William Morton Story
Painless Surgery By Ether
The following is a detailed story of the first practical use of an anesthetic in history. The monument commemorating this historic event is located in Boston Public Garden. The operation itself was performed at the Bulfinch Building at Massachusetts General Hospital in a former operating room now known as the Ether Dome.
"[In 1844] there was a dentist in Boston named William Thomas Green Morton, a native of Massachusetts, about twenty-five years of age. Zealous and successful in his calling, he had already improved in some particulars upon its usual practice; but he was much perplexed by the difficulty of inducing patients to have their old teeth entirely removed before new ones were inserted. It was not common at that day, as it now is, for dentists to advise so unpopular an operation, and it seemed presumption in this young practitioner to demand it. It was useless to explain to patients the great and lasting advantages of such a method, for the pain was too great to be endured, so long as dentists of repute pronounced it unnecessary.
The thought occurred to the young man one day, that perhaps a way might be discovered of lessening human sensibility to pain. He had not received a scientific education, nor had he more scientific knowledge than an intelligent young man would naturally possess who had passed through the ordinary schools of a New England town. Instead of resorting to books, or consulting men of science, he began, from time to time, to experiment with various well-known substances.
First he tried draughts of wine and brandy, sometimes to the intoxication of the patient; but as soon as the instrument was applied, consciousness revived, and long before the second tooth was out, the patient, though not perfectly aware of what was going on, was roaring with agony. He tried laudanum [opium] in doses of two hundred and three hundred drops, and opium in masses often grains, frequently renewing the dose until the patient would be in a condition truly deplorable. Dr. Morton records in his diary, that on one occasion he gave a lady five hundred drops of laudanum in forty-five minutes, which did indeed lessen the pain of the operation, but it took her a whole week to recover from the effects of the narcotic.
This would never do, and he soon abandoned the practice. Attributing his failure to his ignorance, he entered a physician's office as a student of medicine, and while still carrying on his business, pursued his medical studies until he graduated from the medical school of Harvard College a Doctor of Medicine. One day in July, 1844, a young lady called upon him to have a tooth filled which was in so sensitive a condition that she could not endure the touch of an instrument. It occurred to him, at length, to apply to the tooth some sulfuric ether, the effect of which, in benumbing the parts of the body to which it was applied, had become familiar to him during his medical studies. The ether seemed to allay the sensitiveness of the tooth in some degree, but not enough to admit of the operation being finished at one sitting. She had to call several times, and every time she came the ether was applied, always with some effect in lessening her pain. On one occasion, when he happened to use the ether more freely and for a longer time than before, he was surprised to discover that the gum near the tooth was so benumbed as to be almost insensible to the pressure of the instrument.
Now it was that the idea occurred to him, that if, in someway, the whole system could be etherized, his dream of extracting teeth without pain might be realized, at least in part.
But how could this be done? Could the body be bathed in ether? Would washing the whole surface answer? Such thoughts as these passed through his mind; for although he had witnessed the effects of laughing-gas, it did not yet occur to him to try whether ether inhaled would benumb the common source of pain and pleasure, the brain. Meanwhile he reflected constantly upon ether, read and conversed upon ether; always hopeful, and sometimes confident that he was upon the path leading to a discovery that would make his fortune.
Baffled for the time in his experiments, and absorbed in business and study, several months passed before he took another step toward the great achievement of his life. The subject, indeed, had somewhat faded from his mind, when it was revived by a ludicrous scene in one of the medical class-rooms at the university. Some laughing-gas was administered to a patient for the purpose, as the experimenter said, of pulling a tooth without pain. This is now done every day; but the experiment did not succeed. The gas was administered, but as soon as the experimenter began to pull at the tooth, the patient gave such a yell of agony, that the students laughed and hooted as only medical students can, and the operator retired in confusion.
Here let me pause and tell who the unlucky operator in laughing-gas was. He too, played a leading, perhaps an essential, part in the great discovery. His name was Horace Wells, dentist, of Hartford.
But observe, first of all, that neither of these young men claim to have invented the substances—ether and laughing-gas—now used in destroying sensibility to pain; nor was either of them the first to originate the idea of inhaling gas for the purpose. The idea was original with Sir Humphry Davy. In 1798, when he was twenty years old, he was appointed chemical superintendent of a hospital for the cure of pulmonary diseases by the inhalation of different gases. This appointment led to his undertaking a series of experiments with the various gases employed, particularly the protoxide of nitrogen, sometimes called by him, "the pleasure-giving air," and by us laughing-gas. In the course of his remarks on this gas, he used the following language:
"As nitrous oxide (another name for the same gas), in its extensive operation, appears capable of destroying physical pain, it may probably be used with advantage during surgical operations, in which no great effusion of blood takes place."
