[The Stadium analgeticum - Historical Highlights on the Ether Rush]. / Das Stadium analgeticum ­ historische Streiflichter zum Ätherrausch.

For decades, the term ether rush was synonymous with the practice of short-term anaesthesia, among patients and doctors. The term was first used shortly after the discovery of the anaesthetic properties of ether by Hamburg-based physician Elias Salomon Nathan in an article about the newly discovered ether anaesthesia. Decades later, the surgeon Paul Sudeck, who also worked in Hamburg, also described an anaesthetic technique he practiced as an ether rush and met with great approval from his surgical colleagues, as well as for his anaesthetic mask developed for carrying out the ether rush and the anaesthetic dropper, specified for this purpose.Sudeck did not want to be regarded as the inventor of the special anaesthetic technique and repeatedly pointed out that his procedure had already been described and applied before him, but was forgotten again. Nevertheless, Sudeck's ether rush remained a well-known, widespread analgesic method in German-speaking countries until the end of the 1940s, and it proved its worth many times during the World War. After 1945, when ether lost its pre-dominant role as an inhalation anaesthetic and was replaced by other, new agents and short-acting i. v. administered analgesics, the ether rush was also fell into oblivion and was no longer used.Against the background of the first successfully performed ether anaesthesia on October 16th, 1846 - 175 years ago - at the Massachusetts General Hospital in Boston, the description of the ether rush should be recalled in this context.

Morton's Letheon: When was the name Letheon chosen?

Letheon was the commercial name that Boston dentist William T. G. Morton chose for his ether-based "preparation" that was inhaled to produce insensibility during surgical and dental procedures. The multiple editions of Edward Warren's Some Account of the Letheon (1847) as well as Nathan P. Rice's Trials of a Public Benefactor (1859) provide the only known accounts of the meeting hosted by the physician Augustus A. Gould at which the name Letheon was chosen. Neither Warren nor Rice mentions when the meeting occurred. In all likelihood, it was held at some point in a three-week period from mid-November to just short of December 9, 1846, the publication date of the earliest known reference to the name. The absence of the word Letheon in Morton's public notices around the end of November 1846 or, indeed, in any document until his December 9 advertisement in The Boston Medical and Surgical Journal suggests a later date for the meeting than has been previously reported.

From ACE to ACENO: How America's Munson added Harley's British mixture to nitrous oxide.

An Ohio dentist, Corydon Munson, patented a gasometer with an attachment for vaporizing trace amounts of volatile general anesthetics or their mixtures into unoxygenated nitrous oxide. After vaporizing a variant of George Harley's ACE mixture into nitrous oxide, Munson branded his own novel anesthetic combination as ACENO.

Burnett's "Cocaine" for dandruff.

Joseph Burnett manufactured the diethyl ether used for William T.G. Morton's public demonstration of inhaled surgical anesthesia on October 16, 1846 (Ether Day). A later Burnett product was a hairdressing oil claimed to prevent baldness and dandruff. It contained cocoa-nut oil and was called Cocoaine. In 1902 and 1903, it was sometimes advertised as Burnett's Cocaine (rather than Cocoaine), possibly to emulate the economic success of coca-based beverages such as Vin Mariani and Coca-Cola. Coca leaves are now decocainized before use in preparation of Coca-Cola, and the recovered cocaine is used for scientific and dwindling medical purposes.

Anesthesia-related Ramifications of Benjamin Franklin's Ether-based Refrigeration.

In 1758, Benjamin Franklin froze water by means of the evaporation of diethyl ether. Diethyl ether became the coolant in early mechanical refrigerators and ice makers. Refrigeration advances by Carl von Linde and others provide medical oxygen from the air, liquid nitrogen for cryopreservation and cryoablation, xenon for inhaled anesthesia, and liquid helium for supercooling of magnetic resonance image scanners.

Founding Physicians of the Medical College of Georgia and Their Connections to Crawford Long and the First Surgical Anesthetic.

Milton Antony (1789-1839), an apprenticed trained physician, began educating medical apprentices in 1826 and helped to establish the Medical College of Georgia (MCG) in 1829. Antony recruited additional faculty, Louis Dugas (anatomy and physiology), and Paul Eve (surgery), and together they worked to promote the dissemination of new medical knowledge and enhance and reform medical education. As a result of their efforts, the Southern Medical and Surgical Journal (SMSJ) was established in 1836. The SMSJ became the most successful and widely read regional medical journal. Unfortunately, upon the death of Milton Antony because of the Augusta yellow fever epidemic, the SMSJ ceased publication in 1839. Paul Eve then became Dean of MCG and revived the SMSJ in 1844. Crawford Long (1815-1878) administered ether anesthesia for surgical removal of a neck tumor to James Venable in 1842. For several possible reasons, he did not publish his experience with ether until after Morton's demonstration of ether in Boston in 1846. Crawford Long did meet with Paul Eve, in Augusta at MCG, and was encouraged to publish his experiences with ether in the revived SMSJ, which he did in 1849. It is quite possible that if Milton Antony had lived, and the SMSJ had been continuously published, that Crawford Long may have published his use of ether well in advance of Morton's ether demonstration in 1846. Had that occurred, the great controversy during the mid-nineteenth century over who first used ether for surgical anesthesia would not have existed, and Crawford Long would have received appropriate credit during his lifetime.

