The Introduction of Painless Surgery SISTER VIRGINIA HEINES Nazareth College, Nazareth, Kentucky
.
. .the jicrce extremity of sufering has been steeped in the wafers of forgeffulness, and the deepest furrow i n the knotted brain of agony has been smoofhed forever.-OLIVER WENDELL HOLMES (I)
S
URGICAL anesthesia is a priceless gift to suffering human~ty. . The discovery came upon the world quite suddenly and because of its fitness for ready use, it was as welcome to the medical profession as sulfa drugs and penicillin are today. No other nation succeeded in establishing a true claim to the honor. The achievement belongs to America, but a glance a t the records brings to light an infamous blot of criticism heaped upon those early worker6 which can never be erased. Intervening years have dimmed the memory of the circumstances surrounding the discovery and caused the world to forget the difficulties and trials attending its introduction to surgery. Since the centenary of the fist use of ether in operations wiII occur on October 16, 1946, a brief sketch of this notable contribution to the history of medicine is timely. The idea of painless surgery probably began with the discovery of Sir Humphry Davy. At the Medical Institute in Bristol, England, he found that nitrous oxide gas was perfectly respirable. In his "Researches, Chemical and Philosophical," published in 1800, he states: "As nitrous oxide gas, in extensive operations, appears capable of destroying physical pain, i t may probably be used with advantage during surgical operations in which no meat diiusion of blood takes place" (2). Forty years later the exhilarating effects of laughing gas began to attract attention in America, and furnished the spark for independent experimentation with anesthetical drugs. Doctor Horace Wells, a dentist in Hartford, Connecticut, conceived the idea of using nitrous oxide in dentistry and gave a public demonstration, in 1844, before a class in surgery a t Cambridge College. The exhibition proved a failure and Wells abandoned the project. Doctor W i i a m T. G. Morton of Boston experimented with the use of ether in tooth pulling, and was convinced of its value for painless operations. Doctor Charles T. Jackson, a prominent geologist, chemist, and physician (3), also of Boston, gave definite information to Morton regarding the preparation and properties of sulfuric ether as it was then designated. Jackson knew nothing of the intense research that Morton was carrying on as a prelude to the introduction of the drug as an anesthetic. The latter made the rirst painless tooth extractionunder ether on September 30, 1846, and was the anesthetist for the fist successful operation under the agent on .October 16, 1846, a t the Massachusetts General Hos-
pital in Boston. Later it became known that Crawford W. Long, a country practitioner of Athens, Georgia, had used ether in surgical operations a t least eight times between the dates of March 30, 1842, and October 16, 1846. After etherization had been accepted by the medical profession, Wells and Jackson appeared upon the scene to He claim to the honor of discovery. A veritable "war of pamphlets" (4) started and a maelstrom of bitter controversy engulfed the claimants for over two decades. It is not the purpose of this paper to revive any of the hitter contention but to present some of the interesting details connected with the discovery which might be Iost in a general biographical account. Nitrous oxide frolics were quite the vogue in the early part of the 19th century. The Hartford Cuurant ran the following notice one day in December, 1844 (5): A grand exhibition of the e5ect produced by inhaling NITROUS OXIDE, EXHILARATING OR LAUGHING GAS! will be given at Union Hall this (Tuesday) evening, December 10, 1844. TWELVE YOUNG MEN have volunteered to inhale the gas to commence entertainment. EIGHT YOUNG MEN are engaged to occupy the front seats to protect those under the influence of the gas from injuring themselves or others. N.B. The gas ail1 be administered only to gentlemen of the fmt rcspertability. The ohject is to make the entertainment in every respect a genteel affair.
That evening, an apothecary by the name of Abial Cooiey was one of the volunteers. Under the influence of the gas he danced around the hall, running here and there, knocking himself against the chairs and benches, shaking the hands of his friends, even chasing some of them around the room, until finally, he fell exhausted into a seat beside Doctor Wells and his wife. When completely recovered Cooley was astonished to find that his legs were badly bruised as he had experienced no pain. Wells quickly caught the significance and questioned h i closely as to the effects of the stupefaction produced by the gas. He asked Doctor Gardner Q. Colton, who was giving the chemical lectures a t the time, why a man could not have a tooth pulled while under the influence of the drug. Colton replied that he did not know as the idea had never occurred to him. Wells was willing to have the effects tried on himself
and had Colton administer the gas to h i the next day, whiie another dentist, Doctor John Riggs (for whom Riggs's disease or alveolar pyorrhea is named), extracted a molar tooth for him (6). On coming to, he exclaimed, "A new era in tooth pulling. It did not hurt me as much as the prick of a pin. It is the greatest discovery ever made" (7). The gas had been put into a rubber bag and administered through a homble wooden faucet similar to the contraption used in country cider barrels. It was given in quantities just sufficient to exhilarate or stimulate the subject (8). The wife of Doctor Wells relates her own experience with these bags (9): "In the winters of 1844 and 1845, and repeatedly thereafter, I made hags of Indian (rubber) cloth for my husband, to be used in administering this gas in dental surgery and frequently saw them in the hands of my husband when engaged in his profession." The failure of the demonstration caused Doctor Wells to become discouraged. He gave up his dental practice and tried various occupations to make a living. At one time he was a bud fancier, traveling through towns with a troup of singing canaries; a t another he attempted to sell shower baths and coal sifters during a public craze of hygienic conditions; finally, he went to Paris with the hope of buying European art treasures and sellinrr them to collectors in the United States a t a profit (lo?. While there he presented his claim to the to the Academy of Arts and discovety of Sciences and that body confetred upon him an honorary M.D. (11). Fully 17 years passed before the use of nih.ousoxide gas in dentistry was revived by Doctor of New Britain, Colton at the suggestion of the and Smith of New Haven* Connedicut. In Colton Dental Association was established in New York and i t is on record that of the 150,000 patients who received the gas that year not a single death occurred (11). The termination of the life of Doctor Wells was a tragic One. The New Tribune for January 25' for throwing gives an account of his on passing pedestrians, his suicide in a city jail, and the decision of the flost-mortem examination. The jury "after a brief co~sultationrendered a verdict that the deceased came to his death while laboring under an aberration of mind" (12). This issue of the Tribune also contains several letters written to the paper by Wells the night of his death. He explains the reason for his arrest adding that he had always endeavored to keep his conduct above reproach, and felt that he could never live down this disgrace. I n a letter to his wife, he said, "I feel I am fast becoming a deranged man or I would desist from this act. I cannot keep my reason and live." An extract from a deposition that Mrs. Wells gave several years later, when urged to support her husband's claim to the discovery of anesthesia, sums up the family history (9) : I am the widow of Horace Wells, surgeon-dentist, of said city of Hartford, deceased. We were married on the 9th day of July.
f I
' i
1
I.(
/),!)i, -
From "Dr. WeUSsS. Iha D k c o ~ e r mof Aneslhe*ia," Gee, Lockwood, and l rainard, Printer. 1870
AD. 1838. We had one child, a son now living, named Charles Thoinas, who is 13 years of age, Doctor Wells, my husband, was a native of New Hampshire and settled in said Hartford, as a dentist, some years before our marriage. He had a large, extensive, and lucrative practice which he pursued forseveral years, until he was obliged to ahandm it on account of ill health. H~ was iocessantly engaged in ewtracting teeth with this agency, and in trying experiments on himself and others. He would lie awake nights and often abruptly leave his meals to hasten to his office.
