Part 1

Transcriber’s notes:

The text of this e-book has been preserved as in the original, including archaic spellings, but some illustrations have been repositioned closer to the relevant text. Italic text is denoted by _underscores_. Subscripted text is enclosed within curly brackets preceded by an underscore.

[Illustration: AN OPERATION ON THE EYE

From an MS. of the XIII century]

[Illustration: A SURGEON PERFORMING AN OPERATION

From a woodcut of the XVII century]

ANÆSTHETICS

ANTIENT AND MODERN

AN

HISTORICAL SKETCH

OF

ANÆSTHESIA

BURROUGHS WELLCOME & CO.

London (Eng.)

_Branches_: New York Montreal Sydney Cape Town

[All rights reserved

INDEX

PAGE

Anæsthesia, Dawn of, 7

Anæsthesia, Chloroform for, 69

Anæsthesia in Romance, 23

Anæsthesia in Roman Times, 17

Anæsthesia in the Antient Poets, 25

Anæsthesia, Local, in Antient Times, 27

Anæsthetic, an Antient Chinese, 18

Anæsthetics, Early Egyptian, 7

Anæsthetic, an Early Irish, 19

Anæsthetic, Freezing as an, 27

Anæsthetic, Mesmerism as an, 34

Anæsthetics used by the Hindus, 18

Anæsthetics, Chemical Era of, 30

Anæsthetics in the Middle Ages, 19

Anæsthetics, Local, 67

Anæsthetics of Antient Greece, 11

Carbon Tetrachloride, 67

Chloric Ether, 58

Chloroform, Discovery of, 58

Chronology, 73

Cocaine, 68

Colton, Dr. G. Q., 41

Davy, Sir Humphry, 33

Ether Epoch, 44

Ether, Sulphuric, 33

Ethyl Bromide, 67

Eucaine, 68

Faraday, Michael, 33

Holmes, Dr. Oliver Wendell, 52

Hypnotism, 37

Indian Hemp, 9

Jackson, Charles T., 50

“Letheon”, 52

Lycoperdon, 19

Mandragora, 11

Methyl Chloride, 66

Morphine, 29

Morton, W. T. G., 54

Nitrous Oxide Era, 41

Novocaine, 69

Opium, 27

Oxygen, 30

Priestley, Joseph, 32

Simpson, Sir James Young, 63

Stovaine, 69

Sulphuric Ether, 33

Wells, Horace, 42

[Illustration:

Comment adam et eue furent crees au ij · et au · iiij · c · de genesis

_From a woodcut of the XV century_

“And the Lord God caused a deep sleep to fall upon Adam, and he slept: and He took one of his ribs, and closed up the flesh instead thereof.”

_Genesis, chap. ii, verse 21_]

ANÆSTHETICS, ANTIENT AND MODERN

AN HISTORICAL SKETCH OF ANÆSTHESIA

“So God empal’d our Grandsire’s (Adam’s) lively look, Through all his bones a deadly chilness strook, Siel’d up his sparkling eyes with Iron bands, Led down his feet (almost) to Lethe’s sands; In briefe so numm’d his Soule’s and Bodie’s sense, That (without pain) opening his side from thence He took a rib, which rarely He refin’d, And thereof made the mother of Mankind.”

[Sidenote: The Dawn of Anæsthesia]

Thus a sixteenth century poet quaintly describes, and draws an impression of, from sacred records, the first operation tempered by anæsthesia. It has been claimed that in the “deep sleep” that the Creator “caused to fall upon Adam” is the germ of the idea of anæsthesia that has come down to us from the dim ages of the past. It is probable that primitive man employed digital compression of the carotid arteries to produce anæsthesia, as the aboriginal inhabitants of some countries do to-day. According to Caspar Hoffmann, this method was practised by the antient Assyrians before performing the operation of circumcision. Curiously enough the literal translation of the Greek and Russian terms for the carotid is “the artery of sleep.”

[Sidenote: Early Egyptian anæsthetics]

The antient Egyptians are believed to have used Indian hemp and the juice of the poppy to cause a patient to become drowsy before a surgical operation. Pliny relates that they applied to painful wounds a species of rock brought from Memphis, powdered, and moistened with sour wine, which is the first record we have of local anæsthesia with carbonic acid gas.

