centuries, Russian doctors widely used euthanasia during operations. Rectal anesthesia also appeared at that time; Opium was injected into the rectum and tobacco enemas were performed. Under such anesthesia, hernia reductions were performed.
Although anesthesiology is believed to have been born in the 19th century, many discoveries were made long before that and served as the basis for the development of modern methods of pain management. Interestingly, the ether was discovered long before the 19th century. In 1275, Lullius discovered “sweet vitriol” - ethyl ether. However, its analgesic effect was studied by Paracelsus three and a half centuries later. In 1546, ether was synthesized in Germany by Cordus. However, it began to be used for anesthesia three centuries later. One cannot help but recall that the first tracheal intubation, albeit in an experiment, was performed by A. Vesalius.
All methods of pain relief used until the mid-19th century did not produce the desired effect, and operations often turned into torture or ended in the death of the patient. An example given by S.S. Yudin, described back in 1636 by Daniel Becker, allows us to imagine the surgery of that time.
“A German peasant accidentally swallowed a knife and the doctors at the University of Königsberg, making sure that the patient’s strength allowed for the operation, decided to perform it, after first giving the victim “painkiller Spanish balm.” With a large gathering of doctors, students and members of the medical board, the gastrostomy operation began. After praying to God, the patient was tied to a board; The dean marked with charcoal the place of the incision, four transverse fingers long, two fingers below the ribs and retreating to the left of the navel, the width of the palm. After this, surgeon Daniel Schwabe opened the abdominal wall with a lithotome. Half an hour passed, fainting occurred, and the patient was again untied and tied to the board. Attempts to pull out the stomach with forceps were unsuccessful; Finally they hooked it with a sharp hook, passed a ligature through the wall and opened it at the direction of the dean. The knife was pulled out "with applause from those present." In London, in one of the hospitals, there is still a bell hanging in the operating room, which they rang so that the screams of the patients could not be heard.
The American William Morton is considered the father of anesthesia. It is on his monument in Boston that it is written “BEFORE HIM, surgery at all times was an agony.” However, to this day, debate continues about who discovered anesthesia - Wells or Morton, Hickman or Long. For the sake of fairness, it should be noted that the discovery of anesthesia was due to the work of many scientists and was prepared at the end of the 18th and beginning of the 19th centuries. The development of the capitalist formation led to the rapid development of science and a number of great scientific discoveries. Significant discoveries that laid the foundation for the development of anesthesia were made in the 18th century. Priestley and Schele discovered oxygen in 1771. A year later, Priestley discovered nitrous oxide, and in 1779 Ingen-House ethylene. These discoveries gave a significant impetus to the development of pain management.
Nitrous oxide initially attracted the attention of researchers as a gas that had an exhilarating and intoxicating effect. Watts even designed an inhaler for inhaling nitrous oxide in 1795. In 1798, Humphry Davy discovered its analgesic effect and introduced it into medical practice. He also designed a gas machine for “laughing gas”. It has long been used as a means of entertainment at musical evenings. English surgeon Henry Hill Hickman continued studying the analgesic effect of nitrous oxide. He injected nitrous oxide into the animals' lungs, achieved complete insensibility, and under this anesthesia performed incisions and amputation of ears and limbs. Hickman's merit also lies in the fact that he formulated the idea of anesthesia as a defense against surgical aggression. He believed that the task of anesthesia is not only to eliminate pain, but also to correct other negative effects of surgery on the body. Hickman actively promoted anesthesia, but his contemporaries did not understand him. At the age of 30, in a state of mental depression, he died.
In parallel, studies of other substances were carried out. In 1818, in England, Faraday published materials on the analgesic effect of ether. In 1841, chemist C. Jackson tested this on himself.
If we adhere to historical truth, then the first anesthesia was not performed by V. Morton. On May 30, 1842, Long used anesthesia to remove a head tumor, but he was unable to evaluate his discovery and published his material only ten years later. There is evidence that Pope removed the tooth under ether anesthesia several months earlier. The first operation using nitrous oxide was carried out at the suggestion of Horace Wells. Dentist Riggs, under anesthesia with nitrous oxide given by Colton, pulled out Wells' healthy tooth on December 11, 1844. Wells performed 15 anesthesia procedures for tooth extractions. However, his further fate turned out to be tragic. During Wells' official demonstration of anesthesia in front of surgeons in Boston, the patient nearly died. Nitrous oxide anesthesia was discredited for many years, and H. Wells committed suicide. Only a few years later, Wells' merit was recognized by the French Academy of Sciences.
