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On December 11, 1844, a Connecticut dentist named Horace Wells sat down in a dentist's chair and had one of his own teeth extracted while breathing nitrous oxide. Remarkably, he felt no pain! This was the first time in history that an inhaled gas had been successfully used as a surgical anesthetic in a clinical setting, transforming medicine and how people experience treatment.
It’s hard to imagine a world where we don’t have to experience pain in surgery. Before anesthesia, though, surgery was an experience of pure terror. Now, the operating room is a place where healing can happen without suffering.
Surgery before anesthesia
It is difficult to fully appreciate how different medicine was before the development of effective anesthetics. Surgery before the mid-19th century was performed on conscious patients, who were typically restrained by multiple assistants and sometimes given alcohol or opium to dull the pain. This, as you can imagine, was not the most effective method. Therefore, speed became the primary virtue of a surgeon, because the faster the procedure, the less the patient suffered. Believe it or not, one surgeon — Robert Liston — actually got famous for amputating a leg in under 30 seconds!
Laughing gas
Nitrous oxide is sometimes called "laughing gas" because of its tendency to produce euphoria and laughter. It was first known to chemists since its synthesis by Joseph Priestley in 1772 and its further development by Humphry Davy in the late 1790s. Davy himself noted that nitrous oxide seemed to diminish physical pain and speculated that it "may probably be used with advantage during surgical operations," but the medical establishment largely ignored the suggestion for decades. In hindsight, the average patient’s surgical experience likely would have been much better had laughing gas been used in operations.
By the 1840s, nitrous oxide inhalation was actually used as a source of popular entertainment at public demonstrations and traveling shows, where audience members would inhale the gas and stagger around giggling for the amusement of crowds. At one such demonstration, something critical was observed: a man who inhaled the gas and injured his leg during the resulting stumbling showed no sign of pain until the gas wore off. The implication, then, became clear.
The first use
The next day, Horace Wells (who had witnessed that demonstration) arranged to have his own wisdom tooth extracted while under nitrous oxide, administered by a colleague. He reported feeling nothing. Excited, he attempted to demonstrate the technique at Massachusetts General Hospital in Boston in January 1845. Unfortunately, the demonstration went poorly: the patient cried out during the procedure, possibly because he had not received enough gas. Wells was dismissed as a fraud, and was booed by the audience.
Wells's failure to successfully demonstrate the use of laughing gas was later compensated by William Morton’s work, whose work with ether anesthesia received much of the public recognition in 1846. Today, nitrous oxide remains in use as an anesthetic and analgesic, particularly in dentistry — the specialty where Horace Wells first proved it could work with his very own tooth.
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