Henry Jacob Bigelow Inhaled Nitrous Oxide While an Undergraduate at Harvard College.

When teenaged Henry Jacob Bigelow was an undergraduate at Harvard College in 1833-1837, he prepared nitrous oxide gas for demonstrations to other students. Bigelow's son, William Sturgis Bigelow, related the claim, and there is an eyewitness account from Augustus Goddard Peabody, a fellow Harvard undergraduate with Bigelow. Peabody wrote to Henry David Thoreau about a nitrous frolic. College chemistry primed Bigelow to support the concept of inhaled surgical anesthesia when the idea came to Boston in 1845-1846. Bigelow's chemistry professor was John White Webster. According to Harvard alumnus Edward Everett Hale, in addition to demonstrating effects of nitrous oxide, Webster presciently treated two cases of carbon monoxide poisoning with copious volumes of synthetic oxygen gas. The career of Webster was inhibited by financial difficulties that were suspected to be contributory when he was convicted of the 1849 murder of physician George Parkman at the Harvard Medical School, then adjacent to Massachusetts General Hospital and its Ether Dome. Webster suffered the death penalty in 1850.

Anaesthetic or "Antiaesthetic" or "Antaesthetic"? Correspondence From Andrew Buchanan, MD, to James Simpson, MD, Concerning a Name for the Agents Producing Insensibility.

In November 1847, James Young Simpson, MD, of Edinburgh, Scotland, applied the word anaesthesia to the state of narcotism and insensibility produced by the inhaled vapors of sulfuric ether and chloroform, along with the word anaesthetic as an adjective to denote that state and as a generic term for agents capable of inducing the state of insensibility. In March 1848, Andrew Buchanan, MD, of Glasgow, Scotland, penned a letter to Simpson to suggest a more semantically precise word, the spelling of which is not clear in Buchanan's letter. We do not know whether Simpson replied to Buchanan. Simpson continued using the words anaesthesia and anaesthetic in his publications.

A Newly Discovered Manuscript of Charles T. Jackson, MD, on the Preparation and Administration of Anesthetics for Humans and Animals.

A newly discovered handwritten manuscript of Charles T. Jackson, MD, contains instructions for the preparation and administration of sulfuric ether, information on Jackson's preferred mixture of ether and chloroform, an account of his experiments with other potential anesthetic agents, and his comments on etherizing cattle and other animals. Jackson's nine-page manuscript is believed to have been written in the autumn of 1851, around the time that he submitted his memorial on the discovery of etherization to Baron von Humboldt, and made a separate submission to the US Congress.

The Perfect and Famous Anesthetic Known as Methyl in Boston in 1895.

Extravagant claims were made for proprietary dental anesthetics in Boston, MA, in the late 1800s. For instance, in 1883, Urial K. Mayo introduced an inhaled Vegetable Anaesthetic comprised of nitrous oxide that had been uselessly pretreated with botanical material. This misguided concept may have been inspired by homeopathy, but it was also in line with the earlier false belief of Elton R. Smilie, Charles T. Jackson, and William T.G. Morton that sulfuric ether could volatilize opium at room temperature. In 1895, the Dental Methyl Company advertised an agent they called Methyl, a supposedly perfect topical anesthetic for painless dental extraction. The active ingredient was probably chloroform. Anesthetic humbug did not cease in Boston on Ether Day of October 16, 1846.

Charles T. Jackson and William T.G. Morton Patented the "Ethereal Solution of Opium" of Elton Romeo Smilie.

The Jackson-Morton 1846 patent for surgical insensibility by means of sulphuric ether states that opiates can be added to the ether and co-administered by inhalation. The erroneous concept that ether could carry opiates in its vapor phase at room temperature was proposed in Boston in 1846 by Elton Romeo Smilie (1819-1889), who believed that the opiates were more important than the ether vehicle.

John Snow and the First Second-Gas Effect.

In 1847, British anesthesia pioneer John Snow (1813-1858) observed that patients did not manifest cyanosis during induction with hypoxic mixtures of ether vapor in air. He hypothesized a molecular mechanism that would be understood over a century later as the second gas effect.