.. . . . . .
My husband died in New York. January 24,1845. He became insane, and I verely believe by reason of the opposition of Morton to his discovery. I also believe that his health was greatly impaired with the experiments which he made on himself with the gas, ether, and chloroform.
Many verified the statement of Mrs. Wells that her husband had become an addict of chloroform through the incessant use of the drug for demonstration purposes. He had been on the verge of a great discovery but ridicule of the first failure brought discouragement. Scientific tendencies frequently manifest themselves in early years. Hugh H. Young in the Bulletin of the History of Medicine for July, 1942, relates an incident in Crawford Long's childhood that may have been retold in the family circle and thus fixed the thoughts of the growing boy definitely on medicine as a profession. At the age of five he accidentally severed completely three fingers on the hand of his little sister with a hatchet. Instead of running away he grasped the
bleeding membtrs and held them in position while his mother coated the fingers with sugar and bandaged them. The sugar, a preventive of decomposition, proved a good antiseptic, as a perfect healing resulted with no deformity (13).
considered a good substitute. The young men inhaled the ether, hilarity ensued, and several of them received severe bruises, which the observant eye of Long noted did not seem to cause them any discomfort while they were under the influence of the drug. He a t once drew the conclusion that it must have the power of producing insensibility to pain and decided to give it a test in his surgical operations. On March 30, 1842, he administered it to a patient by the name of James Venable before removing a small cystic tumor from the back of the neck. Long said: "When giving i t to Veuable with one hand I held the towel over his mouth and nose pennittinghim to breathe a little fresh air as he inhaled the drug: I kept my hand upon his pulse. When he became insensible to the prick of a pin, I operated. As an inducement to Venable to allow himself to be the subject of such experiment, my charge for the operation was merely nominal" (14). The record in an old account book shows the transaction (15): March 30, 1842 James Venable Ether and excising tumor.. ................... . $ 2 00 May 13th. Sul. Ether.. ...................... 0.25 June 6, excising tumor.. . . . . . . . . . . . . . . . . . . . . . . 2.00
FRoNTlsPIECE OP PAMPRLET BY J. MARIONSIMS,M.D., 1877 Crawford Williamson Long was horn in the southern village of Danielsville, Georgia, on November 1, 1815. After completing his early education in his native clime, he traveled on horseback to Lexington, Kentucky, to matriculate at Transylvania University, then one of the three medical schools in the country. This school numbered among its distinguished faculty Benjamiu Winslow Dudley, as Professor of Surgery. A few miles away in ill^ lived the famous ~ ~ to perform an McDowelll who was lhefirst Transylovarian tumor operation S U C C ~ S S ~ U ~ ~From Y. vania, Long went to the University of Pennsylvania and from there received his M.D. in 1839. After graduation he spent some time in N~~ York city serving and performing and in returned home to open an officein the isolated town of Jefferson, ~ackson-County,Georgia. One day the friends of Doctor Long proposed to carry Out a nitrous oxide in his room' He them he had neither the gas nor apparatus to Prepare it, but could offer them some sulfuric ether which he
The first operation had been so successful that Venable permitted Doctor Long to remove a second tumor from his neck several months later. Between March, 1842, and September, 1846, Doctor Long performed eight operations with the use of ether. He did not publish his results until his attention was called to a controversy that had arisen over the claims of Doctor William T. G. Morton of Boston as the discoverer of anesthesia. Long contributed a paper to the Southern Medical and Surgical Journal under the title of "An account of the first use of sulphuric ether by inhalation" (16). In an article read by him a t the meeting of the faculty of the Georgia Medical College in 1846, he explains his delay of publication (13): The first notice I saw of the use of ether or rather of Doctor Morton's "letheon" as an anesthetic, was in the editorial of the Medical Examine, for December 1846, in which the editor gives the following extract from a paper by Doctor H. J. Bigelow contained in the Boston Journal. "The preparation is inhaled from a small two-necked glass globe, and smells of ether and is, we havelittledoubt, an etherealsolutionof some narcoticsubstance."
....... I commenced h ~ a communication ~ i t o the ~Medical Examiner for publication in the journal to notify the medical profession that sulphuric ether, when inhaled, would of itself render surgical ~.~ ~ ~~ toainless. that it had been used~ bv mefor that ~ , i o- n .qand ~ ~ ~ - ourpose for more than four years. I was interrupted when I h a d written a few lines, and was prevented by a lahoriotls country practice from resuming my communication until the Medical Examiner of January 1847 was received. It contained several articles giving accounts of different experiments in etherization. in which surgical operations were performed without pain. On reading this article I determined to wait for a few months before publishing an account of my discovery in order to learn whether any surgeon would present a claim to having used ether in surgical operations prior to the time i t was used by me, X C O U " ~ ha, been published, so far as I have been able hut a, to ascertain, of the inhalation of ether being used to prevent pain. ~
~
~~. ~
~
...
him to Eurupe. This brought the wcrk of the Southern doctor prominently before the world, but the recognition had come too late for him to enjoy it. He died the next year on June 16, 1878, while in the act of adIn the spring of 1854 Doctor Jackson, one of the ministering the anesthetic to a patient. claimants from the New England States, visited Long Several years went by before the South awakened to several times at his home in Athens, Georgia, with the the fact that a great discoverer had lived and died in its purpose of comparing notes on priority of discovery. midst. The Legislature of Georgia, in 1907, selected When leaving the office the last time, Jackson said, Long and Alexander Stephens, his roommate at "Well, Doctor, you have the advantage of us other Franklin College, now the University of Georgia, to be claimants to the first discovery and use of sulfuric ether the honored sons of Georgia in Statuary Hall in our as an anesthetic, but we have the advantage of having nation's Capitol. On June 14, 1921, a medallion monufirst publ~shedit to the world" (17). Doctor Long re- ment was erected on the main driveway facing the old marked later, "My claim to the discovery and the use of Chapel where he had graduated 86 years befcre. A sulfuric ether rests upon the facts of my use of it on beautiful statue of Doctor Long was unveiled on March March 30, 1842, of which I have published indisputable 20, 1926, by his two daughters, Frances Long Taylor evidence under oath and from reputable citizens" (18). and Emma Long. The same year a plaque was acJackson said of him, "He is a very modest and retiring cepted by the University of Edinburgh from the man and not disposed to bring his claims before any but a medical and scientific tribunal" (19). Many years passed before Doctor Long's work was known to the public. We have some interesting details of his l i e from the pen of his daughter: in surgical operations as early as March 1842, my friends think I m u l d be doing myself injustice not to notify my brethren of the medical profession of my priority in the use of ethm by inhalation in surgical operations.
From an exceedingly well-written paper by Doctor Hugh Young of Baltimore, who had access to all the material relating to my father's discovery, read before the Johns Hopkins Histarical $aciety, November 8, 1896. I quote the following: "Long's work was unknown to the world until 1877, when J. Marion .Cjims, learning of him through accident, investigated his claims, was fully convinced of their merit, and vigorously demanded their recognition by the medical profession." His paper appeared in the VirgVirginio Medical A4onlhly. May 1877. . . . Although my father held himself aloof from the notorious ether controversy, in his spare moments he vigilantly safeguarded his own claims by procuring evidences from witnesses of operations which he had performed upon patients anesthetized by the inhalation of sulphuric ether. He went calmly on his way tending the sick, caring for his own, sure of himself, confident and fair to all, generous even to opponents, courteou* even to critics.
...
To justify his delay of publication, Doctor Long often said: "Had I been engaged in the practice of my profession in a city, where surgical operations are performed daily, the discovery would, no doubt, have been confided to others, who would have assisted in the experiments; but occupying a different position, I acted differently, whether justifiable or not" (20). Doctor W. H. Welch remarked of him a t the celebration of Ether Day in Boston, 1908 (21): Long is necessarily deprived of the larger honor which would have been his due had he not delayed publication of experiments with ether until several years after the universal acceptance of surgical operations. While the accepted rule t h a t scientific discovery dates from publication is a wise one, we need not in this instance withold from Doctor Long the credit of independent and prior experiment and discovery, we cannot assign to him any influence upon the historical development of our knowledge of surgical anesthesia or any share in the introduction to the world a t large of the blessings of this matchless discovery.
DoctorSims, arenownedgynecologist,wroteapamphlet entitled, "History of the Discovery of Anesthesia" (a), distributed it here in the United States, and took it with
Pvom "Dr. Jockson's Discour7y ojElhrr" by William Borbcr, NaUonaI ma go^ ainc, O d . , 1896, Boslonion Publirhing Co.
Southern Society of Clinical Surgeons. On April 15, 1926, another memorial was unveiled in the quaint courthouse yard of his birthplace, Danielsville, Georgia, and in 1940 the United States Ckwernment issued a
WM. T. G. MORTON,M.D.. BOSTON,MAKINGTHE FIRST AT THE MASSACHUSETTS GENERAL PUBLICDEMONSTRATION HOSPITAL SURROUNDED BY THE MEDICAL STAPPOP THATINSTITUTION. ' LEFTTO RIGHT: DRS.HENRY J. BIGELOW, A. A. GOULD,J. MASONWARREN, JOHNCOLLINS WARREN, WILLIAM MORTON, SAMUEL PARRMAN, GEORGE HAYWARD; RIGHTFRONT. DR.S . R. TOWNSEND.
Sled cngroving from "Trials of n Bm%dorn by Nolhan P. Rice Pudney and R u s d l . N& Yark. 1859
commemorative postage stamp on which Doctor Long's picture was produced (13). I11 B y whom pain in surgery was averted and annulled, Before whom, in all time, surgery was agony, Since whom science has control of pain. [Inscription on Dr. Morton's monument erected by citizens of Boston in Mt. Auburn Cemetery-written by Dr. Henry J. Bigelow (22).]
William Thomas Green Morton was born on a farm in the township of Charlton, Massachusetts, August 9, 1819. The boy had a great desire to study medicine, but after completing his elementary education in two academies, Northfield and Leicester, was obliged to leave school because of the business reverses of his father. In August, 1840, the American Society of Dental Surgeons was organized, and accepted the Baltimore College of Dental Surgeons as its first member. Morton read of this and conceived the idea of using some money left him by an aunt to study dentistry. By this profession he hoped to save enough to study for a medical degree. After graduation.from the Baltimore college he returned to Boston to open a dental office in copartnership with Doctor Horace Wells of Hartford. The business end of this agreement did not succeed and the partnership was dissolved a year later.
At the very outset of his career Doctor Morton set about finding some way to lessen the pain caused by the extraction of teeth. James G. Mumford in his "Narrative of Medicine in America" (23) tells that it was customary in those days for dentists when fitting false teeth to place them upon gold plates set directly above the fangs of the old teeth. Doctor Morton obtained a new kind of solder for attaching the teeth, which was of the same material as the plate itself. In the old arrangement a galvanic action was often set up between the solder and the gold plate, so that a black line formed around the base of the teeth. To demonstrate the use of the solder satisfactorily, he saw that the fangs of the old teeth would have to be removed. But few persons had the stoicism to undergo the ordeal, and preferred to have the teeth soldered to the old roots rather than to endure the pain of extraction. In July, 1844, a Miss Parrott of Gloucester called a t Morton's office to have a tooth filled. Her keen sensibility to pain caused him to apply ether to the d e c t e d part. This use of ether was no secret as other dentists were using "ether drops" freely ( 1 ) . Morton noticed that when he probed into the sensitive part of the bone with his instrument no pain was felt by the patient. She said to him, "Doctor, I neither feel the instrument in the tooth nor your hand on my face, though I plainly see i t in the looking glass" (24). The idea instantly occurred to him "like a grasp of steel" that possibly the whole human system could be brought under the influence of the drug in cases of greater and more diiuse pain. During that summer while visiting his fatherin-law's farm in Framingon, Connecticut, he carried on numerous experiments with the etherization of insects, birds, and dogs, but reached no conclusion. His dental practice was now thriving and he decided to begin work toward the coveted M.D. On his return to Boston that fall he matriculated a t the Harvard
Medical School. The great need for an agent to produce insensibility to pain during surgery was brought home to him more than ever as he witnessed the lecture demonstrations a t the Massachusetts General Hospital. The failure of Doctor Wells only served to stimulate Morton to renewed energy. I n the wring of 1846, he went to his farm in Wellesley to start a new line of experiments and was so successful that on his return to Boston he asked Doctor Granville G. Hayden, another young dentist, to take ,.barge of his business fora while. *"gust he bought from Joseph Burnett, a reIn liable apothecary, some sulfuric ether and induced his two students. William P. Leavitt and Thomas B. Spears, to inhale it from a handkerchief (25). The effects produced stupefaction but caused too great excitability. Thinking that surer &ects might be pro.duced through some kind of an inhaler, Morton had a Mr. Wightman fashion a quart tuhulated globe receiver. It was tried but with no better results. Doctor Morton then decided to consult Doctor Jackson. Doctor Charles T. Jackson of Boston was not only a physician hut a chemist and geologist of high reputation. He had been appointed State Geologist of Maine, Rhode Island, and New Hampshire, and had set up a laboratory for research in analytical chemistry. Jackson "possessed the inventive faculty; the habit of incessant investigation, the capacity of getting fruitful results; and the ability to suggest successful expedients to others" (26). He was a brilliant conversationalist and his open way of relating scientific facts must have been advantageous to his young assistants. He had been interested in the properties of ether for several years. On one occasion after using i t to overcome the effects of chlorine gas, he deliberately inhaled it to unconscionsness for the sake of observing the phenomena further. "He found that the vapor washed free of alcohol and acids and mixed with a considerable quantity of atmospheric air could be inhaled with entire safety to the extent of somewhat prolonged unconsciousness, and that by it the sensory nerves were incapable of feeling pain even before consciousness was quite lost and a little while after i t was regained. He cornmunimanufacturing cated this to chemists, and people suffering from toothache'' (27). Doctor Morton tells of his visit to Jackson's laboratoryin a ~~~~i~ to the ~~~d~~~ of Arts and Sciences at Paris (28). I n the meantime I became satisfied that the bottle and glass I had were not large enough for my purpose and not wishing to go t o unnecessary expense, I said t o Dr. Hayden that I would borrow a eas bae - from Dr. Tackson's lahoratorv. also with the intention of ascertaining something more accurately as t o the d i e r e n t do setting preparations of ether, if I could find I I am aware him upon thesame track of experiments with that by this admission I may show myself not to have been possessed by the most disinterested spirit of philosophic enthusiasm, clear of all regard for personal rights or benefits; hut i t is enough for me t o say that I felt I had made sacrifices and nm risks for this object, that I believed myself to be close upon it, yet where another, with better opportunities for experimenting, availing himself of my hints end labors, might take the prize from me.
