Horace Wells as a classic tragic hero.

Horace Wells is discussed in a literary manner as a classic tragic hero. Wells' apparent failed end is not the ultimate truth concerning him. His story helps us see and confront life. Many of the scientific, personal, and social issues he grappled with are relevant to us today such as human experimentation and drug addiction. His idealism and romantic pursuit are to be admired. We benefit today from the achievements of his daring and fateful quest.

From Dental to Mental Institutions: A Quadruple Threat of Nitrous-Oxide Administration Before and During Mental Asylum Admission.

During the 19th century, patients undergoing anesthesia for surgical and dental procedures were at risk of being given hypoxic or dilute nitrous oxide on four separate occasions. Primary and secondary saturation during surgery could account for two administrations of 100% nitrous-oxide anesthesia, while both diagnostic and therapeutic doses of dilute nitrous oxide were frequently administered in mental asylums.

From Dental to Mental Institutions: Elmer McKesson's Secondary Saturation with Nitrous Oxide.

As popularized by Elmer McKesson, MD, "secondary saturation" with nitrous oxide could expose patients to a second burst of 100% laughing gas to relax their muscles to assist surgeons. On rare occasions, this technique could provide a second opportunity for hypoxic brain damage and possible admission postoperatively to insane asylums.

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.

Townley's Chloroform Inhaler.

While cataloguing the historical items in the Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK, we discovered an unusual chloroform inhaler, which incorporated two air-inlet tubes in addition to its main inspiratory valve as well as a funnel on one of its lateral walls. An accompanying card stated that the device was thought to be a modification of Snow's inhaler, by James Robinson. It had been found among some old instruments in a General Practice in Huntingdon, Cambridgeshire, and had probably been acquired by an early practitioner named Dr. Newton, who qualified in 1851 and performed a lot of minor surgery in the practice. Using information published in books, medical journals, instrument catalogues, and other sources available in the public domain, we sought to confirm the identify of this inhaler and further investigate its provenance. Soon after the introduction of chloroform anesthesia in November 1847, James Robinson modified Snow's ether face-piece to produce an ingenious device for administering the vapor of chloroform. However, Robinson's inhaler did not include the air-inlet tubes, or funnels, which are an integral feature of the device found in the Addenbrooke's collection. Following further research, we formally identified our device to be of the type introduced by James Townley in 1862 for use with his "Anodyne mixture." We describe Townley's chloroform inhaler and provide an insight into the life and work of its inventor, as well as Dr. Newton and his son, who may have used the apparatus in the Cambridgeshire area.

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.

The Ayre's T-piece turns 80: A 21st century review.

Ayre's T-piece, first introduced 80 years ago, continues to be widely used in pediatric anesthesia despite colossal advances in equipment and technology. We present a review of its history, advantages, and disadvantages, and place in modern-day clinical practice.

Frozen in Time: A History of the Synthesis of Nitrous Oxide and How the Process Remained Unchanged for Over 2 Centuries.

Three major factors have contributed to the unrivaled popularity of nitrous oxide (N2O) among anesthetists in the 20th century and beyond: its impressive safety profile, its affordability, and its rapid induction and emergence times. These 3 characteristics of N2O have been discussed and written about extensively throughout the medical literature. Nonetheless, the characteristic that contributed most to N2O's initial discovery-the elegance and simplicity of its synthesis-has received substantially less attention. Although N2O was first used as an anesthetic in Hartford, CT, in 1844, it had been identified and synthesized as a distinct gas in the late 18th century. In this article, we track the developments in the recognition and early synthesis of N2O, highlight the major players credited with its discovery, and examine its evolution from the late 1700s to today. The discovery and assimilation of N2O into common medical practice, alongside ether and chloroform, heralded a new paradigm in surgical medicine-one that no longer viewed pain as a fundamental component of surgical medicine. Its continued usage in modern medicine speaks to the brilliance and skill of the chemists and scientists involved in its initial discovery.

Efficient application of volatile anaesthetics: total rebreathing or specific reflection?

The circle system has been in use for more than a 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. Its functional basis relies on molecular sieves such as zeolite crystals or activated carbon. In a circle system, the breathing gas is rebreathed after carbon dioxide absorption; a reflector on the other hand specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. Reflection systems can be used in conjunction with intensive care ventilators and do not need the permanent presence of trained qualified staff. Because of easy handling and better ventilatory capabilities of intensive care ventilators, reflection systems facilitate the routine use of volatile anaesthetics in intensive care units. Until now, there are three reflection systems commercially available: the established AnaConDa™ (Sedana Medical, Uppsala, Sweden), the new smaller AnaConDa-S™, and the Mirus™ (Pall Medical, Dreieich, Germany). The AnaConDa consists only of a reflector which is connected to a syringe pump for infusion of liquid sevoflurane or isoflurane. The Mirus represents a technical advancement; its control unit includes a gas and ventilation monitor as well as a gas dispensing unit. The functionality, specific features, advantages and disadvantages of both systems are discussed in the text.