[Sidenote: The “Wine of the Condemned”]

The “sorrow-easing drug” which, as we are told in the fourth book of the “Odyssey,” was given by Helen to Ulysses and his comrades, probably consisted of poppy juice and Indian hemp. It is indeed actually stated that she learned the composition from Polydamnia, the wife of Thone, in Egypt. It is possible also that the “wine of the condemned,” mentioned by the prophet Amos, may have been a preparation of these drugs.

[Illustration: MANDRAGORA (_the Phallus of the Field_)

Inscribed in cuneiform characters and in Egyptian hieroglyphics ca. 3000 B.C.]

There are several passages in the Talmud which point to the fact that the practice of easing the pain of torture and death, by stupefying the sufferers, was a very antient one.

Thus it is stated: “If a man is led forth to death, he is given a cup of spiced wine to drink, whereby his soul is wrapped in night”; and again, “Give a stupefying drink to him that loseth his life, and wine to those that carry bitterness in their heart.”

In connection with crucifixion, which was a common punishment for malefactors among the Jews before the Christian era, with the sanction of the Sanhedrin, the women were wont to ease the terrible death agony of the sufferers by giving them something in the nature of a “wine of the condemned” upon a sponge. It is probable that the “wine mingled with myrrh” which, according to St. Mark, was offered to Christ before nailing Him upon the Cross, was indeed a narcotic draught, given with the object of lessening His sensibility to the agony.

The earliest reference to anæsthesia by inhalation is contained in the works of Herodotus, who states that the Scythians were accustomed to produce intoxication by inhaling the vapour of a certain kind of hemp, which they threw upon the fire or upon stones heated for the purpose. This was probably _Cannabis indica_, or Indian hemp, which was employed by Oriental races as an anæsthetic from very early times.

[Sidenote: Anodyne poultices to deaden pain]

At the siege of Troy the Greek army surgeons employed anodyne and astringent poultices to assuage the pain of the wounded. Thus Patroclus, when his dagger from the thigh of Euryphylus--

Cut out the biting shaft; and from the wound With tepid water cleansed the clotted blood; Then, pounded in his hands, the root applied Astringent, anodyne, which all his pain Allay’d; the wound was dried, and stanched the blood.

_Iliad._

[Illustration: GATHERING MANDRAGORA

From an MS. of the XII century]

From this interesting description of the manner in which the early Greek surgeons treated a wound, it is evident that, although they had no actual knowledge of anæsthetics, they had found from experience the advantage of cleansing the wound and applying an astringent and anodyne dressing to deaden sensibility to pain, which probably, unknown to them, also possessed antiseptic qualities.

MANDRAGORA AS AN ANÆSTHETIC

[Sidenote: The anæsthetics of antient Greece]

That the early Greeks also used certain methods for deadening sensibility to pain is evidenced by several of the antient writers. Pindar states “Machaon eased the sufferings of Philoctetes with a narcotic potion.” Theocritus also alludes to Lucina, the goddess of the obstetric art, as “pouring an insensibility to pain down all the limbs of a woman in the throes of labour.” Aphrodite, to assuage her grief for the death of Adonis, is said to have thrown herself on a bed of lettuce and mandragora.

There is no medicinal plant around which cluster more mysterious and quaint associations than mandragora. The Babylonians employed it more than 2000 years B.C., and a figure cut from the root was used at that early period as a charm against sterility. It is probable that the antient Hebrews also believed it to possess these properties, judging from the story of Rachel related in the book of Genesis. The early Egyptians employed mandragora, which they called the “phallus of the field,” as a medicinal agent, both as an anodyne and an anæsthetic, and also used it in many of their superstitious rites.

[Illustration: GATHERING MANDRAGORA

From an MS. of the XIII century

“To gather ye mandragora, go forthe at dead of nyght and take a dogge or other animal and tye hym wyth a corde unto ye plante. Loose ye earth round about ye roote, then leave hym, for in hys struggles to free hymself he wyll teare up ye roote, which by its dreadfull cryes wyll kyll ye animal.”]

Theophrastus is the earliest writer on botany to allude to the virtues of mandragora, among which he mentions its property of inducing sleep, and of its use as an aphrodisiac in love potions. The Greeks gave mandragora the name of “Circeum,” derived from that of the witch Circe, and believed that an evil spirit dwelt in the plant; for, when uprooted, it was said to utter such frightful shrieks that no mortal man might hear them and live.