He obtained the loan of the bag from Doctor Jackson and as he was leaving the laboratory, Jackson said, "WeSl, Doctor, you seem to be all equipped, minus the gas." Then followed a conversation that was to be repeated many times later to ascertain how much Doctor Tackson had contributed to the discovery.
Seelngi
opportunity open, I said in as careless a as I could assume, "why I giveether H~ said that I could do what 1pleased with him [the patient] that he would not be able t o help himself. Finding the subject open I made the inquiries I wished t o as t o different kinds and of ether. He told me something ahout the preparations and thinking that if he had any it would be of the purest kind, I asked him to let me see his. He did so, hut remarked that i t had been standina sometime and told me he could recommend somethine better than the gas-bag t o administer the ether with, and gave me a flask with a glass tube inserted in it.
Taking Jackson's advice, Morton obtained some pure ether after finding that the 6rst sample he had used contained alcohol and sulfur acids as impurities. This same day of the visit to Jackson, September 30, 1846, he shut himself up alone in a room to make the experiment on himself (29). Taking the tube and flask, I shut myself up in my room, seated myself in the operating chair and commenced inhaling. I found the ether so strong that it partially suffocated me, but produced no decided e5ects. I then saturated my handkerchief, and inhaled it from that. I looked a t my watch, and soon lost consciousness. As I recovered I felt a numvness in my limbs and a sensation like nightmare, and would have given the world for somebody to come and arouse me. I thought for a moment I would die in that state and that the world would only pity or ridicule my folly. . I gradually raised my arm and pinched my thigh, but I could see that the sensation was imperfect. I attempted to arise from the chair but fell hack. I immediately looked a t my watch and found that I had been insensible between seven and eight minutes.
..
Highly excited as to the successful results, Doctor Morton determined to continue investigation on the wonderful substance before going home that day. Toward evening a man by t h e name of Eben Frost came into the oflice. He was suffering from the toothache and begged Morton to mesmerize him before the extraction. His testimonial tells what took place (30): This is t o certify, that I applied to Doctor Morton a t 9 o'clock this evening su5ering nuder the most violent toothache that Dr. Morton took out his pocket-handkerchief, saturated it with a preparation of his, from which I breathed for about half a minute, and then was last in sleep. In an instant more I awoke, and saw my tooth lying upon the floor. I did not experience the slightest pain whatever. I remained 20 minutes in the office afterward. and felt no unpleasant effectsfrom the operation. EBEN H. FROST 42 Prince Street Boston
We witne-sed the above operation, and the statement is, in all respects correct; and, what is more, the man asked where his was, Or if it was Out. A. G. TENNY,Journal-office G. HADEN. Surgeondentist Boston, $ept. 30th. 1846.
William Leavitt remembered Morton as saying after this event, "I have got it now. I shall take my patients
into the front room and extract their teeth and then and putin a new set and take them into the back send them off without their knowing anything about the operation" (31). The first notice of the painless extraction appeared in the Boston Daily Adoerfiserfor October 1, 1846. It attracted the attention of Henry Bigelow' One Of the at the Massachusetts and he visited Morton in order to witness some of the administrations of the anesthetic. Doctor Morton then received the following invitation from Doctor Warren to he the anesthetist during an operation (32) : Dear Sir. I write, a t the request of Doctor J. C. Warren, to invite you t o be present on Friday morning, a t 10 o'clock a t the Hospital, and to administer, to a patient who i s then to be operated upon, the preparation which you have invented to diminish the sensibility to pain. Yours Respectfully.
C. F. HEYWOOD, House-Surgeon of the Massachusetts General Hospital October 14, 1846. L W Morton. Tremont Row.
That morning Morton arose a t 4 o'clock and went to the instrument maker's to get him to fashion an inhaler of some special design. As the hour of 10 approached and the apparatus was not quite complete, Doctor Morton seized i t and hurried off to the hospital. The patient, Gilbert Ahbott, a printer by trade, was suffering from a congenital tumor just below the jaw on the left side of the neck. Ten o'clock came and went and still no sign of Morton. After waiting 15 minutes, Doctor Warren picked up his knife to operate, saying, "As Doctor Morton has not yet arrived, I presume he is otherwise occupied." At that moment a side door opened and in rushed Morton carrying his inhaler. Doctor W m e n said, "Well, Sir, your patient is ready." Pausing long enough to apologize for his delay and to see the incredulity on the faces of the surgeons and spectators, he bravely set about giving the ether to the oatient. In two minutes the man dro~oedinto a deeo sleep. Morton then turned to Doctor Warren and addressed him with these words, "Doctor, your patient is ready." There was the silence of the tomb as the operator seized the bunch of veins and made the incision. Not the slightest movement or sign of sensibrlity was made by the patient, and gradually a change came over the spectators. A great discovery was bemg used before them. When the operation was over Doctor Warren turned to those present with the words, "Gentlemen, this is no humbug" (33). The truest picture of the circumstances surrounding this memorable day comes from the pen of his devoted wife, Elizabeth Whitman Morton, written for the occasion of the 50th anniversary of the discovery in lS9G (34):
..
discarded. I assisted him nearly beside myself with anxiety, for the strongest influence had been brought t o bear upon me t o diqsuade him from making the attempt. I had been that one things was sure to happer, either the test would fail and my husband would be ruined by thc world's ridicule or he would kill the patient and be tried for man slaughter. Thus I was drawn in two ways: for while I had un bounded confidence in my husband it did not seem possible that so young a man (he was only 27 years old a t this time) could be wiser than the learned and scientific men, before whom he pro. posed t o make this demonstration. After resting a few hours, Doctor Morton was off early in the morning t o see the instrument-maker. . . From that moment I saw nothing of him for twelve hours, which were hours of mortal agony. How they dragged along as I sat a t the window, expect^ ing every moment some messenger to tell me that the patient had died under the ether, and that the doctor would be held responsible! . . . it was not untilnearly four that Doctor Morton walked in with his usually genial face so sad that I felt failure had comr . . . he said, "Well dear, I succeeded," not highly elated, but as it were crushed down bv a Load of discouraeement. This was due not only to bodily falinleand thr ructio;; after his great eff.,rt.. but to a n intuitivr. pnceprion of the troubles in store for him It is literally true Doctor Xfortorl never was the same after thsa
.
