The Dawn of Modern Anesthesia

How a 19th-century recreational drug became a medical breakthrough

William T.G. Morton administers ether to a patient. (Thomas Jefferson University)

In 1844, a Connecticut dentist named Horace Wells came to Harvard to share an astonishing discovery: If a person inhales the right quantity of the chemical nitrous oxide, the result is that they will feel no pain during medical or surgical procedures. It was hard to believe—a game-changing discovery that could instantly and permanently alter the practice of surgery.

And it was, as made evident to the elite Harvard University, a total fraud.

After all, when Wells proudly gave a demonstration of it in front of an eager class of Harvard Medical School students and faculty, the poor boy he selected as his patient continuously screamed out in wretched pain whenever Wells tried to extract his rotten tooth. They called Wells a swindler and said his discovery was a humbug. Wells was crushed, and his career never recovered.

But as it turned out, Wells was not a fraud. It was an “incident of history gone awry.” The young man with the rotten tooth would later admit that he actually felt no pain and didn’t even know the extraction had happened until he saw the bloody tooth in the dentist’s hands. But as no one at the time knew, his screaming was simply one of the most common side effects of inhaling nitrous oxide gas. For reasons that were unknown, individuals who had recently inhaled nitrous oxide were known to scream, groan, or show agitated behavior—despite the fact that they were feeling absolutely no pain.

Unfortunately for Wells, he was not aware of this side effect, and neither was his audience at Harvard. So it happened that a medical breakthrough was showcased at one of the country’s leading medical schools, and no one even knew it.

And even stranger, this wasn’t the first time.

The pain-erasing effects of nitrous oxide were discovered almost a half-century earlier by a chemist named Humphrey Davy, who began his experiments with the chemical at England’s Pneumatic Institution. However, these experiments were largely performed on himself and sometimes his friends. He became so fixated on the high he felt when inhaling the gas—addicted, some would later say—that he risked his life more than once in his attempts to inhale larger and larger quantities, and even had a colleague built him a portable gas chamber so he could have access to the gas wherever and whenever he wanted.

Although Davy was clearly very impressed with nitrous oxide’s ability to seemingly stop the body from feeling pain, it seems that he never thought to promote it as an anesthetic for surgery. Instead, he promoted it as a cure for hangovers, and proceeded to perform detailed experiments—on himself, of course—to see just how many bottles of wine he could drink in a night and still have the effects “erased.”

But Davy was not alone in missing the enormous potential of nitrous oxide, despite frequent interaction with it. In the early 1830s, sulfuric ether and nitrous oxide were both used as recreational drugs. In America, the fashionable and the young found themselves at “laughing gas parties” or “ether frolics,” a popular traveling amusement.

In the 1830s and 1840s, it was not uncommon for a showman claiming to be a “professor of chemistry” to set up show in towns, villages, and cities throughout the United States with the express intent of showcasing these amazing gases and their “exhilarating features.” Of course, the most crowd-pleasing moments of the night were when the “professor” invited members of the audience to the stage to inhale the gases themselves. The sudden loss of equilibrium and inhibition would delight and shock the roaring crowds.

It was at one of these “laughing gas” demonstrations in 1844 that dentist Horace Wells realized the potential of sulfuric acid and nitrous oxide. The morning after witnessing the spectacle, he convinced a colleague to extract one of his teeth after he himself had inhaled some nitrous oxide. After the tooth was successfully removed, an elated Wells shouted out, “It is the greatest discovery ever made! I didn’t feel as much as the prick of a pin!”

But if Wells’ disastrous experience at Harvard had a bright spot, it was that he met John Collins Warren, the influential professor of surgery at the Massachusetts General Hospital.

Warren was already familiar with the idea of using nitrous oxide as an anesthetic through his acquaintanceship with Charles Thomas Jackson, “one of the most eccentric and bizarre of all personalities connected with the discovery of surgical anesthesia.”

Jackson, a graduate of Harvard Medical School, began inhaling nitrous oxide in 1841, and by 1844, he had persuaded several local dentists that the gas could be helpful in relieving the pain of their patients’ toothaches. And it was Jackson who suggested in September 1846—nine months after Wells’ embarrassing incident at Harvard—that another Boston-area dentist, William T.G. Morton, use sulfuric ether mixed with air, believing it might prove to be an even better anesthetic than nitrous oxide. Morton tried it out and found the results astonishing. He then asked John Collins Warren if he might share this latest innovation with his class.

And that is how on October 16, 1846, in the same surgical amphitheater as Wells’ fiasco, Warren and Morton gave the first-ever public demonstration of the effects of this “anonymous” liquid on a patient.

It was an incredible sight.

Morton served as the esthetician, who both prepared the anesthesia mixture and administered it by tipping a jug of gas into the patient’s face. The confident Morton looked out into the audience as the young patient slowly seemed to lose complete consciousness. Once the patient seemed fully out, Warren stepped in skillfully to remove a small tumor from the young man’s neck. The patient seemed peacefully asleep during the whole procedure, even as the scalpel sliced through his flesh and the suture needles repeatedly pierced his skin.

After the surgery was over, the duo patiently waited for the grand finale. Finally, the patient appeared to wake up from this man-made slumber and told the slack-jawed audience that he felt no pain.

It was then that Warren—who had not spoken during the entire surgery—finally uttered his iconic words about the dawn of a new era in surgery:

“Gentlemen, this is no humbug.”

This post is adapted from Cristin O'Keefe Aptowicz's Dr. Mutter's Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine.