Are you sleeping comfortably? Then we’ll begin

The Boston Globe has an excellent article on the moment when a a group of huddled doctors turned a side-show curiosity into the medical revolution of surgical anaesthesia.

16th October 1846, Boston, Massachusetts, was when the first operation under anaesthesia was conducted in with a brave patient and liberal doses of ether.

The piece is interesting because it notes that the pain killing properties of certain gases or vapours, like laughing gas (nitrous oxide) and ether, were already well known, but the use of them in an operation needed a fundamental change of attitude in the medical establishment.

This was largely due to the fact that pain was considered beneficial during an operation, as it ‘stimulated’ the patient and supposedly made them less likely to die, but because that experiencing pain was considered to be morally virtuous.

Removing pain through ‘artificial’ means was therefore considered ethically dubious and consequently regarded by suspicion by the high horse riding doctors of the time.

Interestingly, the article notes that some of these views continue to this day in attitudes regarding anaesthetics and ‘natural’ childbirth:

Before 1846, the vast majority of religious and medical opinion held that pain was inseparable from sensation in general, and thus from life itself. Though the idea of pain as necessary may seem primitive and brutal to us today, it lingers in certain corners of healthcare, such as obstetrics and childbirth, where epidurals and caesarean sections still carry the taint of moral opprobrium.

In the early 19th century, doctors interested in the pain-relieving properties of ether and nitrous oxide were characterized as cranks and profiteers. The case against them was not merely practical, but moral: They were seen as seeking to exploit their patients’ base and cowardly instincts. Furthermore, by whipping up the fear of operations, they were frightening others away from surgery and damaging public health.

The article is by Mike Jay who wrote the The Air Loom Gang, a biography of madman, spy and accidental architect James Tilly Matthews.

The biography is one of my favourite books of all time and was interested to see that Jay has another book just out called The Atmosphere of Heaven about a Victorian medical society who pioneered the study of laughing gas.

Link to Boston Globe article ‘The day pain died’.

6 Comments

  1. StunnedMullet
    Posted June 9, 2009 at 2:32 am | Permalink

    The other realm where this “morality” reigns supreme is that of anti-depressants.
    Alleviating a depressed affect is the desired goal, but creating Happiness or Joy is an anathema.
    Which is why many abandon them complaining of the “deadening” feeling they create.

  2. Posted June 9, 2009 at 8:24 am | Permalink

    Sadly the medical profession continues to be just as arrogant today. Any doctor who is healing patients outside the agreed guidelines is likely to be struck off, even if there is good scientific evidence behind his practices.

  3. Vicky
    Posted June 9, 2009 at 8:27 am | Permalink

    While I agree that there can often be a faint air of disapproval around the idea of pain relief in chlidbirth, I think a huge amount of this comes from mothers themselves. So much of mothering is competitive: the big stuff like breastfeeding versus formula feeding, cloth nappies versus disposable, pain relief versus no pain relief; and the little stuff like precisely when you start feeding solids and whether you use a wheeled walker.
    Doctors’ attitude to childbirth (at least in the US and the UK) is, by and large, to medicalise it, which includes offering pain relief at the first hint of discomfort.

  4. Gingor
    Posted June 9, 2009 at 12:51 pm | Permalink

    Interesting stuff
    @StunnedMullet
    The everything must be earned, (protestant work ethic?) mentality is big amongst tattooists and, er, tattooees?. Many are disparaging about anaesthesia.
    @Vicky
    I think you’re right, the pressure comes from the public too. Some people value the ‘journey’ as much as the end result. Seeing others taking ‘short cuts’ perhaps makes them feel devalued.
    P.S. am i racist for snigering at the term “Yankee dodge”?

  5. airship1951
    Posted June 9, 2009 at 5:52 pm | Permalink

    There was also an important religious objection to the use of anesthesia in childbirth. Pain in childbirth was the curse that God put on Eve in the Garden when she and Adam disobeyed God:
    Genesis 3:16 To the woman he said, “I will greatly increase your pains in childbearing; with pain you will give birth to children.”
    Among staid, conservative 19th Century Protestants, pain in childbirth was considered a woman’s God-decreed lot in life. To them, ameliorating pain in childbirth was an insolent slap to the face of God.

  6. bowser
    Posted June 9, 2009 at 10:29 pm | Permalink

    Vicky: as I understand it the objection is not a disapproval of using pain relief in childbirth, but that it is over-used. As you say, doctor’s attitudes are to medicalize it, which at least in the US is usually standard procedure. With respect to my wife, she gave birth to both our children completely naturally, and “competitiveness” had nothing to do with it. She objected because she wanted to make the decision herself rather than the doctor. And, as Gingor says, she didn’t want to have the experience altered by pain medication, she didn’t want to be out of contact with her body and what was going on.
    The upshot of this is that ethical/moral decisions are always personal. We can never have a morality based on science because what is scientifically logical leads to absurd conclusions that many find intuitively immoral. For example; Peter Singer’s claim that a fully functional chimpanzee infant has more right to life than a mentally retarded human infant, and that according to Singer, the humane thing to do (and morally justified to prevent suffering) is to euthanize the human infant. Further, Singer goes so far as to say that in a decision situation, where a choice between choosing the life of the retarded human infant and the normal chimp infant were forced, the morally right decision would be to choose the life of the chimp infant over that of the human infant.
    Pain relief is a matter of choice and personal preference. Morality and science should both inform the decision, but one should not be disregarded at the expense of the other.


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