Pain is called a health watchdog. It is a universal signaling device that warns the body about the possibility of injury and damage. However, pain can also become a ruthless executioner. Today, reliable chemical agents have been found that make it possible to stop pain, but we must remember that the history of all analgesics, anesthetics, anesthetics goes into the deep past, to the ointments and tinctures of ancient healers and healers.
People began to think about the problems of eliminating pain from the very moment the foundations of surgery began to appear. Almost any manipulations performed with the tissues and organs of a living person are very painful, and the immobility of the patient is one of the conditions for the successful work of the surgeon, while even tying the object does little, since the operated person can easily die from pain shock.
Hemlock that doesn't hurt
The search for means to help reduce pain has been carried out since the most dense times. In Syria, they used temporary stunning of the victim by squeezing the cervical vessels. The Egyptians rubbed crushed Memphis stone (a kind of marble) with vinegar into the patient's skin, achieving local cooling of the tissues by releasing carbon dioxide. For the same they used ice, snow and cold water. We tried to achieve pain relief by tightly tightening and bandaging the limbs.
A special niche was occupied by various infusions and extracts of narcotic and intoxicating substances. In the ancient Egyptian papyrus of Ebers, which dates back to 1550 BC, there is the first mention of the use of such drugs before surgery.
Belladonna, opium poppy, hemlock, mandrake, Indian hemp, alcoholic beverages - this is an incomplete list of what was included in the first pain relievers. Homer's Odyssey mentions a mixture of wine and opium to reduce suffering and anger. The Chinese surgeon Hua Tuo (3rd century AD) widely used Indian hemp juice for amputation and gluttony. Shamans in South America applied chewed coca leaves to their wounds to relieve pain. In ancient Rome, many operations were performed, including breast reduction and cataract removal, and real syringes with needles no thicker than one millimeter were used to inject anesthetics. By the way, the term "anesthesia" was invented by the Greek philosopher Dioscorides to describe the action of the mandrake.
Of course, the effectiveness of the first painkillers was not very high, and besides, the Aesculapians, not knowing how to dose the content of opiate alkaloids in infusions, could easily send the patient to their forefathers without any operation.
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The punishment of the Lord
The times of the dark Middle Ages with their religious fanaticism turned out to be “dark” for anesthesia. The Holy Church considered alcoholic anesthesia to be immoral, and the extraction of extracts from intoxicating plants was almost a black book. It was just dangerous to do this kind of thing. Pain was declared to be "God's punishment" sent down to mortals for their sins. “Pain saves the soul,” the preachers kept saying. The Church actively prohibited interfering with the natural course of things. The knowledge and experience of antiquity began to be forgotten.
In the 13th century, doctors were advised to give patients with dog earwax mixed with tar before surgery. The effectiveness of such recipes is illustrated by the bells that were hung in hospitals to drown out screams from operating theaters.
The situation developed into a stalemate: it usually did not work to overcome pain by prayer, and it was forbidden to prepare anesthetics. The doctors had to look for alternative methods.
The easiest way was a good blow to the forehead with a mallet. The person simply turned off, and the doctor had time to operate on him. True, the anesthesiologist had to have a correctly delivered blow and remarkable experience in order to send the patient to a knockout, and not to heaven. Bloodletting was considered another common method: one had to open the patient's vein and wait until he lost enough blood to lose consciousness.
As a result of the efforts of the church fathers, the physicians of the modern era had to practically rediscover what their ancient colleagues used on a daily basis.
Funny anesthesia
In the 18th and 19th centuries, the rapid development of science and technology pushed doctors and pharmacologists again to search for effective pain relievers. At first, the familiar cocaine and opium were used. In 1879, the Russian doctor Vasily Anrep found out that the injection of a weak solution of cocaine under the skin causes a loss of sensitivity at the injection site. Cocaine's triumph lasted for several decades. Drug pills were prescribed even to children for toothache. The opium tincture "Laudanum" enjoyed no less success. It could be freely purchased at any US pharmacy as a remedy for all ailments, from cough to diarrhea and migraine. Only many years later, medicine drew attention to the harm caused by "harmless" potions to the consumer.
At the same time, in the field of surgical anesthesia, the 19th century was marked by real breakthroughs. Here, the search for pioneer doctors turned to volatile substances. Inhalation with opiate vapors was used in ancient Egypt, and the famous Hippocrates used hemp smoke during operations. In Europe, after a millennium, they decided to turn to other substances. One of the drugs considered to be the cornerstones of modern anesthesiology is diethyl ether. Ether was discovered back in the XIII century by the philosopher and alchemist Raymond Lullius, who called the substance "sweet vitriol". Subsequently, "vitriol" was opened at least six times, until Crawford Long in 1842 first used it to euthanize a patient before surgery. Unfortunately, Long published the discovery materials only ten years later, and William Morton is considered the official father of anesthesia.who operated in 1846. By the way, nine years earlier, Holmes Coot had successfully used chloroform. In addition to Morton, Coot and Long, experts name Hickman and Wells among the pioneers of anesthesia.
The discrepancies are quite natural, because the researchers were moving in many directions at once. Discoveries were often made in a completely curious way, and for some reason the life of inventors was tragic. So, in 1844, while attending a circus performance, dentist Horace Wells witnessed how a volunteer from the hall, breathing nitrous oxide, fell from the stage with laughter and broke his leg, but he never stopped laughing. In the same year, Wells conducted an experiment on himself. Having breathed in "laughing gas", he managed to remove a healthy tooth and did not feel pain. Arriving in Boston, the doctor, for advertising purposes, tried to conduct a public demonstration operation, but something went wrong, and the patient almost died. The failure put an end to Wells' career, he fell into depression and committed suicide in 1848.
The English surgeon Henry Hickman continued to study nitrous oxide as a pain reliever. He did very well, but like Wells, he died in depression at the age of 30. It should be noted that Charles Jackson, who in fact suggested to Morton the idea of using the ether, suffered an unenviable fate: for a long time he tried to prove his priority in the authorship of the invention, then went crazy and died in some godly institution. However, the discovery of special wealth did not bring Morton himself.
Anesthetic innovation came to Russia at the same time as to Europe. Professor Chistovich is put on a par with Morton and Wells, and the first amputation in Russia under ether anesthesia was performed in 1846 by Nikolai Pirogov. He also published the world's first monograph on anesthesia.
One tablet
In the 20th century, with the two world wars, the development of anesthesia received an additional impetus, and anesthesiology for the first time emerged as a separate medical profession. To date, surgery has in its arsenal sufficient means for local anesthesia and general anesthesia, administered both intravenously and by inhalation. Modern drugs are much more effective and safer than those invented in the 19th century. Although it is not always possible to reduce side effects to zero to this day.
Probably, you should not touch such things as hypnosis anesthesia or absolutely incredible operations without a scalpel, performed by Filipino healers, but someday humanity will learn to do without surgical interventions at all, and therefore, without anesthesia. Billions of tiny nanobots, injected into a patient's body with a simple pill, will painlessly heal teeth, heal an ulcer, clear blood clots in blood vessels, remove an emerging tumor … but this, of course, is fantasy, although … not as crazy as it seems.
Magazine: Mysteries of History №10. Author: Eduard Shaurov