Here, then, is the suggestion, but only the suggestion, and it was put forward by Sir Humphry, with a hesitation unusual in an experimenter twenty-one years of age. The gas only appeared capable of destroying pain, and its advantageous use was only probable in some cases. Sir Humphry Davy's experiments with the laughing-gas, an account of which he published in the year 1800, attracted universal attention, and it became common, in courses of chemical lectures, both in colleges and lyceums, to administer the gas. The fact, therefore, became familiar to a large number of persons, that people under the influence of this gas were not susceptible to such pain as is inflicted by pinching or slight pricking with a pin.
Horace Wells, born in Vermont in 1815, established himself, in 1836, at Hartford as a dentist. Being an intelligent man and skillful operator, he soon obtained a large practice. Like Dr. Morton, he was much inconvenienced by the unwillingness of patients to submit to the pain of having dental operations performed thoroughly; and like Dr. Morton, too, he had tried the effect of laudanum and spirituous liquors in lessening sensibility. He had even thought of trying the laughing-gas; but he was prevented from doing so by the dread of it which existed in the public mind, owing to u person having died from the effects of it in Connecticut some years before. It does not appear, from his narrative, that he had ever heard of Sir Humphry Davy's suggestion, quoted above.
"Reasoning from analogy," he says, "I was led to believe that surgical operations might be performed without pain, by the fact that an individual, when much excited from ordinary causes, may receive severe wounds, without manifesting the least pain; as, for instance, the man who is engaged in combat, may have a limb severed from his body, after which he testifies that it was attended with no pain at the time; and so the man who is intoxicated with spirituous liquor may be severely beaten without his manifesting pain, and his frame in this state seems to be more tenacious of life than under ordinary circumstances. By these facts I was led to inquire if the same result would not follow the inhalation of exhilarating gas."
This was the state of his mind on the subject when, on the 10th of September, 1844, Mr. G. Q. Colton gave in Hartford a public exhibition of the laughing-gas, which Dr. Wells attended. In the course of the evening a man, after inhaling the gas, bruised himself severely by falling over some benches. Dr. Wells was quick to observe that the man felt no pain, and he at once said to a friend: "A man, by taking that gas, could have a tooth extracted, or a limb amputated, and not feel the pain! "
The very next day—that is to say, September the 11th, 1844—he put the matter to the test by having one of his own teeth extracted while under the influence of the gas. The operation was painless. Soon after he repeated the experiment about fifteen times with perfect success. Other dentists in Hartford employed the same gas in their practice during the autumn of 1844. We have the sworn testimony to this effect of respectable dentists who used the gas at that time, and of several gentlemen who had teeth extracted without pain after inhaling it. The friends of Horace Wells, I think, have established their main position, that he was the first man in the world who ever successfully used a gas for destroying sensibility to pain. If human testimony can establish anything, it has established this.
It seems, also, that Dr. Wells was aware that ether possessed the same property, that he often conversed with professional friends upon the pain-suspending power of ether, and that the question was discussed between them, whether it would answer as well as the nitrous oxide. They concluded—but without having tried the experiment—that the nitrous oxide gas was easier to inhale, less offensive, and more safe. For the extraction of teeth, the laughing-gas is still found more convenient than ether; but it would not avail for any operation in surgery which requires more than a few minutes.
In December, 1844, Dr. Wells went to Boston for the purpose of making known his discovery to physicians and scientific men. Dr. Jackson, he says, received his statements with ridicule and contempt. The celebrated surgeon Dr. Warren, however, gave him an opportunity to address the medical class of Harvard College on the subject, and to perform an experiment before them.
It is not an easy matter to address a class of medical students with effect, for they are not the most patient of mortals, and they are accustomed to express their in a noisy and emphatic way Dr. Wells, too, not yet thirty years of age, was constitutionally [reserved], and did not succeed very well in his preliminary remarks. But a successful experiment would have made amends. The class having assembled in another room to see a tooth extracted without pain, the gas was administered to the patient. Unfortunately he did not take enough, and the moment the wrench was applied he roared with pain. The class hooted, hissed, and laughed immoderately. Dr. Wells retired in confusion, and returned to Hartford to report that Boston had given a sorry welcome to his discovery.
This scene it was which set young Morton again upon the path of discovery. The thought flashed upon his mind: Why not try the effect of inhaling ether? But at once another question arose: Is it safe?
