Surgery Before Anesthesia

1
Surgery Before Anesthesia

• Reminiscing in 1897 about preanesthesia surgery,
  one elderly Boston physician could only compare
  it to the Spanish Inquisition. He recalled yells
  and screams, most horrible in my memory now,
  after an interval of so many years.

2
Early attempts at Pain Control

• Narcotics made from plants such as marijuana,
  belladonna and jimsonweed
• Hypnotism
• Distraction by rubbing with stinging nettles
• Knocking patient unconscious with a blow to the
  jaw
• Opium and Alcohol
• Soporofic Spounge

3
The Soporific Sponge
4
Recipe

• "The composition of a savour for conducting
  surgery, according to Master Hugo, is as follows
  take opium, and the juice of unripe mulberry ,
  hyoscyamus (henbane), the juice of hemlock, the
  juice of leaves of mandragora, juice of climbing
  ivy, of lettuce seed, and of the seed of the
  lapathum (dock), one ounce of each. Mix all these
  together in a brazen vessel, and then put into it
  a new sponge. Boil all together out under the sun
  during the dog days, until all is consumed and
  cooked down into the sponge.

5
Recipe continued

• As often as there is need, you may put this
  sponge into hot water for an hour, and apply it
  to the nostrils until the subject for the
  operation falls asleep. Then the surgery may be
  performed and when it is completed, in order to
  wake him up, soak another sponge in vinegar and
  pass it frequently under his nostrils. For the
  same purpose, place the juice of fennel root in
  his nostrils soon he will awaken."

6

• Texts on the soporific sponge survive from every
  century from the 9th through the 13th, and it was
  still described from the 14th through the 17th
  centuries, though with increasing warnings about
  contraindications.

7
Other Early Anesthesia

• The most common before the 15th century was
  probably the use of liberal quantities of alcohol
  plus or minus opium and a wooden stick to bite
  down upon
• The amount of alcohol needed to induce sedation
  would also induce nausea and vomiting and death
  instead of sleep.

8
Contribution to what we know now

• The experimentation with these many different
  agents has provided a significant influence on
  anesthesia today.
• The lack of adequate pain control motivated many
  to study alternative approaches.
• Opium derivatives are used consistently in
  anesthetic practice.
• The use of cannabis is being re-evaluated
  especially in relation to chronic pain.

9
References

• http//www.priory.com/homol/History20of20Anaesth
  esia.pdfsearch22history20alcohol20opium20sur
  gery22
• http//neurosurgery.mgh.harvard.edu/History/before
  th.htm
• http//www.medindia.net/patients/patientinfo/Anaes
  thesiahistory_about.htm.htm