ANESTHESIA and ANTISEPTIC  SURGERY      Papaver somniferum: Opium Poppy

THE BLESSINGS of ANESTHESIA are best appreciated in the light of what preceded it: In The journals of Fanny Burney (The Journals and Letters of Fanny Burney  (Madame D’Arblay), Vol. 6, France, 1803-1812, ed. Joyce Hemlow et. al., Oxford, 1975), a Victorian novelist describes her mastectomy in 1816 without anaesthetic. She had consulted a surgeon after discovering a lump in her breast.  She received a message that surgery was necessary, and that the surgeons would come to her home. The operation was performed in her apartment, after she had contrived to send her husband and son away on several errands:

I mounted, therefore, unbidden, the Bed stead – & M. Dubois placed me upon the Mattress, & spread  a cambric handkerchief upon my face.  It was transparent, however, & I saw, through it, that the Bed stead was instantly surrounded by the 7 men & my nurse.  I refused to be held; but when, Bright  through the cambric, I saw the glitter of polished Steel –  I closed my Eyes.  I would not trust to convulsive fear the sight of the terrible incision.

Yet -- when the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunctions not to restrain my cries.  I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still?  so excruciating was the agony.

When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound.

I concluded the operation was over – Oh no! presently the terrible cutting was renewed – & worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered – Again all description would be baffled – yet again all was not over, – Dr. Larry rested but his own hand, & -- Oh heaven! – I then felt the knife (rack)ling against the breast bone – scraping it!

ANESTHETICS began to be used seriously beginning in the United States with Wells, (1815-48) who employed nitrous oxide for dental extraction in Boston. In 1846 Morton (1819-68) used ether in Boston. Shortly after the practice was taken up in Britain and in 1847 Simpson (1811-70) introduced chloroform for use in obstetrics.

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