Bedside Rounds

49 - The Ether Dome

Sep 30, 2019

The podcast dives into the harrowing past of surgical practices before anesthesia, where patients endured torturous procedures. It details the journey of ether from recreational use to a groundbreaking medical discovery. Listeners will learn about the historical application of mandrake and other herbal anesthetics, and the painful legacy of bladder stone surgeries. The narrative contrasts grim realities with transformative moments in 1846, showcasing the monumental shift in pain relief and surgical techniques.

43:27

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Quick takeaways

The introduction of inhaled ether transformed surgery from a rapid, painful ordeal into a more humane practice, significantly reducing patient suffering.

Controversies surrounding the credit for ether's discovery reveal the ethical complexities and rivalries that shaped the evolution of medical anesthesia.

Deep dives

The Gruesome Reality of Pre-Anesthesia Surgery

Surgery before the introduction of anesthesia was a harrowing experience for patients and surgeons alike. Surgeons, often lay barbers, aimed for speed to minimize patient suffering, leading to some grim outcomes; for instance, Robert Liston famously completed amputations in under a minute but had a high risk of fatalities. The psychological toll on surgeons was also significant, as exemplified by Asa Fitch’s recollections of the agony he witnessed, which conflicted with the emotional detachment he learned to adopt in his surgical training. This environment prompted the urgent need for a solution to mitigate the pain associated with surgical procedures.

Intro

4min

The Painful Legacy of Bladder Stones: A Historical Surgery

6min

Exploring Historical Anesthesia: Mandrake and Its Discontents

4min

The Journey of Ether: From Recreation to Anesthesia

20min

The Justinian Plague: A Historical Overview

6min

Exploring Humanity's Fascination with Ancient Plagues

3min

The world before anesthesia was brutal -- surgeons inflicted torture on largely conscious patients, hoping to finish an operation as quickly as possible. But all of that changed with the introduction of inhaled ether. This episode covers the context behind the discovery of etherization, with myths about screaming medicinal plants, a “missing recipe” of medieval general anesthesia, 19th century recreational drug use, and a controversy carved in granite.

Sources:

Brown, M. The Palgrave Handbook of the History of Surgery. 327–348 (2017). doi:10.1057/978-1-349-95260-1_16
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Robinson, D. H. & Toledo, A. H. Historical Development of Modern Anesthesia. J Invest Surg 25, 141–149 (2012).
Chidiac, E. J., Kaddoum, R. N. & Fuleihan, S. F. Mandragora. Anesthesia Analgesia 115, 1437–1441 (2012).
Vargas, I. Ether Frolic: The Day Pain Stopped. Bulletin Anesthesia Hist 28, 53–56 (2010).
Whalen, F. X., Bacon, D. R. & Smith, H. M. Inhaled anesthetics: an historical overview. Best Pract Res Clin Anaesthesiol 19, 323–330 (2005).
Prioreschi, P. Medieval anesthesia – the spongia somnifera. Med Hypotheses 61, 213–219 (2003).
Stallings, S. & Montagne, M. A chronicle of anesthesia discovery in New England. Pharm Hist 35, 77–80 (1993).
Litoff, J. & Pernick, M. S. A Calculus of Suffering: Pain, Professionalism, and Anesthesia in Nineteenth-Century America. Am Hist Rev 91, 176 (1986).
Leake, C. D. Letheon: The Cadenced Story of Anesthesia. Science 199, 857–860 (1978).
CRAWFORD W. LONG (1815-1878) DISCOVERER OF ETHER FOR ANESTHESIA. Jama 194, 1008–1009 (1965).
Riches, E. Samuel Pepys and His Stones. J Urology 118, 148–151 (1977).
CWRIGHT, F. The early history of ether. Anaesthesia 15, 67–69 (1960).
Insensibility during Surgical Operations Produced by Inhalation. New Engl J Medicine 35, 379–382 (1846).
SURGICAL HUMBUG. Lancet 5, 646–647 (1826).