This first operation under the influence of ether was not considered by the operator to be a complete success, yet i t has been made the subject of a large painting by the artist, Samuel Hinckley, Washington, D. C. It depicts Doctor Morton surrounded by the leading surgeons of the hospital in the act of administering the anesthetic with the use of his inhaler (35). The name "letheon" had been selected by Morton, hut Doctor Oliver Wendell Holmes suggested the one in general use today (36). His letter states: Boston Nov. 21, 1846. My dear Sir: Everybody wants t o have a hand in a great discovery. All I will do is to give you a hint or two, as to names or the name, t o be applied to the state produced and the agent. The state should I think he called "anesthesia." This signifies insensibility, more particularly (as used. by Linnaeus & Cullen) of touch (see "Good-Nosology," p. 259). The objective will be "anesthetic." Thus we might say the state of anethesia or the anesthetic state. . . . I would have a name pretty soon and consult some acconlplished scholar such as President Everett or Doctor Bigelow, Sr.. before fixing upon the terms which will be repeated by the tongues of every civilized race of mankind. You could mention these words which I suggest for their cow sideration: but there may he others appropriate and agreeable. Yours respt., 0.W. HOLMES.
Rene Fulop-Miller in his "Triumph over Pain," tells an amusing incident that happened about this time in connection with the discovery (37). Eben Frost had been the first patient to have his tooth painlessly extracted by ~ o c t o Morton. r He was a music teacher, but after the meat event life was comoletelv changed " for him. His name was often in the newspapers, everyone wished to see him, hear the story from his own lips, and learn what he thought of Morton. Frost was the "first guinea pig" for etherization. "It was impossible to talk of the event without mentioning his name, in
-
fact, he seemed to become indispensable to Doctor Morton. When he talked about the discovery he spoke about i t as 'ours'; the words 'Morton and I' were perpetually in his mouth. 'Come along, Frost,' Doctor Morton would say as he left to hold appointments with medical men. Frost was already to 'come along.' He sat in the waiting room, expecting the demand. . . . He no longer gave music lessons, but devoted his whole life to the new task of shadowing Morton and perpetually retelling the story of the painless extraction." The news of the discovery was carried to Europe on the first steamer that left Boston. Testimonials of joy and praise came to the United States from England, Germany, Russia, India, and many other nations. In November the Government issued a patent for the use of the drug under the name of "letheon." Doctor Morton on legal advice included Doctor Jackson in the patent, but the latter relinquished his claim for a nominal sum and 10 per cent of the profits (14). Morton never enforced the right of patent, "for his human~ t was y too great to keep back from suffering millions so precious an agency of relief. Yet, he was critiziced on all sides for taking out the patent, and cruel attacks were made upon him that cut him to the heart" (38). The fact that he used a secret name and tried to put it on a paying basis caused criticism and resentment, which still rankles in the hearts of men today. But the surgeons of the Massachusetts General Hospital declined to use the preparation as it was under patent and had a secret name. Doctor Morton wrote a t once to Doctor Warren, explained the exact nature of the drug, offered to give free rights to all charitable institutions and to sell the right to surgeons, physicians, and dentists for a small sum. Rlght of use was given to the army and navy, hut after acknowledging its value, the offer was declined by the Government, although the dmg was used by both departments. After the explanation to the surgeons, Morton was then asked to give a public demonstration a t the hospital on November 7. Denison D. Slade, M.D., was an eyewitness (35) to this first successful amputation case. In his article entitled, "Fist capital operation under the influence of ether," he tells that no better place in all Boston could have been selected for this great event than the General Hospital. Its wide and airy halls, the stone stairways, the scrupulously clean and well-waxed floorsof the wards and private rooms, its curtained beds, and every article of furniture, above all, its skilled nurse, bespoke an attention to the primary objects of the institution, and to the comfort and care of the humblest patient. The dome contained a Large and commodious operatingtheatre, to become in 1846, the starting point of a discovery which was destined t o go around the world. . . Hooks, rings, and pulleys inserted in the walls to aid in the reduction of dislocated limbs, met the eye, happily for suffering to he henceforth and forever discarded. While the assembly was scanning these various objects, gazing upward also at the elegant and well-lighted dome, and taking
.
cognizance of every trivial incident, as is customary with impatient crowds, the six hospital surgeons entkred the room.
Doctor Slade gives a lengthy description of these men, for they were of international fame because of their skidl as surgeons and physicians. First came the senior Warren, a man of rather above the medium height with a somewhat stooping form. For many years he had continued to hold the rank of first in surgery and his lectures as Professor of Anatomy and Surgery in Harvard University were spirited and popular. By his side walked George Hayward, Professor of Clinical Surgery, rather short in stature and making a marked contrast to his companion. The other four who completed the group were: S. D. Townsend, formerly a naval surgeon, J. Mason Warren, Henry J. Bigelow, and Samuel Parkman. The last three had been recently added to the hospital staff and were already making a good start toward a brilliant career as skillful operators. The news of the event had been noised abroad among the Harvard Medical students, the medical profession, and the public in general. An hour or so before the appointed time, all seats in the vast amphitheater were taken as well as every place available for standing. Those in the front rows knelt on the floor for those behind to see better. When Doctor Morton entered to give the anesthetic, he saw instead of a staff of surgeons and students as anticipated, spectators of every description, and yet in that vast sea of faces, not one that was enthusiastic--only incredulity or, a t bestcuriosity. He was attired as usual in a blue frock coat with brass buttons and a large and elegant scarf. The patient was a young girl by the name of Alice Mohan, and had been an inmate of the hospital for 18 months. An infected knee joint necessitated amputation of the leg. After a few words of encouragement, Doctor Morton brought her completely under the influence of the ether in three minutes, as could be seen by complete muscular relaxation, drooping eyelids, and immobile pupils. The amputation occupied less than two minutes, not including the time consumed in tying the arteries. When the patient returned to consciousness, "she was ignorant of the loss of her limb, and could hardly be persuaded of the fact" (39). The first amputation under ether had been a success. Doctor Morton was the hero of the hour. Formal announcement of the discovery was made to the medical world by Doctor Bigelow in a paper read before the Academy of Arts and Sciences. It was puhlished in the Boston. Medical and Szrrgical Journal, November 18, 1846. IV
And then the storm of controversy broke. The public press and medical journals teemed with accounts of experiments and operations with ether. Doctor Wells returned from Europe and put in his claim to the discovery of anesthesia. A heated discussion then took place between them through the Boston Medical and
Surgical Journal (40), the nature of which can be seen from a letter written to Morton by Wells, quoted in palt:
rectified from B u r n e t t ' s b u t my obligation t o him hath extent, no further.
Doctor Morton,
He did not put me upon the experiments and when he recommended the highly rectified sulphuric ether, the &ect he anticipated was only that stupefaction which was not unknown, and he did not intimate in any degree a suspicion of that insensibility t o pain which was demonstrated and astonished the scientific world.
...
Dear SirI have just seen a copy of your claim and find that it is nothing more than what I can prove priority of discovery t o by a t least 18 months. When in Boston, a t your room, I was well satisfied that the principal ingredient was ether, and t o all appearances, it was just the effect of this alone upon the patient t o whom I saw it administered in your office. Now, I do not wish, or expect. t o make anv monev out of this invention. nor t o cause vou t o be the l o w ; but I h~rereaolvedtogivea history of itsinrroductiou, that I may have what credit belon~Fto me, although it is in my p.nrer to inralidntr your parent b y a word, yet, ,r, long ns we remain on good turns. I shall not do it
.
