INTRODUCTION OF GENERAL ANESTHESIA

Background

In retrospect, a modern person wonders what kind of mental blindness could have prevented physicians from actively pursuing a remedy for the horrors of surgery. Medical historians have stated that the secularization of pain therapy ^[109] and slowly evolving concepts of disease were the primary influences that determined the introduction of anesthesia in the middle of the 19th century.

Before the Renaissance, disease was considered to result from an imbalance among the four basic fluids within the body: blood, phlegm, yellow bile, and black bile. This theory was slow to dissipate, and remnants of these ideas were still present at the end of the 18th century. However, seminal research studies by Giovanni Battista Morgagni (1682–1771) demonstrated that disease resulted from organ dysfunction and as such was amenable to treatment by various interventions, with surgical drainage and extirpation among them.^[110] Rudolph Virchow (1821–1902), who carried on these concepts of disease in the 19th century,^[111] considers that modern medicine began with Morgagni because he pursued the study of disease from a symptom to the organ from which the symptom arose. Occurring at the same time was a trend away from viewing surgical pain as inevitable religious suffering into a more active search for some preventive medical intervention.

Although surgical technique was in development, the patient presented a problem to the surgeon, chiefly because of active physical resistance and because the cries and screams were distracting and often left the patient emotionally and physically exhausted. These factors, combined with the inevitable sepsis, resulted in high mortality rates. No wonder that by the middle of the 19th century there was greater determination by some surgeons to devise ways of improving operating conditions to decrease appalling surgical mortality figures, which in some reports reached nearly 50%. Bold approaches and risks were required, and these factors came together in Boston, Massachusetts, on October 16, 1846, when William T. G. Morton demonstrated the use of ether inhalation for surgical anesthesia.