Combined anesthesia was first proposed. When and who invented anesthesia? Preparing the patient for anesthesia

Modern medical historians believe that the first methods of anesthesia arose at the dawn of human development. Of course, then it was customary to act simply and crudely: for example, until the 18th century, the patient received general anesthesia in the form strong blow with a baton to the head; after he lost consciousness, the doctor could begin the operation.

They have been used as local anesthesia since ancient times. narcotic drugs. One of the oldest medical manuscripts (Egypt, approximately 1500 BC) recommends giving patients opium-based drugs as an anesthetic.

Opium in China and India for a long time was unknown, but the wonderful properties of marijuana were discovered quite early there. In the 2nd century AD. During operations, the famous Chinese doctor Hua Tuo gave patients a mixture of wine and powdered hemp, which he invented, as anesthesia.

Meanwhile, in the territory of America not yet discovered by Columbus local Indians Cocaine from the leaves of the coca plant was actively used as an anesthesia. It is reliably known that the Incas in the high Andes used coca for local anesthesia: a local healer chewed the leaves and then dripped juice-rich saliva onto the patient’s wound to relieve his pain.

When people learned to produce strong alcohol, anesthesia became more accessible. Many armies began to take supplies of alcohol with them on campaigns to give it as a pain reliever to wounded soldiers. It is no secret that this method of anesthesia is still used in critical situations (on hikes, during disasters) when it is not possible to use modern drugs.

In rare cases, doctors tried to use the power of suggestion as anesthesia, for example, putting patients into hypnotic sleep. A modern follower of this practice was the notorious psychotherapist Anatoly Kashpirovsky, who in March 1988, during a special teleconference, organized pain relief for a woman who had a tumor removed from her breast in another city without anesthesia. However, there were no successors to his work.

The first public anesthetic operation, performed on October 16, 1846, is one of the most iconic events in the history of medicine.
At this moment, Boston, and the entire United States, for the first time acted as a global center of medical innovation. Since then, the ward in the very center of the Massachusetts General Hospital, in which the operation took place, began to be called the “Ether Dome”, and the term “anesthesia” itself was coined by the Boston physician and poet Oliver Wendell Holmes to designate a strange new state of inhibited consciousness, which was witnessed by the doctors of this city. News from Boston spread around the world, and within weeks it became clear that this event had changed medicine forever.

But what exactly was invented that day? Not chemical substance- The mysterious substance used by William Morton, the local dentist who performed the procedure, turned out to be ether, a volatile solvent that had been widely used for decades. And not the idea of ​​anesthesia itself - ether and the anesthetic gas nitrous oxide were both inhaled and carefully studied before. Back in 1525, the Renaissance physician Paracelsus recorded that chickens from this gas “fall asleep, but after a while wake up without any negative consequences", and that for this period the gas "quenches the pain."

The milestone marked by the great event that occurred in the Firmament was less tangible, but much more significant: there was a huge cultural shift in the understanding of pain. Operating under anesthesia could transform medicine and significantly increase the capabilities of doctors. But first there had to be certain changes, and changes not in the field of technology - the technology had already existed for a long time - but in the readiness of medicine to use it.

Until 1846, religious and medical beliefs prevailed that pain was an integral part of sensations and, accordingly, of life itself. To modern eyes, the idea of ​​the necessity of pain may seem primitive and cruel, yet it has lingered in some corners of health care, such as obstetrics and childbirth, where epidurals and caesarean sections still carry a stain of moral shame. At the beginning of the 19th century, doctors who were interested in the analgesic properties of ether and nitrous oxide were considered eccentrics and hucksters. They were condemned not so much for the practical side of the issue as for the moral one: they sought to exploit the basic and cowardly instincts of their patients. Moreover, by fueling fear of surgery, they discouraged others from undergoing surgery and undermined public health.

The history of anesthesia began in earnest in 1799 in the laboratory of one poor resort town called Hotwells in the vicinity of the English city of Bristol.

This was the laboratory of the "Institute of Pneumatics" - the brainchild of Thomas Beddoes, a radical doctor, firmly looking to the future, and confident that new advances in chemistry would transform medicine. In those days, chemical drugs were viewed with suspicion, and they were considered last resort, were resorted to only in extreme cases, and not without reason, since most of them were toxic mixtures of elements such as lead, mercury and antimony. Beddoe spent years assuring his colleagues that chemistry was “daily revealing the deepest mysteries of nature,” and that bold experiments were needed to apply these discoveries to medicine.