Doctor Jackson wrote letters to the French Academy of Sciences, an outstanding science tribunal of that time, claiming the honor for himself. He made it on these grounds: In 1842 he had performed several experiments with ether, and had been convinced of its value in surgery; he had advised Morton to use i t and had even given him the apparatus for his first successful case; and that his pressing duties as geologist, chemist, and physician left him no time to develop his findings. The French Academy after learning of the Boston dentist's demonstration, awarded its Montyon prize to both, jointly. Doctor Jackson after some hesitation accepted the money, but Morton refused i t a t once as he thought himself to be the true discoverer of anesthesia. The prize consisted of 5000 francs and was to be divided equally between the two men. When some time had elapsed and Doctor Morton's share remained untouched, the commission after a lengthy deliberation decided to have a medal made for him. On one side was the bead of Minerva, surrounded by the words, "National Institute of France," and on the other side, "Academy of the Sciences, Montyon Prize for Medicine and S~rgery-1847-1&i&~11iam Thomas Green Morton, 1850." A difficulty arose when i t was found that the medal cost a little less than the awarded money, so to use all of it, a goldsmith was instructed to enrich the frame with a laurel garland in relief (41). Doctor Morton collected all of his evidence and wrote a Memorial to the Academy of Arts and Sciences a t Paris, which was presented by M. Arago in the autumn of 1847. His connection with Doctor Jackson is made quite clear (42). I am ready t o acknowledge my indebtedness t o men and t o books for all my information upon this subject. I have got here a little and there a little. I learned from Doctor Jackson, in 1844, the effectof ether directly applied t o a sensitive tooth, and proved, by experiment, that i t would gradually render the nerve insensible. I learned from Doctor Jackson, also, in 1844 the effects of ether when inhaled by the students a t college, which was corroborated by Spear's account, and by what I read.
. . .. . . .
I further acknowledge that I was subsequently indebted to Dodor Jackson for valuable information as t o the kinds and preparation of ether, and for the recommendations of the highly
Sarah Barker in Harper's for 1865 gives an interesting account of the vain struggles of the next few years (43). She was present a t a lecture in which Doctor Morton told how he had been continually besieged by professional gentlemen, who took up his valuable time by speculative doubts, questioning him on the accuracy of his experiments. He saw clearly that he would have to fight alone to convince the public and the medical profession in order to preserve anesthesia for future generations. Drawing upon private funds he engaged physicians a t $1000 each, instructed them how to use the agent and sent them forth to all parts of the United States, London, Paris, and Saint Petersburg. He enlarged his own apartments, converted them into a hospital, where operations were to be performed free, nothing asked but a certificate from the patients to be used publicly. He spent several thousand dollars for the manufacture of pure ether and made an offer, declined by the U. S. Government, to supply it to wounded of the Mexican War for one cent a patient. He made 27 trips to a hospital in a nearby city to get ether tried there. He contributed articles to medical journals, paying as much as $1600 on one occasion to get an article printed. He published a weekly bulletin of successful cases in English, German, and French. His mail box was so jammed that he had to abandon the work of his dental practice, as well as his studies for an M.D., and hire a secretary to help him to answer the letters. Not all were critical or damaging. Many came from eminent surgeons and scientists a t home and abroad, praising his work, but those be valued the most were the "thank you" notes of grateful human beings. For more than a year after the discovery ether had not yet been tried in the Pennsylvania Hospital, one of the largest hospitals in the country. Medical journals and the daily press carried cruel criticisms (44). The Philadelphia Medical Examiner for December 16, 1846, said: "We are persuaded that the surgeons of Phiiadelphia will not be seduced from the high professional path of duty, into the quagmire of quackery by this will-o-the-luisp," and in the New Orleans MedicaE Journal for January 27, 1847: "Why mesmerism, which is repudiated by the sawans of Boston, has done a thousand times greater wonders and without any dangers here threatened. What shall we hear next ?" An association of merchants and scientific men from Boston petitioned Congress to grant Doctor Morton adequate compensation for all the expenditures he had incurred in trying to introduce ether for the common
That he carried no rancor in his heart toward the good. The House of Representatives committed the subject to the Committee of Ways and Means in the Government or his fellowmen can be seen from an exform of an appropriation of two b i s for $100,000 tract of a letter written during the Civil War to a friend each. "It came into the House some days after the in Washington, D. C.: Battle of the Wilderness a t a moment when one could On previous occasions i t has been my privilege t o visit battle look Out of the Capito1 and see acres of fields and thus t o administer the pain-destroying agent which it hospitals, filled with wounded men for whose comfort pleased God t o make me the human agent t o intraduce for the and relief anesthetics were used a thousand times a day. benefit of sufferinghumanity. H o w little I ever think, however, yet, the subject was notunder consideration five min- when originally experimenting with t h e properties of sulphuric ether an my own person, that I should ever successfully adUtes before the appropriation was dead" (45). minister i t to hundreds in one day and thus prevent an amount This lack of recognition by the Government, his wife of agony fearful to contemplate, tells us. was the neatest sorrow during his last years, ... ... . principally because other nations honored him with Far myself I am repaid for the anxiety and often wretchedness decorations and orders. Russia sent him the Cross of which I have experienced since I ht discovered and the Order of St. Vladimir, Norway and Sweden gave the anesthetic qualities of sulphuric ether, by the consciousness him the Cross of the Order of Vasa, and the French that I have thus been the instrument of averting pain from thouAcademy conferred a medal commemorating the event. sands and thousands of maimed and lacerated heroes, who have calmly rested in a state of anesthesia while undergoing surgical Still these three medals are meager compared to the operations, which would otherwise have given them intense number that Doctor Jackson received from various .. . . . . . societies. Two pages of them may be seen in the National Magazine for 1896 (46). In 1852 an honorary gratitud-happy am I to have They are worthy of a M.D. was given to Doctor Morton by his alma mat-, alleviated their suffering. F O ~the dead heroes we mourn-hut Washington University, which afterward converged let all the patriotic benevolence and science, and philanthropy of into the College of physicians and Surgeons of ~ ~ l t ithe - republic he brought into requisition for the benefit of manmore (47). One of his most treasured possessions had kind. been a small silver casket from the Board of Trustees ~i~ personal qualities may be gleamed from a of the Massachusetts General Hospital, bearing the munication to D~~~~~ ~~~d~~ (49): inscription, "He has become poor in a cause which has Boston, April 18, 1895. made the world his debtor" (33). The casket contained W. R. Hayden, $1000 as a token of gratitude and sympathy. This trophy and other medals are now preserved in Boston MY dear Sir; I wish that you had known William G. Morton. I knew him by the Boston Historical Society. well. I met him not infrequently in those years when the subject With hopes of compensation from the Govern- bf anesthesia engrossed his time and thoughts. ment gone, broken in health, and pressed down with I like t o bear him in mind as he w a s a refined, courteous enormous debts, Doctor Morton now in dire poverty gentlemen, thoughtful of others' feelings and convenience, generwas unable to save his country home "Etherton" from ous and warmly appreciative of any kindness and sign of good the receiver's hands. Shortly after his marriage he W i ~ ~ ~ ~ ~ d ~and t ~ardent-even i S i n g sanguinein had purchased a farm in Needham, pursuits (in which he was remarkably methodical) and though Wellesley, had a cottage built there in old English style, often grieved and indignant a t the gratuitous injuries and misand there spent his happiest days. With his own hands representations heaped upon him by unprincipled opponents, I and every spot do not remember that I ever heard from his lips an opprobrious he had helped to beautify ae his enemies. upon them was connected with some treasured family epithet, or saw indications of an effort t o retaliate Respt. yours, event. After the sale, kindness of heart prompted the JOHN J. MAY. buyer to offer the use of Etherton to Doctor Morton Doctor Morton died suddenly a t the age of 48 years. and his family free of rent. West Needham is now the seat of Wellesley College. A public library has On July 6, 1868, he left Etherton cottage for New York been built upon the site of the Morton home, and the City to answer another claim of Doctor Jackson's that surroundings have been converted into a public park had appeared in one of the leading journals. This was the first of its k i d that had been printed for some (47). H ~ sou, S m l i a m james ~ ~(1845-1920) r of t iyew ~ time.~ His wife was summoned to his bedside five days later. He improved s&ciently to wish to drive to York City tells of the anguish of those days (48) : Washington Heights, but hardly had they passed The discovery of surgical anesthesia, while a boon t o the through central park when the illuess came upon him. world, was a tragedy t o its author and t o his family. Science, He was taken to St. Luke's Hospital and died in an civilization, had given with too free a hand and required a compensating sacrifice, whose lot was his. ~ h o u his ~ h misfortunes hour. "The chief surgeon and the house physidans," have been the foundation of countless fortunes t o others, his says Mrs. Morton, "gathered about him. At a glance sorrow the source of inexpressible happiness t o millions; though the &ief surgeon recognized him and said to me: hislifewasonesinglelifeunb1es~edbywhatwastoothersblessing, is Doctor M ~ ~ I ~simply ~ ?replied, P eyes.' henever complained, but pursued his way, simply, patiently, and to a group of house he honestly, humbly thankful t o have been the benefactor of his After a pupils and said, 'Young gentlemen, you see lying before race.