To prevent this catastrophe, it was usual in gathering the plant to take a dog and let him be sacrificed to the rage of the demon. This method is thus described by an antient writer:--“To gather ye mandragora, go forthe at dead of nyght and take a dogge or other animal and tye hym wyth a corde unto ye plante. Loose ye earth round about ye roote, then leave hym, for in hys struggles to free hymself he will teare up ye roote, whych by its dreadfull cryes wyll kyll ye animal.”

Certain rites and ceremonies were sometimes performed before gathering the root, such as making three circles round it with a sword, and the earth being loosened with an ivory spade, while to drown the cries of the fatal herb a horn was sometimes blown by the gatherer.

According to an antient German legend, the mandragora always grew with greater luxuriance beneath or near a gallows, for the flesh of the felons hanged thereon was believed to nourish the mysterious root in which the demon dwelt. Another legend current was, that the leaves of the plant sometimes glowed with a peculiar light at night.

The supposed likeness of the root to the human form gave rise to many of the superstitions connected with mandragora, and it was believed in early times that there were actually two distinct species, viz., male and female. These roots were often carved to resemble the human figure, and were worn as charms to ward off disease.

[Illustration: MANDRAGORA

From an MS. of the XV century]

[Sidenote: Mandragora as an anæsthetic]

The first mention of mandragora (_Mandragora Atropa, L._), as an anæsthetic, is made by Dioscorides (_ca._ A.D. 100), who evidently recognised the difference between the hypnotic and anæsthetic effects of the drug, from which one may assume that it was employed for both purposes in the medical practice of that day. Respecting the former, he states: “Eating which [mandragora] shepherds are made sleepy,” and, referring to the latter property, he remarks that “three wine-glassfuls of a liquid preparation of the root are given to those who are about to be cut or burnt, for they do not feel the pain.”

Of the preparations of mandragora, he gives the following: “There are those who boil the root in wine to a third part, and preserve the decoction, of which they give a cyathus [small glass] in want of sleep or severe pains in any part, and also before operations with the knife, or the actual cautery, that they may not be felt”; also “a wine is prepared from the bark of the root, without boiling, and three pounds of it are put in a cadus [eighteen gallons] of sweet wine; of this, three cyathi are given to those who require to be cut or cauterised, when, being thrown into a deep sleep, they do not feel any pain.”

[Sidenote: “Morion,” a Grecian anæsthetic]

Dioscorides also refers to a substance called “morion,” believed to be the white seed of the mandragora root, which is mentioned also by Pliny as a narcotic poison. “A drachm of it,” he states, “taken in a draught, or in a cake or other food, causes infatuation, and takes away the use of the reason; the person sleeps without sense, in the attitude in which he ate it, for three or four hours afterwards. Physicians use it when they have to resort to cutting or burning.”

These allusions serve to prove how frequently anæsthesia was practised by the physicians of antient Greece, to whom the narcotic property of mandragora, which is allied to _Atropa Belladonna_, or deadly nightshade, was well known.

[Illustration: GATHERING MANDRAGORA

From a drawing of the XVI century

The plant is being uprooted by the struggling dog, whilst a horn is blown to drown the cries of the fatal herb]

The younger Pliny (A.D. 32–79), in his “Natural History,” also describes the use of mandragora as a narcotic, and gives preference to the use of the leaves over the root for that purpose. “The dose,” he says, “is half a cyathus, taken against serpents, and before cuttings and puncturings, that they may not be felt.” He further adds: “For these purposes it is sufficient for some persons to seek sleep from the smell,” from which it is clear that this anæsthetic was also used by inhalation.

With reference to mandragora, Sir Benjamin Ward Richardson once prepared a draught according to one of the recipes given by Dioscorides, and took it. He tells us that “the phenomena repeated themselves with all faithfulness, and there can be no doubt that, in the absence of our now more convenient anæsthetics, ‘morion’ might still be used with some measure of efficacy for general anæsthesia.”

Further allusion is made to mandragora as a surgical anæsthetic by Apuleius in his “Liber de Herbis,” in which he says: “If anyone is to have a limb mutilated, burnt, or sawn, he may drink half an ounce of mandragora with wine; and while he sleeps the member may be cut off without any pain or sense.”