St John's Hospital (Morton House), Launceston, Australia: A history of the hospital and Dr William Russ Pugh's first operations under ether.

On 7 June 1847, William Russ Pugh, MD, performed two operations at the St John's Hospital and Self-Supporting Dispensary, Launceston, Tasmania, while his patients were rendered insensible by the inhalation of sulphuric ether. These operations are the earliest documented surgical operations under ether in Australia. St John's Hospital officially opened on 1 September 1845. The hospital may have closed in late 1853 because of financial difficulties. The two-storey Georgian-style building which served as the hospital was completed c1831-1832. It has served as a residence, school, boarding school, hospital, medical consulting rooms and commercial offices. The building is now known as Morton House. We could not identify the date when the name Morton House was adopted, or explain the origin of the name. The earliest identified use of this name is in May 1873 in a newspaper advertisement for boarders. No person with the surname Morton is known to have been associated with the building as an owner or as a tenant. The name Morton House may honour William T.G. Morton, MD, the Boston dentist who performed the first public demonstration of surgical etherisation on 16 October 1846.

Dr Snow killed a bird: The genesis of pharmacokinetics and pharmacodynamics in anaesthesia.

This essay presents a pharmacologist's perspective of what would be now called 'preclinical research' and 'uncontrolled clinical trials' surrounding the first public demonstration by William Thomas Green Morton of painless surgery achieved by the inhalation of ether in a patient at the Massachusetts General Hospital on 16 October 1846. Of the many people who made history in those earliest days of surgical anaesthesia in both the United States and Great Britain, John Snow stands out for his personal research that spanned basic science and clinical medicine. Primarily, Snow used the relationship between the vapour pressure of a volatile liquid and temperature to design a vaporiser. This allowed control of the inspired concentration of the volatile liquid epitomised by diethyl ether, and thus the time-course and depth of anaesthesia. In an era when developments in anaesthesia were almost exclusively based on empirical modifications to apparatus and technique, Snow, and to a lesser extent his contemporary Andrew Buchanan, stood out from all others in advancing the quantitative basis of anaesthesia. Both described the physiological basis of control over gas uptake whereby they related that gas moved across concentration gradients in the body: alveolar to arterial to tissue to venous gas tensions, and Snow devised a progressional semi-quantitative scale of five 'stages' of ether anaesthesia. They thereby introduced the elements of what would be referred to 'pharmacokinetics' and 'pharmacodynamics', a century later. This essay attempts to place them and their scientific insights into context with contemporaneous principal personae and knowledge.

A Newly Discovered Manuscript of Charles T. Jackson, MD: "History of the Patenting of the Application of Sulphuric Ether for the Production of Insensibility".

In 2016, the Wood Library-Museum of Anesthesiology, Schaumburg, IL, acquired an unpublished 11-page manuscript written by Charles Thomas Jackson, MD, (1805-1880). The undated manuscript, now fully transcribed, provides Jackson's perspective of the first 6 weeks of the ether discovery, from early October 1846 to mid-November 1846. It chronicles Jackson's observations and discussions pertaining to United States Patent No. 4848, granted to him and William Thomas Green Morton, MD, (1819-1868). Jackson's manuscript did not yield new information on the discovery of surgical etherization or the subsequent dispute between him and Morton. The manuscript may, nevertheless, be one of the earliest documents on etherization known to have been written by Jackson.

Intrarectal Anesthesia in Neurosurgery.

In the early days of modern neurologic surgery, the inconveniences and potential dangers of general anesthesia by chloroform and ether using the so-called "open-drop technique" led to the quest for alternative methods of anesthesia. This became all the more necessary, since patient positioning and the surgical arrangements often hindered the use of a drop bottle. One approach to solve this problem was intrarectal ether application. The present article aims to shed light on this original, less well-known anesthesia technique in the neurosurgical field.

[Questions on the first operation with ethyl ether as anaesthetic by Dr. Peter Parker].

Ethyl ether was the first accepted effective general anaesthetic. It was introduced into China by an America missionary, Dr. Peter Parker. This was one of the historical events of medical communication between China and the West. In the records of the first operation with ether, however, Dr. Parker unusually omitted the patient's medical record number and the date of the operation, while those of other operations with ether anesthetics were all available. This was very unusual for a doctor like Peter Parker who always recorded every important case in detail in the hospital reports. It seems that he deliberately rather than carelessly omitted the information for some reasons. Based on the analysis of Parker's reports, a conclusion is made that the anesthetic effect of the case was actually ineffective. Furthermore, possible answers to this are outlined and question by discussion based on the situation that Parker faced in the late Qing era.