-
-
you a man who has done more for humanity and for the relief of suffering than any other man who has ever lived!' In the bitterness of the moment, I put my hand into my pocket, and taking out the three medals, laid them beside my husband, saying: 'Yes, and here is all the recompense he has ever received for it' " (50). Doctor S. Weir Mitchell, novelist, poet, and famous physician, penned "The Birth and Death of Pain" and read it October 16, 1896, on the occasion of the semicentennial of anesthesia (51) : How did we thank him? Ah! no joy bells rang. No peons greeted and no poet sang, No cannon thundered from a guarded strand That mighty victory t o a grateful land! We took the gift, so humbly, simply given, And coldly selfish-left our debt t o Heaven. How shall we thank him? Hush! a gladder hour Has struck for him; a wiser, juster power Shall know full well how fitly t o reward The generous soul, that found the world so hard.
Doctor Morton had five children, three sons and two daughters. One son, Edward, served through the Zulu war in South Africa as a member of the Cape Mounted Rifles, winning the award of the Victoria Medal. Bowditch Morton studied a t the Massachusetts Institute of Technology and graduated from Harvard Medical School in 1881. His oldest son, William James Morton, M. D. (184.51920) (52), of New York City
held for nearly 30 years the position of Professor of Diseases of the Mind and Nervous Svstem and Electrotherapeutics in the Post-Graduate ~ e d i c a School l and Hospital of the great metropolis. He was a pioneer in the use of radium and Roentgen rays and wrote probably the first book in the English language on the medical use of the latter (53). The literature on the ether controversy is voluminous, not so many books, but hundreds of pamphlets, and articles in the medical journals and leading publications of the day. The attacks were open and cruel and were carried on for a period of over 20 years. The "Dictionary of American Biography" has struck the keynote of the whole situation: In the discovery of surgical anesthesia, Crawford W. Long. Horace Wells, and Charles T. Jackson, all shared, yet Morton acted independently and conducted experiments with ether on his own initiative. Moreover, he took entire responsibility for the outcome of his first public demonstration upon human beings, and in so doing he, before any one else, convinced the surgical world of the value of the discovery; for this contribution alone may allow him credit as the discoverer, and this indeed was the opinion of those of his contemporaries most competent to judge The regrettable feature of his conduct may lessen but cannot roh him of the honor which is his due (54).
Doctor Jackson lived the longest of the four claim ants. In 1873 he was forced to retire from his active ~rofessionas the once brilliant mind had ceased to funclion normally. He died on August 28, 1880, at the McLean Asylum, Somerville, Massachusetts. As soon i s i t is possible to photograph several scenes in Eurooe connected with the d i s c o v e ~a. ~ronosalhas been made (55) to make the story of ether into a great motion picture. As the millions, who have benefited by use of this agent, witness the unraveling of the sad story, regret will be mingled with gratitude; regret for the trials, misfortunes, and bankruptcy attending the discovery, gratitude for the blessing of a priceless gift to painless surgery. 2 .
.
A
LITERATURE CITED
(31 (4)
EMBRSON. E. W.. ~ t l e h t i c~ o i t h l v?8; . 679 (1896). SIMS, J. MARION."History of th; discovery of anesthesia.'' Virginia Med. Monthly (May, 1877).
1.5) -FTTLOP-MILLER. RENE. " T r i ~ m ~over h Pain." Translated .---~ '
,I . . .
..l,.l
_.\
.
.. ,
.,,.:
,
/
' ~
-
I
%..,,,....,'
.
_,
I,.
-
I
Courlcsy J . B. LUpincoll Co.. Philndelphio
THIS PICTURE FORMS THE FRO~~TISPIECE OF AN ARTICLE BY JOHN C. WARREN, M.D., IN THE TransactiOm of the Ameruar NOTE OCSur~ical Association FOR 1897. T H EFOLLOWING ARTICLE. "[Note-The illustration represents the operating theatre of the Massachusetts General Hospital in the winter of 1847. The sponge used here is known as the first sponge with which ether was given. This method was adopted in February, 1847, by Dr. J. Mason Warren. The surgeons whose portraits appear in this picture are, on the patient's left, Dr. John C. Warren, Dr. Samuel Parkman; on the right, Dr. J; Mason Warren and Dr. Townsend. The etherizer is probably Dr. Henwoon. The daguwotype from which the photogravure is taken, has been in possession of the writer's family since that time.]" CURRED AT THE END OF THE
(13)
(14) (15) (16)
by EDENand C E D ~ RPAUL.: B & S - ~ e r h l l Company, New York, 1938, p. 105. KEYS. THOMAS, Anesthesiology, 2, 552 (1941). Reference (I), p. 586. ER~ING, HENRYW., "Horace Wells, Discoverer of Anesthesis," Yale University Press, New Haven, 1933, p. 6. SMITH, TRUMAN, "Examination of the Question of A n e r ~ thesia," J. A. Gray, Printers, New York, 1859, p. 19. Reference (5), p. 109. COLTON,G. Q., "True History of the Discovery of A n e - ~ thesia," A. G. Sherwood, New York, 1886, pp. 1-15. Nnu York Tribune, January 25, 1848, Obituary of Horace Wells. YOUNG, HUGHH., Bulletin oJHislory of Medicine, 12, 191 (July, 1942). TAYLOR. FRANCES LONG,"Crawford Williamson Long," Hoeher, New York, 1928. Boston Medical and Surgical Jourm2.64, 230 (1861). FLITCRAET, J. F., Dictionary of American Biography, 11, 375 (1933).