The official date of birth of anesthesiology is October 16, 1846. It was on this day in a Boston hospital that surgeon John Warren, under ether anesthesia given by W. Morton, removed a vascular tumor of the submandibular region. This was the first demonstration of anesthesia. But V. Morton performed the first anesthesia a little earlier. At the suggestion of the chemist C. Jackson, on August 1, 1846, under ether anesthesia (ether was inhaled from a handkerchief), he removed a tooth. After the first demonstration of ether anesthesia, Charles Jackson reported his discovery to the Paris Academy. In January 1847, the French surgeons Malguen and Velpeau used ether for anesthesia and confirmed the positive results of its use. After this, ether anesthesia became widely used.
Our compatriots also did not remain aloof from such a fateful discovery for surgery as anesthesia. In 1844, Ya. A. Chistovich published an article “On the amputation of the thigh using sulfuric ether” in the newspaper “Russian Invalid”. True, it turned out to be unappreciated and forgotten by the medical community. However, for the sake of justice, Ya. A. Chistovich should be put on a par with the names of the discoverers of anesthesia W. Morton, H. Wells.
It is officially believed that F.I. Inozemtsev was the first to use anesthesia in Russia in February 1847. However, somewhat earlier, in December 1846, N.I. Pirogov in St. Petersburg performed amputation of the mammary gland under ether anesthesia. At the same time, V.B. Zagorsky believed that “L. Lyakhovich (a native of Belarus) was the first in Russia to use ether for anesthesia during operations.”
The third substance that was used in the initial period of development of anesthesia was chloroform. It was discovered in 1831 independently by Suberan (England), Liebig (Germany), Gasrie (USA). The possibility of using it as an anesthetic was discovered in 1847 in France by Flourens. Priority for the use of chloroform anesthesia was given to James Simpson, who reported its use on November 10, 1847. An interesting fact is that N.I. Pirogov used chloroform for anesthesia twenty days after D. Simpson’s message. However, the first to use chloroform anesthesia were Sedillo in Strasbourg and Bell in London.
In the second half of the 19th century, after the first attempts to use various types of anesthesia, anesthesiology began to develop rapidly. N.I. Pirogov made an invaluable contribution. He actively introduced ether and chloroform anesthesia. N.I. Pirogov, based on experimental studies, published the world's first monograph on anesthesia. He also studied the negative properties of anesthesia, some complications, and believed that for the successful use of anesthesia it is necessary to know its clinical picture. N.I. Pirogov created a special apparatus for “etherization” (for ether anesthesia).
He was the first in the world to use anesthesia in military field conditions. Pirogov’s merit in anesthesiology also lies in the fact that he was at the forefront of the development of endotracheal, intravenous, rectal anesthesia, and spinal anesthesia. In 1847 he used the introduction of ether into the spinal canal.
The following decades were marked by improvements in anesthesia techniques. In 1868, Andrews began using nitrous oxide mixed with oxygen. This immediately led to the widespread use of this type of anesthesia.
Chloroform anesthesia was initially used quite widely, but high toxicity was quickly revealed. A large number of complications after this type of anesthesia prompted surgeons to abandon it in favor of ether.
Simultaneously with the discovery of anesthesia, a separate specialty, anesthesiology, began to emerge. John Snow (1847), a physician from Yorkshire who practiced in London, is considered the first professional anesthesiologist. It was he who first described the stages of ether anesthesia. One fact from his biography is interesting. For a long time, the use of pain relief during childbirth was constrained by religious dogma. Church fundamentalists believed that this was contrary to the will of God. In 1857, D. Snow administered chloroform anesthesia to Queen Victoria during the birth of Prince Leopold. After this, pain relief for childbirth was accepted by everyone unquestioningly.
In the mid-19th century, the foundations of local anesthesia were laid. It was already mentioned above that the first attempts at local anesthesia by cooling, stretching the limb, and using the “Memphis” stone were made in Ancient Egypt. In later times, many surgeons used such anesthesia. Ambroise Pare even created special devices with pelotes to compress the sciatic nerve. The chief surgeon of Napoleon's army, Larey, performed amputations, achieving pain relief with cooling. The discovery of anesthesia did not lead to the cessation of work on the development of local anesthesia methods. A fateful event for local anesthesia was the invention of hollow needles and syringes in 1853. This made it possible to inject various drugs into tissues. The first drug used for local anesthesia was morphine, which was administered in close proximity to the nerve trunks. Attempts have been made to use other drugs - chloroform, soponium glycoside. However, this was very quickly abandoned, since the introduction of these substances caused irritation and severe pain at the injection site.