His project became the first example of a medical research institute created specifically to create new types of drug treatment, and, as the name suggests, focused on studying the properties of newly discovered gases. Lung diseases, and tuberculosis in particular, were the leading causes of death in 18th-century Britain, and Beddoe spent countless agonizing hours observing their end stages. He hoped that inhaling artificial gases could alleviate the disease or maybe even cure it.

He hired an unknown young chemist, Humphry Davy, as an assistant, and after setting sail and experimenting through trial and error, they arrived at the study of a gas called nitrous oxide.

This gas was first obtained in 1774 by Joseph Priestley, who dubbed it “nitrogenous dephlogisticated air.” When Davy and Beddoe tried to inhale it using green silk bags, which they commissioned from the great engineer James Watt, they discovered that the gas had a completely unpredictable effect on the psyche. They went to great lengths to describe the intense euphoria and disorientation produced by the gas, and to explain how a gas unknown in nature could have such a powerful effect on the human brain. They recruited everyone they knew as test volunteers, including the young poets Samuel Taylor Coleridge and Robert Southey, and the experiments became a brilliant but messy mixture of medical theory and poetry, philosophy and fun.

The discovery of laughing gas changed medicine beyond Beddoe's wildest dreams. This powerful stimulant, appearing as if by magic from thin air, became a harbinger of a chemical future in which, in the words of Beddoe, “man will one day dominate the sources of pain and pleasure.”

However, as they progressed, the experiments led researchers away from the slightest hint of pain relief. The reaction of most subjects was not expressed in loss of consciousness, but in jumping around the laboratory, dancing, screaming and poetic epiphanies.

The interest with which the “Institute of Pneumatics” reacted to the effects of gas on the human psyche, and especially to its “sublime” effects on the imagination, was determined by the romantic sentimentality of the participants in the experiments and their search for a language to express their inner worlds. This sentimentality, as it spread, would still play an important role in transforming attitudes towards pain, but its early adherents still adhered to social attitudes of its time. Davy believed that "a strong mind can endure any degree of pain in silence" and regarded his numerous cuts, burns and laboratory misadventures as decorations for bravery and a source of pride. Coleridge, on the contrary, reacted sharply and painfully to pain, perceiving it as a moral weakness, and believed that his shameful and painful addiction to opium was to blame for this.

Even if they had concentrated entirely on the analgesic properties of nitrous oxide, it is difficult to imagine that Beddoe and Davy would have been able to sell the idea of ​​surgical anesthesia to the medical world of 1799. Neither did volunteer surgeon Stephen Hammick, an employee of the Plymouth Naval Hospital, who was so overcome with euphoria that he fought off everyone who tried to take the silk bag from him. In the rest of the world, doctors remained opposed to medical experimentation of any kind, and even Beddoe's modest attempts to try gases on tuberculosis patients were harshly criticized on ethical grounds. It was believed that the skill of the surgeon and the courage of the patient were the most important elements of the operation, and the bulky equipment of gas anesthesia ( chemical reactions, hot retorts and uncomfortable air cushions) were regarded as life-threatening obstacles to important procedures.

As a result, it was nitrous oxide's ability to induce pleasure rather than suppress pain that captured the public's imagination. Medical professionals wrote off this ability as a curiosity with no therapeutic use, and it found its twilight refuge in concert halls and variety shows. Foreshadowing modern hypnosis shows, the entertainer offered air cushions to some audience members; selected volunteers took the stage and were encouraged to express their intoxication in song, dance, poetry, or bursts of contagious laughter.

It was thanks to these entertainments that by the twenties of the 19th century, nitrous oxide received its firmly stuck nickname “laughing gas” and became a staple of American mass celebrations. Before the invention of his mass-produced revolver, Samuel Colt toured the States with a laughing gas show, which he promoted with Robert Southey's poetic line: "That must be the gas that makes seventh heaven."

It was in this dark society that visiting doctors and dentists first noticed something surprising about those people who wandered and stumbled under the influence of the gas: they could injure themselves without feeling pain. William Morton and his associates began to study the feasibility of using gas in the operating room.

The use of gases to expel pain had been discussed even before Beddoe and Davy's gas experiments: in 1795, Beddoe's friend Davies Giddy asked whether, if gases were found to have sedative properties, “they could be used before painful operations? "

But half a century after the first experiments, strong opposition to painless surgery still existed, both medically and religiously. Since time immemorial in religion, pain has been regarded as an accompanying element of original sin and, being such, as an irreducible component of the conditions of human existence. Pain was often explained as the mercy of God, the “voice of nature” that keeps us from harm by warning us of physical dangers.