On searching his medical books, he found a passage which informed him that ether, when long inhaled, produces a kind of stupefaction, from which it was not certain that the patient could be restored. At least, it was not possible to ascertain to what degree of stupefaction it was safe to reduce the patient. Discouraging as this was, he began from this time timidly to experiment upon himself. At first he made a mixture of opium and ether, which he warmed over a fire, and then inhaled the vapor that was generated. Some degree of numbness, he thought, was produced, but the experiment gave him headaches so severe that he was obliged to discontinue them. He received soon after a student of dentistry, who told him that he had often inhaled pure ether when he was a school-boy, and in considerable quantities, without experiencing any harm.
Fortified by this and other testimony, he bought a quantity of ether, and went into the country to make experiments upon animals. After many absurd failures and some partial successes, he succeeded in etherizing a dog, a frisky black-and-tan terrier, and this he accomplished in the way commonly practiced at the present time. A handful of cotton saturated with ether was placed at the bottom of a tin vessel, and the dog's head held directly over it.
"In a short time," says Morton, ''the dog wilted completely away in my hands, and remained insensible to all my efforts to arouse him by moving or pinching him." And, what was infinitely more important, three minutes after the vessel was taken away, the dog was frisking about as usual, totally unharmed! Need I say that the experimenter was in the highest elation? "Soon," said he to a friend, "I shall have my patients coming in at one door, have all their teeth extracted without knowing it, and then, going into the next room, have a full set put in."
Feeling now that he held a great discovery in his hand, he engaged an experienced dentist to take entire charge of his business, while he devoted all his time to experimenting with ether. Again he went into the country, where he again subjected his innocent dog to the process. One day the animal, exhilarated by the ether, dashed against the glass jar containing the fluid, and broke it, so that only a small portion remained at the bottom. There was no further supply nearer than Boston, and, unwilling to lose the fruits of his journey, he suddenly determined to use the little ether remaining in an experiment upon himself. He dipped his handkerchief in the ether, held it over his mouth and nose, and inhaled the gas strongly into his lungs. A feeling of lassitude stole over him, and this was followed by a single moment's unconsciousness.
"I am firmly convinced," he afterwards said, "that a tooth could have been drawn at that time without pain."
Nothing remained but to try the complete experiment of actually extracting a tooth from a patient under the influence of ether. Long he tried in vain to hire and persuade some one to run the risk of a trial. He repeated the experiment upon himself more than once, remaining on one occasion insensible for nearly eight minutes without experiencing any subsequent harm. Having now no lingering doubt of the safety of the process, he waited impatiently for some one to come in who would consent to submit to the stupefying influence.
"One evening," he tells us, "a man entered the office suffering great pain, and wishing to have a tooth extracted. He was afraid of the operation, and asked if he could be mesmerized. I told him I had something better; and saturating my handkerchief with ether, gave it to him to inhale. He became unconscious almost immediately. It was dark, and Doctor Hayden held the lamp, while I extracted a firmly rooted bicuspid tooth.
There was not much alteration in the pulse, and no relaxation of the muscles. He recovered in a minute, and knew nothing of what had been done to him !"
The discovery was accomplished. A short time after, the process was repeated on a large scale in the operating room of the Massachusetts General Hospital, in the presence of a great number of contemptuous students and incredulous physicians. A painful and widely rooted tumor was cut from the face of a young man while he was under the influence of ether, administered by Dr. Morton. When the patient returned to consciousness, he said to the surgeon:
"I have felt no pain, but only a sensation like that of scraping the part with a blunt instrument."
The students were no longer contemptuous, nor the doctors unbelieving; but all gathered about Dr. Morton, profoundly impressed with the importance of what they had seen, and overwhelmed him with congratulations. This great discovery brought upon the discoverer, during the rest of his life, little but vexation and bitterness. As the process could not be patented, he wasted many years and many thousands of dollars in trying to induce Congress to make him a grant of public money. He did not succeed; and, although he received considerable sums from hospitals and medical colleges in recognition of his right, he became at last a bankrupt, and the sheriff held his estate. His circumstances afterwards improved; but he died upon his farm in Massachusetts, a comparatively poor man.
He was ever hopeful and cheerful. More than once I have heard him relate this tale, and I witnessed his calm demeanor under the repeated disappointments he had to suffer from not receiving expected aid from Congress. He never complained, and was never cast down; but, making the best of such good fortune as befell him, enjoyed life to the end, and never so much as during his last years.
By all means let the people of Connecticut erect their monument to the memory of Dr. Wells, who, first of all mankind, succeeded in destroying sensibility to pain through the inhalation of a gas. Not the less let us honor the memory of Morton, who carried the discovery another step forward, —that last step, which renders it one of the most precious of all the incidental results of scientific discovery.
Bulfinch Building at Massachusetts General Hospital
Parkman & North Anderson Streets
Boston, MA 02114