(17) Reference (14). p. 91. (18) Reference (15), 64, 229 (1861). (19) TAYLOR, FRANCES LONG,Annals of Medical Hirtory, 7, 267 (1 9251 *----,.
(20) Reference (13), p. 201. (21) WELCH.W. H.. "A Consideration of the Introduction of
.
(231 . . M ~ M F ~ R D . ' ~ AGM E"~~ k ; a t i v eof Medicine in America." J. B. ~ i p i i n c o t Company, t Philadelphia, 1903. (24) BARKER,SARNi, Harper's Neu Monthly Magazine. 31, 454 (1865). (25) Littell's Living Age, No. 201, 529 (March 18,1848). (26) MERRILL.GEORGEP.. Dictionary of American Biography, 1 1 627 11022) *-, --,. \-"
(27) 1281 (29j (30)
Reference (3), p. 680. Reference (251. o. 21. Reference (1); p: 588. RICE,NATHAN P., "Trials of a Public Benefactor," Pudney and Russell, New York. 1859, p. 62. (31) Reference (251, p. 534. (32) Reference (30). p. 89. (33) Reference (1). p. 591. McClure Magazine, 7, 314 (34) MORTON, ELIZABETH WHITMAN, (1896). (35) SLADE, DENISON D., Scribner Magazine, 12,518 (1892) (36) Reference (30). p. 137. (37) Reference (5). p. 139. (38) Reference (34). p. 316. (39) Reference (35). p. 523. 140) Reference (2). D.30. (41j Reference (5); b. 215. (42) Reference (25). p. 569. (43) Reference (24), p. 453. 144) Reference (15). 35. 414 (1846). . . (45) Reference i24j; p. 460. National Magazine, 5, 46 (1896). (46) BARBER, WILLIAM, (47) Reference (34). p. 317. (48) Reference (22). o.21. ~ e f & & c e(34), p. 318; MITCHELL, S. WEIR, Birth and Death of Pain," Century Company, New York, 1914, p. 416. Private archives of the Medical Society of the County of New York, New York. CHOATE, JOSEPHH., JR., Bill introduced into New York Legislature, 1913. Reference (16). 13, 270 (1934). Private letters in the rare hook room of the New York Academy of Medicine, New York City.
,
ADDITIONAL BIBLIOGRAPHY BASKERVILLE, C., Science, 34, 163 (1911). BIGELOW, HENRYJ., ''Surgical Anesthesia," Little. Brown, and Company, Boston, 1900. BIGELOW, HENRYJ., "Century of American Medicine, 17761876," H. C. Lea, Philadelphia, 1876. Boston Medical and Surgical Journal, 35 (August, 1846, to January, 1847) and 36 (February t o July, 1848). BOWDITCH, N. I., "Ether Controversy," J. Wilson, Boston, 1848. CHOATE. JOSEPH,JR., "In the Matter of Applicstion of William J . Morton," Evening Post Printing Office, New York, 1915.
DENNIS,F. S., "Achievements of American surgery," Trow Directory, New York, 1892. DUNSTER,EDWARD S., "History of Anesthmia," Fiske and Douglas. Ann Arbor, 1875, pp. 1-25. DWINELLE. W. H.. "The Casket and the Ribbon," J. W. Woods. ~altimore,1849: Evening Port, New York (July 16, 1868). FLEXNER, J. T., ''Doctors on Horseback," Viking Press, New York, 1937. GWATHMEY. J. T.. "Anesthesia," 1905. GAY,MARTIN,"Statement of the Claims of CharlesT. Jackson to the Applicability of Pain to Surgical Operations," Boston, 1847. HODGES,R. M., "Narrative of the Events Connected with the Introduction of Sulphuric Ether inSurgicalUse," Little, Brown and Company, Boston. 1891. JACKSON! CHARLES T., "Manual of Etherization," Officeof Littell's Lwmg Age, Boston, 1861. JACKSON,C H A ~ L ET., S "Geological ~ u r v e & and Reports," Mudge and Son, Boston, 1863. LORD,J. L., AND H. D. LORD,"A Defense of Dr. Charles T. Jackson's Claim to the Discovery of Etherization," Boston,. 1848. MCKELWAY, A. D., Daily Eagle, Brooklyn, New York (June 16. lorn, '"AT,.
MORTON, WILLIAM JAMES,"X-ray or Photography of the Invisible and Its Value in Surgery," American Teohnical Book Company. New York. 1896. MORTON. WILLIAMJAMES."Try~sinfor cure of cancer." Medirnl
..
MORTON. WILLIAMTHOMAS GREEN,"Appeal to the ~ i b l i cby the Members of the Medical Profession in New York, 1858." G. F. Nesbitt and Campany, New York, 1858. MORTON,WILLIAMTHOMAS GREEN,"Remarks on the Proper Mode of Administerine Sul~hnricEther." Dutton and Wentworth, Boston, 1847. Mom, VALENTINE, "Pain and Anesthetics," McGill and with^ crow, Washington, 1863, pp. 1-16. PAGE,M E R E D I ~"Men , who discovered sleep," Radio script of Ohio University, 1935. "Proceedings in Behalf of the ort ton Testimonial," Rand and Avery, Boston, 1861. Proc. Roy. Soc. Med., 11, 63 (1918). RAVENEL. M. P.. Literarv Dicest. 117.47 (1934) ~~
~~~
~
~
- .
Session, 1849. Report of Naval Committee, Hous-32nd Congress-2nd Session, 1852. Reoort of Militam Committee. S e n a t e 3 2 n d C o n g r e s ~ 2 n d session, 1852. . Report of Naval Committee, Senate-32nd Congress-2nd Session, 1853. Reoort of Select Committee. House-32nd Conmess-1st Ses;ion, 1853. SNELL. E. L., C m t w y Magazine. 48, 164 (1894). SOIFER,MAX E., "Historical notes on Horace Wells," Bull. Hist. Med., 9, 101 (1941). WALES, JOSEPH,"Di~coveryby the Late Dr. Horace Wells," E. Green, Hartford, 1852. WARREN,JOHN COLLINS,Transactions oJ the American Surgicrrl Arrociation, XV,pp. 1-25 (1897). WELCH,W. H., "Doctor Wells, the Discoverer of Anesthesia." Case, Lockwwd and Brainard, Printers, Hartford. 1870. YOUNG. HUGHH., .Tohnr HopkinsHorpitnl Ruiletin. 8,174 (18971
TO OUR READERS Every so often i t is important to know the reactions of our readers to the muterial we publish. Accordingly, there mill be a survey made very shortly of readers' opinions and comments. This will be in the form of o questionnaire which you will be asked tofill out and return. You will be given an opportunity to comment on the types of articles publishedand to nakesuggestionsconcerning ourloholeeditorialpolicy. It isurged that you give this your prompt a d careful attention, to the end that the J O L ~ N A L may better meet your wishes and needs. We regret that this survey must be mode so impersomlly; we wish i t could haw been in theformof personal intsruiews.