This view was reflected in the medical worldview of that time. Many doctors still believed that pain was the reason why patients did not die during operations. General failure of body systems due to painful shock was common cause death during surgery, and it was thought that due to loss of sensation the mortality rate would become even higher. The prognosis of a screaming, albeit suffering, patient is better than that of a lethargic and lifeless one.

However, the new sentimentality marked the beginning of a more noble and compassionate society, and it also began to gradually change medicine. Cruelty to animals was widely condemned and banned, corporal punishment of children and public hangings were increasingly criticized as inhumane, and pain came to be regarded as a traumatic experience that should be mitigated whenever possible.

Along with this medical workers have begun to recognize that eliminating pain is not just a ploy to get weak-willed patients into the chair, but may be the key to the surgery of the future. With the development of technology, more and more sophisticated and lengthy operations appeared, and the ability of patients to endure them became a limiting factor in the path of development. It was due to the changing demands of surgeons, as well as the feelings of their patients, that pain relief prevailed over time.

The motivation behind William Morton's pioneering Boston experiment, like his competitors', was that of both the dentist and his patients: the pain associated with pulling teeth and removing cysts was not conducive to business success. By 1840, dental technology had improved markedly, but potential clients were put off by the painful and lengthy procedures associated with it. There were many people who wanted new dentures that looked natural and fit tightly, but only a few were willing to tear out their rotting stumps to install these dentures.

William Morton was not an altruist; he wanted not only fame, but also money. For this reason, during the operation, he did not admit that he used ordinary medical ether for anesthesia, but began to claim that it was the gas “leteon” invented by him (from the word “Lethe”, the river of oblivion). Morton received a patent for his invention, but this did not help him. It became clear quite quickly that main component“leteon” is ether, but it was not covered by the patent. On both sides of the ocean, doctors began to use medical ether for anesthesia; Morton tried to defend his rights in court, but never received the money. But he got fame; it is he who is usually called the creator of anesthesia.

However, in fact, ether was actually the first to be used as an anesthesia by the American surgeon Crawford Long. On March 30, 1842 (four years before Morton), he performed the same operation - he removed a tumor from the patient's neck under general anesthesia. Subsequently, he used ether many times in his practice, but did not invite spectators to these operations, and published a scientific article about his experiments only six years later - in 1848. As a result, he received neither money nor fame. But Dr. Crawford Long lived a long, happy life.

The use of chloroform in anesthesia began in 1847 and quickly gained popularity. In 1853, English physician John Snow used chloroform as a general anesthesia during Queen Victoria's birth. However, it quickly became clear that due to the toxicity of this substance, patients often experience complications, so currently chloroform is no longer used for anesthesia.

Both ether and chloroform were used for general anesthesia, but doctors dreamed of developing a drug that would effectively work as local anesthesia. A breakthrough in this area occurred at the turn of the 1870s-1880s, and the long-awaited miracle drug was... cocaine.

Cocaine was first isolated from coca leaves by the German chemist Albert Niemann in 1859. However, for a long time, researchers were of little interest to cocaine. The possibility of using it for local anesthesia was first discovered by the Russian doctor Vasily Anrep, who, according to the scientific tradition of that time, conducted a series of experiments on himself and in 1879 published an article on the effects of cocaine on nerve endings. Unfortunately, almost no attention was paid to her then.

But a series of scientific articles about cocaine written by the young psychiatrist Sigmund Freud became a sensation. Freud first tried cocaine in 1884 and was amazed by its effects: using this substance cured him of depression and gave him self-confidence. In the same year, a young scientist writes an article “On Coca,” where he strongly recommends the use of cocaine as a local anesthetic, as well as a cure for asthma, indigestion, depression, and neuroses.

Freud's research in this area was actively supported by pharmaceutical firms, which anticipated huge profits. The future father of psychoanalysis published as many as 8 articles on the properties of cocaine, but in recent works on this topic he wrote less enthusiastically about this substance. This is not surprising, since Freud’s close friend Ernst von Fleischl died from cocaine abuse.

Although about anesthetic effect cocaine was already known from the works of Anrep and Freud, ophthalmologist Karl Koller gained fame as the discoverer of local anesthesia. This young doctor, like Sigmund Freud, worked at the Vienna General Hospital and lived with him on the same floor. When Freud told him about his experiments with cocaine, Koller decided to test whether the substance could be used as a local anesthetic for eye surgery. Experiments showed its effectiveness, and in 1884 Koller reported on the results of his research at a meeting of the Vienna Medical Society.