Significant success was achieved after the Russian scientist, professor of the Medical-Surgical Academy V.K. Anrep, discovered the local anesthetic effect of cocaine in 1880. First, it began to be used for pain relief during ophthalmic operations, then in otolaryngology. And only after making sure of the effectiveness of pain relief in these areas of medicine, surgeons began to use it in their practice. A. I. Lukashevich, M. Oberst, A. Beer, G. Braun and others made a great contribution to the development of local anesthesia. A.I. Lukashevich, M. Oberst developed the first methods of conduction anesthesia in the 90s. In 1898, Beer proposed spinal anesthesia. Infiltration anesthesia was proposed in 1889 by Reclus. The use of cocaine local anesthesia was a significant advance, but the widespread use of these methods quickly led to disappointment. It turned out that cocaine has a pronounced toxic effect. This circumstance prompted the search for other local anesthetics. The year 1905 became historic when Eichhorn synthesized novocaine, which is still used today.
Starting from the second half of the 19th century and throughout the 20th century, anesthesiology developed rapidly. Many methods of general and local anesthesia have been proposed. Some of them did not live up to expectations and were forgotten, others are still used to this day. It is worth noting the most important discoveries that determined the face of modern anesthesiology.
1851-1857 - C. Bernard and E. Pelican conduct experimental research on curare.
1863 Mr. Green proposed the use of morphine for premedication.
1869 - Tredelenberg performs the first endotracheal anesthesia in the clinic.
1904 - N.P. Kravko and S.P. Fedorov proposed non-inhalation intravenous anesthesia with hedonal.
1909 - they also offer combined anesthesia.
1910 - Lilienthal performs the first tracheal intubation using a laryngoscope.
1914 - Kreil proposed the use of local anesthesia in combination with anesthesia.
1922 - A.V. Vishnevsky developed the method of tight creeping infiltration.
1937 - Guadel proposes a classification of the stages of anesthesia.
1942 - Griffith and Johnson introduce combined anesthesia with curare.
1950 - Bigolow introduces artificial hypothermia and Enderby introduces artificial hypotension.
1957 - Hayward-Butt introduces ataralgesia into clinical practice.
1959 - Gray proposes multicomponent anesthesia, and De Ka
severe neuroleptanalgesia.
Domestic surgeons A. N. Bakulev, A. A. Vishnevsky, E. N. Meshalkin, B. V. Petrovsky, A. M. Amosov and others also made a significant contribution to the development of anesthesiology. Thanks to their work, new methods of anesthesia were developed, Modern anesthesia equipment has been created.
Anesthesia during surgery was first demonstrated by William Morton, a dentist at the General Hospital, Boston, on October 16, 1846. The audience where he performed the operation was later called the House of Ether, and this date was called Ether Day. In the same year, the anesthetic properties of ether were demonstrated during a meeting of the London Medical Society.
On December 21, 1846, William Squire performed the first leg amputation using ether in London, and the operation was observed by many witnesses; she was a success. The following year, Professor Simpson of Edinburgh pioneered the use of a method in which chloroform was dropped onto a mesh covered with gauze, which was placed over the face of the person being operated on. In 1853, chloroform anesthesia was given by John Shaw to Queen Victoria during the birth of Prince Leopold.
Local anesthesia had not been scientifically described until 1844; Karl Koller accepts the offer of his friend Sigmund Freud and evaluates the effect of cocaine, subsequently describing the use of cocaine in anesthesia of the conjunctival sac, this operation is practiced in ophthalmic surgery.
The beginning of the era of ties was marked by the appearance of neckerchiefs in Ancient Rome. But still, the real triumph of the tie can be considered the 17th century. After the end of the Turkish-Croatian war, Croatian soldiers were invited to →
The first newspaper, very similar to modern ones, is considered to be the French “La Gazette”, which was published since May 1631.
The predecessors of the newspaper are considered to be the ancient Roman news scrolls Acta diurna populi romani (Urgent affairs of the population of Rome) - →