Avicenna, the Father of Arabian medicine, gives special directions as to the employment of mandragora, both as an anæsthetic and a hypnotic; while Averrhöes, another Arabian physician, refers to the soporific effects of the fruit of the same plant. Galen also alludes to its powers to paralyse sensation, and Paulus Ægineta states: “Its apples are narcotic, when smelled to, and also their juice, that if persisted in they will deprive the person of his speech.” According to Isidorus, “a wine of the bark is given to those about to undergo operations, that, being asleep, they feel no pain”; and Serapion confirms this statement in his works.

[Sidenote: Anæsthesia in Roman times]

Evidence of the practice of surgical anæsthesia is to be found in the writings of several physicians during the time of the Roman Empire. It is probable that the practice came to them from the Greek school, for mandragora, which they almost invariably used, grew largely in the Grecian Archipelago. Celsus recommends a pillow of mandragora apples to induce sleep.

HINDU ANÆSTHETICS

From ancient records it appears probable, that the Hindus inhaled the fumes of burning Indian hemp as an anæsthetic at a period of great antiquity. As early as the year 977 they also knew of other drugs which they employed for the same purpose.

Pandit Ballala describes an interesting surgical operation which was performed on King Bhoja at that period. The patient was suffering from severe pain in the head, and, his condition becoming critical, two brother-physicians happened to arrive in Dhar, who, after carefully considering the case, came to the conclusion that a surgical operation was necessary to give relief. They are said to have administered to him a drug called _sammohini_ to render him insensible, and while he was completely under its influence they trepanned his skull and removed the real cause of the complaint. They closed the opening, stitched up the wound, and applied a healing balm.

After the operation, they are said to have administered to the King a drug called _sanjivini_, to accelerate the return of consciousness and to minimise the chances of death.

[Sidenote: An antient Chinese anæsthetic]

It is recorded that “a Chinese physician named Hoa-Tho, who lived about A.D. 220 or 230, was accustomed to administer to his patients on whom he wished to perform painful operations, a preparation called ‘Ma-yo’ (Indian hemp, probably), the effect of which was that, after a few moments, they became insensible as if they were deprived of life.”

Miss Isabella Bird, when visiting the Tung-wah Hospital, in Hong-Kong, states: “The native surgeons do not use chloroform in operations, but they possess drugs which throw their patients into a profound sleep, during which the most severe operations can be performed. One of them showed me a bottle containing a dark brown powder, which, he said, produced this result; but he would not divulge the name of one of its constituents, saying it was a secret taught him by his tutor.”

From very early times the fumes of burning lycoperdon (_Lycoperdon gygantum_) have been used for stupefying bees before taking honey from the hive.

Thus it will be seen from the many allusions we have quoted from writers in the early ages, it is evident that mandragora and Indian hemp were the two drugs which were more or less in general use as anæsthetics in antient times.

ANÆSTHETICS IN THE MIDDLE AGES

[Sidenote: An early Irish anæsthetic]

In a Celtic manuscript of the twelfth century on materia medica, a preparation called “potu oblivionis” is mentioned, of which mandragora was probably an ingredient. A draught of this preparation was used by the early Irish to induce sleep.

[Sidenote: The “Sleeping Sponge”]

[Sidenote: Method of using the “Sleeping Sponge”]

Coming to the fifteenth century, the method of producing insensibility to pain by the inhalation of the volatile principles of drugs, which had been handed down by tradition from the early ages, seems to have been revived by Hugo of Lucca, a Tuscan physician. He is described as “chief of a school of surgeons that treated wounds with wine, oakum and bandaging, with happy success.” Theodoric, his son, who was a monk-physician, and practised surgery, mentions, in 1490, a preparation used by his father which he calls “oleum de lateribus.” This he describes as “a most powerful caustic, and a soporific which, by means of smelling alone, could put patients to sleep on occasion of painful operations which they were to suffer.” The mixture was placed on a sponge in hot water, and then applied to the nostrils of the patient, and was called the “spongia somnifera.” The following is the composition of the “sleeping sponge” and the method of using, as stated by Theodoric: “Take of opium, of the juice of the unripe mulberry, of hyoscyamus, of the juice of hemlock, of the juice of the leaves of mandragora, of the juice of the woody ivy, of the juice of the forest mulberry, of the seeds of lettuce, of the seeds of dock, which has large round apples, and of the water-hemlock, each an ounce: mix all these in a brazen vessel, and then place in it a new sponge; let the whole boil as long as the sun lasts on the dog-days, until the sponge consumes it all, and has boiled away in it. . . . As oft as there shall be need of it, place this sponge in hot water for an hour, and let it be applied to the nostrils of him who is to be operated on until he has fallen asleep, and so let the surgery be performed.”