Almost immediately, Kohler’s discovery began to be applied in literally all areas of medicine. Cocaine was used not only by doctors, but also by everyone; it was freely sold in all pharmacies and was almost as popular as aspirin today. Grocery stores sold cocaine-laced wine and Coca-Cola carbonated drink, which until 1903 contained cocaine.

The cocaine boom of the 1880-1890s cost the lives of many ordinary people, so at the beginning of the 20th century this substance was gradually banned. The only area where the use of cocaine was tolerated for a long time was local anesthesia. Karl Koller, to whom cocaine brought fame, was subsequently ashamed of his discovery and did not even mention it in his autobiography. Until the end of his life, his colleagues called him Coca Collier behind his back, hinting at his role in introducing cocaine into medical practice.

We resort to medical care, feeling that all is not well with your health. The most obvious and understandable sign internal problems body pain. And when we come to the doctor, we first of all wait to get rid of it. However, how often the doctor’s actions intended to help the patient, against his will, cause pain!

It hurts to set a dislocation, it hurts to stitch it up laceration, it’s painful to treat a tooth... It happens that it is the fear of pain that prevents a person from seeing a doctor on time, and he stalls for time, triggering and aggravating the disease. Therefore, at all times, doctors have strived to conquer pain, learn to manage it and pacify it. But this goal was achieved relatively recently: just 200 years ago, almost any treatment was inseparable from suffering.

Achilles bandages Patroclus' wound inflicted by an arrow. Painting of a Greek kylix. V century BC e.

But even for a person unfamiliar with medical manipulations, encountering pain is almost inevitable. Pain has accompanied humanity for as many millennia as it has inhabited the Earth. And probably already a dense healer from a primitive cave tribe tried to reduce or completely remove the painful sensations.

True, now the descriptions of the first " available funds"cause bewilderment and fear. For example, in ancient Egypt, before traditional circumcision surgery, the patient was rendered unconscious by squeezing the blood vessels in his neck. Oxygen stopped flowing to the brain, the person fell into unconsciousness and felt virtually no pain, but such a barbaric method of pain relief could not be called safe. There is also evidence that sometimes patients were subjected to prolonged bloodletting so long that the bleeding person fell into a deep faint.

The first painkillers were prepared from plant materials. Decoctions and infusions of hemp, opium poppy, mandrake, henbane helped the patient relax and reduced pain. In those corners of the globe where they did not grow necessary plants, another painkiller was in use, and also of natural origin, ethyl alcohol, or ethanol. This product of fermentation of organic substances, obtained in the production of all kinds of alcoholic beverages, affects the central nervous system, reducing the sensitivity of nerve endings and suppressing the transmission of nerve excitation.

The listed drugs were quite effective in emergency situations, however, during serious surgical interventions they did not help; in this case, the pain is so severe that herbal decoctions and wine cannot relieve it. Besides, long-term use these painkillers led to a sad result: dependence on them. The father of medicine, the outstanding healer Hippocrates, when describing substances that cause temporary loss of sensitivity, used the term “drug” (Greek narkotikos “leading to numbness”).

Opium poppy flowers and heads.

Ebers Papyrus.

In the 1st century n. e. The ancient Roman physician and pharmacologist Dioscorides, describing the narcotic properties of an extract from mandrake root, first used the term “anesthesia” (Greek anaesthesia “without feeling”). Habituation, dependence side property consumption of modern painkillers, and this problem still remains relevant and acute for medicine.

Alchemists of the Middle Ages and the Renaissance presented humanity with many new chemical compounds and found various practical options for their use. So, in the 13th century. Raymond Lully discovered ether, a colorless volatile liquid, a derivative ethyl alcohol. In the 16th century Paracelsus described the pain-relieving properties of ether.

It was with the help of ether that full-fledged general anesthesia, artificially induced complete loss of consciousness, was first carried out. But this happened only in the 19th century. Before that, the inability to effectively anesthetize the patient greatly hampered the development of surgery. After all, a serious operation cannot be performed if the patient is conscious. So necessary to save lives surgical interventions as amputation of a gangrenous limb or removal of a tumor abdominal cavity, may cause traumatic shock and lead to the death of the patient.

It turned out vicious circle: the doctor must help the patient, but his help is deadly... The surgeons were intensely looking for a way out. In the 17th century Italian surgeon and anatomist Marco Aurelio Severino proposed performing local anesthesia by cooling, for example, shortly before surgery, rubbing the surface of the body with snow. Two centuries later, in 1807, Dominique Jean Larrey, a French military doctor and chief surgeon of Napoleon's army, would amputate soldiers' limbs on the battlefield in subzero temperatures.

