Anesthetics

The easiest pain to bear is someone else’s. In the preanesthesia era, the prospect of surgery was so terrifying that it was not uncommon for a tough-hearted man to commit suicide rather than go through that unbearable, excruciating agony. It is hard to believe t hat t here was a time when nothing was effective to a lleviate surgical pain. The patients were simply strapped down and that was it. As a consequence, speed was the most important attribute of a surgeon in those days. A great English surgeon, Robert Liston at the University College Hospital, once boasted that he had amputated a leg in 29 seconds, along with a testicle of his patient and a finger of his assistant. The operation rooms were often strategically located at the tops of towers in the hospitals to keep fearful screams from being heard. During wartime, surgeries were even worse than battlefield injuries, because during the fight soldiers were temporarily “hypnotized” and became oblivious to pain. Before anesthesia, surgeons resorted to whatever means were available to deaden the pain oft heir patients during operations. The three most popular methods were alcohol, ice, and narcotics. Legend has it that a surgeon first conceived the idea of operating during a patient’s alcoholic coma when he noticed that a drunkard had had parts of his face chewed away by a hog but was not aware of it during a drunken stupor. Chinese surgeon Bian Què (401–310 B.C.) was reported to have operated on a patient’s brain using herbal extracts to render him unconscious more than 2,000 years ago. Hua Tuo (115–205 A.D.) made his patients take an effervescing powder (possibly cannabis) in wine that produced numbness and insensibility before surgical operations. Cold deadens pain by slowing the rate impulse conduction by nerve fiber. Some surgeons used ice to numb limbs before amputations. This method was invented by Baron Dominique Jean Larrey (1766–1842), surgeon of Napoleon’s Grande Armée.