Lalitha Sundararaman, MBBS, MD, Clinical Instructor, Department of Anesthesiology and Pain Medicine, Harvard Medical School, and Fellowship in Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston.

Lalitha Sundararaman, MBBS, MD, Clinical Instructor, Department of Anesthesiology and Pain Medicine, Harvard Medical School, and Fellowship in Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston.

January: The month that saw the revelation and rejection of early inhalational anesthetics

January saw the birth of many eminent personalities whose names came to be linked forever with nitrous oxide, including James Watt, who was born on January 19, 1736. He created much of the early equipment used to isolate and discover the properties of nitrous oxide. Watt was an ardent supporter of the “pneumatic institution” where medicinal and therapeutic applications of various gases were investigated to find a cure for the greatest disease prevalent then – tuberculosis. One of his assistants was Peter Mark Roget. Though known worldwide for founding the “Roget's Thesaurus,” he was also instrumental in nitrous oxide research alongside Watt, Beddoes, and Davy. Though anesthesia has benefited from the discovery of many gases by the pneumatic institution, Watt did not, and both his children died of TB.

Who knew that Shakespeare would be an inspiration for anesthesia?

In his play “The Tragedy of Cymbeline,” there is a line that says, “he that sleeps feels not the toothache.” This was the opening line of Gardner Quincy Colton's show featuring the soporific effects of nitrous oxide, a show that Horace Wells, also born on January 21, 1815, attended. On seeing that inhaled nitrous oxide caused Samuel Cooley not to feel a serious injury, the idea was initiated that nitrous oxide may be used for anesthesia.

He continued to experiment and demonstrated the anesthetic effect of nitrous oxide in January 1846 at Massachusetts General Hospital. However, by his own admission he removed the gas mask too early and the patient experienced some but not severe pain. However, the demonstration was deemed a debacle and Horace Wells left in disgrace. His life spiraled downward and ended on January 24, 1848, only three days after his birthday, when he committed suicide. However, he had kickstarted the use of inhalational anesthetics, an integral part of anesthesia even today.

Nitrous oxide entered psychiatric journals, too!

On January 11, 1842, American psychologist and philosopher William James was born in New York City. Among his many accomplishments, James self-experimented with nitrous oxide inhalation and wrote a colorful account of his experience, “The Subjective Effects of Nitrous Oxide.” This was originally published in the journal Mind in 1882.

It was not just nitrous oxide but ether and chloroform that added to the wins and woes of the history of anesthetic gases in January. On January 19, 1847, James Young Simpson successfully used ether for pain relief in labor. Dr. Simpson and two colleagues, Dr. George Skene Keith and James Matthews Duncan, proceeded to test the soporific and analgesic properties of new chemicals every evening. While regarded as “anesthetic pioneers” in the day, history might have judged then differently today with their recreational and less than scholarly method of intake of the gases. Success is always forgiving, though, and on November 4, 1847, they decided to try chloroform. On inhaling the chemical, a general feeling of bonhomie and cheer had set in. All of them lost consciousness and regained it only on the next day. Simpson however “smelled” a golden opportunity for a new anesthetic. They soon had Miss Petrie, Simpson's niece, try it (definitely no informed consent there!). She fell asleep soon after inhaling it while singing the words, “I am an angel!” Chloroform soon proved that it could also be an angel of death, when on January 28, 1848, Hannah Greener of Newcastle, England became the first fatality reported from chloroform use. On January 1, 1886, Wealthy grocer Thomas Edwin Bartlett died in the Pimlico district of London from chloroform poisoning. This case became widely publicized as a homicide, adding to the notoriety of chloroform. Gradually due to the rising popularity of hexobarbital, nitrous oxide, and ether, anesthetic chloroform met its demise in early 1976.

“It was not just nitrous oxide but ether and chloroform that added to the wins and woes of the history of anesthetic gases in January.”

Image: William James, American psychologist and philosopher (1842-1910). Wikipedia (Public Domain).

Image: William James, American psychologist and philosopher (1842-1910). Wikipedia (Public Domain).

Image: James Young Simpson (1811-1870). Wikipedia (Public Domain).

Image: James Young Simpson (1811-1870). Wikipedia (Public Domain).

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