The Historical Development of Obstetric Anesthesia and Its Contributions to Perinatology.

Scottish obstetrician James Young Simpson first introduced the use of ether and chloroform anesthesia for labor in 1847, just 1 year after William Morton's first successful public demonstration of ether anesthesia at the Massachusetts General Hospital. The contemporaneous development of surgical anesthesia and obstetrics enabled obstetric anesthesia to address the pain of childbirth. Shortly after its introduction, obstetricians raised concerns regarding placental transport, or the idea that drugs not only crossed the placenta, but exerted detrimental effects on the neonate. The development of regional anesthesia and clinical work in obstetric anesthesia and perinatology addressed issues of the safety of the neonate, enabling obstetric anesthesia to safely and dramatically reduce the pain of childbirth.

Obstetric and Other Uses of Ether Before Ether Day, According to the Boston Medical and Surgical Journal of 1828-1846.

From the inception of the Boston Medical and Surgical Journal in 1828 until the prominent public demonstration of surgical anesthesia on Ether Day of 1846, ether was often mentioned in the journal. Many of the examples were related to obstetrics. Because molecular structures were not available in the early 1800s, diverse volatile liquids were termed ethers. In addition to sulphuric ether, so-called ethers included cyanide-releasing propionitrile and ethanolic solutions of chloroform and of the potent vasodilator ethyl nitrite. Familiarity with anesthetically unsuitable ethers may have long deterred consideration of inhaled sulphuric ether for analgesia and anesthesia.

Ciento cincuenta y cinco años de la primera anestesia inhalatoria en el campo de batalla realizada en España / One hundred and fifty five years from the first Spanish inhaled anesthesia in battlefield

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[Did Seikyo Sugita Perform Two Surgical Operations under Ether Anesthesia in 1855?].

Although Seikyou Sugita is said to have provided ether anesthesia for two surgical oprations in 1855 including the scur resection of burned fingers of a man and the resection of a breast cancer of a woman. The details of his administration of the drug were not known because he did not describe these cases at all. According to Treatise on Inhalation of Ether written in 1863 by Shinryo Tsuboi, Sugita failed to provide successful general anesthesia using ether for these patients. The ether he used was prepared by Ryuho Shima, and the failures were likely to be due to impure nature of the agent.

Crawford Williamson Long: The True Pioneer of Surgical Anesthesia.

Anesthesia and analgesia are as old as mankind itself. However, we now know that the true pioneer of surgical anesthesia through inhalation of ether was Doctor Crawford Williamson Long (1815-1878), who endeavored to help his profession and mankind without pursuing any reward or honor. Crawford Williamson Long was a great and beloved American surgeon. He was a well-educated and elegant man with an outstanding personality. Crawford was born in Danielsville, Georgia, in the United States and was the son of James Long and Elizabeth Ware Long. He married Mary Caroline Swain Long and gave birth to 12 children. Long proved the effectiveness of ether after painlessly removing a tumor from the neck. In 1847, a rivalry broke out among Horace Wells, Charles Thomas Jackson, and William Thomas Green Morton for the primacy as regards the discovery of anesthesia. The US Congress offered itself to arbitrate the case of the so called "ether controversy." Finally, a few years after the end of the North American Civil War, while taking care of a patient, Crawford passed away, presumably after suffering a stroke.

Becoming a physician anaesthetist-difficulties encountered for half a century.

William T.G. Morton was not the first to use ether or nitrous oxide as an anaesthetic. However, his public demonstration on 16 October, 1846 (Ether Day), and the notoriety that followed thereafter, are credited for announcing man's victory over surgical pain to the entire world. The use of ether during surgery spread rapidly through most of the world. One would expect that the careers of Ether Day participants would have been greatly affected by this seminal event and that some would go on to become anaesthetists. An examination of the participants' professional lives shows that some became strong advocates of anaesthesia and ether was used extensively for their patients. Some were prolific writers and helped spread the use of anaesthesia. However, attracting physicians to this new discipline proved difficult and there were segments of the medical establishment and society who were unwilling to accept this most significant advancement. In this article, we examine the reasons why many physicians and patients resisted the use of anaesthesia.