developing along lines which ensured accelerated progress under the impetus of the discoveries in bacteriology which were soon to follow, and we could with propriety pass on to the era of bacteriology, if it were not for one great boon, destined to have an enormous influence on the practise of surgery, on the diminution of human suffering and on the general advance of research in medicine. This was the introduction of anesthesia. Surgery had steadily advanced in technic, resourcefulness and daring, but the torments of surgery were such that operations were mainly those of necessity. As Mumford says:
Surgical pain was real enough; there was no disguising it. The terror of operation was a very hell, even in anticipation; the fact itself no man has found words to describe. The shadow of it has lengthened even to our own day. Surgeons as well as patients dreaded the knife.
Robert Liston, two years before the discovery of ether congratulated his students that the "field of operative surgery" was "happily narrowed." Keen writes:
It is a striking commentary on the immediate results of anesthesia to learn that, in the five years before the introduction of ether, only 184 persons were willing to submit themselves to such a dreadful ordeal in the Massachusetts Hospital, an average of 37 operations per annum, or 3 per month. In the five years immediately succeeding its introduction, although the old horror could not be overcome, 487 operations, or almost 100 annually, were performed in the same hospital. During the last year (1898) in the same hospital 3,700 operations were performed.
This change was brought about in 1846, when "W. T. G. Morton, an American dentist, by publicly administering ether, proved to the world that it was a safe and sure anesthetic. The operation was performed by John Collins Warren at the Massachusetts General Hospital and the names anesthesia and anesthetic were suggested by Oliver Wendell Holmes. Anesthesia was therefore essentially a Boston affair as far as its introduction to the world was concerned, but the claims of its discovery made by others (Long, Jackson, Wells, Marcy) leave the question of priority in the knowledge of and use of ether in much confusion. With this phase we are not at present concerned. One year after the demonstration in Boston, Simpson, of Edinburgh, recommended chloroform as an anesthetic of equal value with ether. Not only surgery but obstetrics, dentistry and the various specialties benefited by this great boon of anesthesia and within a year the administration of anesthetics was a universal practise throughout the civilized world. Surgery, freed of its horrors, developed along lines hitherto undreamed of, and made those rapid strides which prepared it for the era of antisepsis in the next generation.
The next lecture will concern itself with the story of Pasteur and the development of bacteriology and the influence of the latter on medicine and surgery.