[Illustration: AN OPERATION ON THE LIVER

From an MS. of the XIV century]

According to Bodin, the sleep produced was so profound that the patient often continued in that condition for several days afterwards. The method of arousing the patient employed by Hugo, however, is thus described: “In order to awaken him, apply another sponge, dipped in vinegar, frequently to the nose, or throw the juice of fenugreek into the nostrils; shortly he awakens.”

According to Canappe, in his work “Le Gyidon pour les Barbiers et les Chirurgiens,” published in 1538, the “Confectio soporis secundum dominum Hugonem” was used by surgeons at that period.

[Illustration: A SURGEON AMPUTATING A LEG

From a woodcut of the XVI century]

Reginald Scott, in a work written in the sixteenth century, gives the following recipe for making an anæsthetic: “Take of opium, mandragora bark and henbane root, equal parts; pound them together, and mix with water. When you want to sew or cut a man, dip a rag in this, and put it to his forehead and nostrils. He will soon sleep so deeply that you may do what you will. To wake him up, dip the rag in strong vinegar. The same is excellent in brain-fever, when the patient cannot sleep; for if he cannot sleep, he will die.”

[Sidenote: Anæsthesia in romance]

The writers and poets of mediæval romance in more than one instance allude to anæsthesia produced by drugs. Boccaccio, who wrote his “Decameron” in 1352, in the story of Dionius, alludes to a certain anæsthetic liquid of Surgeon Mazzeo della Montagna, of Salerno. “The doctor,” he says, “supposing that the patient would never be able to endure the pain without a soporific, deferred the operation until the evening, and in the meantime ordered the water to be distilled from a certain composition, which, being drunk, would throw a person asleep as long as he judged it necessary.” Boccaccio, probably, borrowed his idea from the recipe given by Nichols, a provost of the famous old school of Salerno, who published a recipe for making an anæsthetic, similar to that of Reginald Scott.

In Brooke’s “Tragicall Historye of Romeus and Julietta,” printed in 1562, which supplied Shakespeare with the plot and much material for his play “Romeo and Juliet,” Friar Laurence thus speaks to Julietta: “I have learned and proved of long time the composition of a certain paste which I make of divers somniferous simples, which beated afterwards to powdere, and dronke with a quantitie of water, within a quarter of an houre after, bringeth the receiver into such a sleepe, and burieth so deeply the senses and other spirits of life that the cunningest phistian will judge the party died.

“And, besides that, it hath a more marvellous effect, for the person which useth the same feeleth no kind of grief, and, according to the quantitie of the draught, the patient remaineth in a sweete sleepe; but when the operation is perfect and done, he returneth unto his first estate.”

[Illustration: A SURGEON AMPUTATING A LEG

From a woodcut of the XVI century]

Shakespeare’s references to mandragora, poppy and other “drowsy syrups,” are too well known to need quotation; but the following allusion by Middleton, in his play called “Women beware Women!” is not without interest:--

I’ll imitate the pities of old surgeons To this lost limb, who, ere they show their art, Cast one asleep, then cut the diseased part.

William Bulleyn, the author of “A Bulwark of Defence against Sickness,” who practised as a surgeon in the reign of Henry VIII, describes an anæsthetic which he directs to be prepared from the juice of a certain herb (probably mandragora) “pressed forth, and kept in a closed earthen vessel according to art, bringeth deep sleep, and casteth man into a trance, or deep terrible sleep, until he shall be cut of the stone.”

[Sidenote: Allusions to anæsthesia by antient poets]

The poet Marlowe thus refers to mandragora in his play “The Jew of Malta”:--

_Barabas_:

I drank of poppy and cold mandrake juice, And being asleep, belike they thought me dead, And threw me o’er the walls.

Du Bartas, as translated by Sylvester in 1592, makes the following allusion to anæsthesia:--

Even as a surgeon minding off to cut Som cureless limb; before in use he put His violent engins in the victim’s member, Bringeth his patient in a senseless slumber: And griefless then (guided by use and art) To save the whole, saws off the infested part.