In 1799, the English chemist Humphry Davy discovered and described the effect of nitrous oxide, or “laughing gas.” He tested the pain-relieving effect of this chemical compound on himself at the moment when his wisdom teeth were cutting. Davy wrote: “The pain completely disappeared after the first four or five inhalations, and the unpleasant sensations were replaced for a few minutes by a feeling of pleasure...”

A. Brouwer. Touch. 1635

Marco Aurelio Severino. Engraving 1653

Davy's research later attracted the interest of his compatriot, surgeon Henry Hickman. He conducted many experiments on animals and became convinced that nitrous oxide, used in the right concentration, suppresses pain and can be used for surgical operations. But Hickman was not supported by either his compatriots or his French colleagues, and he was unable to obtain official permission to test the effects of nitrous oxide on humans either in England or France. The only one who supported him and was even ready to provide himself for experiments was the same surgeon Larrey.

But a start had been made: the very idea of ​​using nitrous oxide in surgery was expressed. In 1844, the American dentist Horace Wells attended a popular performance at the time, akin to a circus: a public demonstration of the effects of laughing gas. One of the voluntary test subjects severely injured his leg during the demonstration, but upon coming to his senses, he assured that he did not feel any pain. Wells suggested that nitrous oxide could be used in dentistry. New drug He first experienced it on himself, and radically: another dentist removed his tooth. Convinced that laughing gas was suitable for use in dental practice, Wells tried to attract general attention to the new remedy and staged a public operation using nitrous oxide. But the operation ended in failure: the volatile gas “leaked” into the audience, the patient experienced unpleasant sensations, but the audience who inhaled the gas had a lot of fun.

T. Phillips. Portrait of Sir Humphry Davy.

A. L. Girodet-Triozon. Portrait of Dominique Jean Larrey. 1804

On October 16, 1846, the first widely known operation performed using ether anesthesia was performed at the Massachusetts Central Clinic (Boston, USA). Dr. William Thomas Green Morton euthanized the patient using diethyl ether, and surgeon John Warren then removed the patient's submandibular tumor.

Dr. Morton, the first anesthesiologist in official history medicine, practiced as a dentist until 1846. He often had to remove the roots of patients' teeth, which each time caused them severe pain Naturally, Morton wondered how to alleviate this pain or avoid it altogether. At the suggestion of the physician and scientist Charles Jackson, Morton decided to try ether as an anesthetic. He experimented on animals, on himself, and successfully; All that remained was to wait for the patient to agree to anesthesia. On September 30, 1846, such a patient appeared: E. Frost, suffering from severe toothache, was ready to do anything just to get rid of the pain, and Morton, in the presence of several witnesses, performed an operation on him, using ether anesthesia. Frost, having regained consciousness, stated that during the operation he did not experience any unpleasant sensations. This indisputable success of the doctor for the general public, alas, went unnoticed, and therefore Morton ventured into another demonstration of his discovery, which took place on October 16, 1846.

Dr. Morton's first anesthesia.

Morton and Jackson received a patent for their invention, and thus began the triumphant and life-saving march of anesthesia throughout the world. On the monument erected in Boston to Dr. William Thomas Greene Morton, the words are inscribed: “Inventor and discoverer of anesthesia, who averted and destroyed pain, before whom surgery was always a pain, after which science controls pain.”

Doctors around the world greeted Morton's discovery with joy and enthusiasm. In Russia, the first operation using ether anesthesia was performed just six months after the demonstration in Boston. It was performed by the outstanding surgeon Fyodor Ivanovich Inozemtsev. Immediately after him, the great Nikolai Ivanovich Pirogov began to widely use ether anesthesia. Summarizing the results of his surgical activities during Crimean War, he wrote: “We hope that from now on the ethereal device will be, just like a surgical knife, a necessary accessory for every doctor...” Pirogov was the first to use chloroform anesthesia, which was discovered back in 1831.

But the faster anesthesiology developed, the more clearly surgeons began to understand negative aspects anesthesia with ether and chloroform. These substances were very toxic, often causing general poisoning of the body and complications. In addition, mask anesthesia, in which the patient inhales ether or chloroform through a mask, is not always possible (for example, in patients with impaired respiratory function). There were many years of searching ahead, anesthesia with barbiturates, steroids, and the widespread introduction of intravenous anesthesia. However, everyone new look anesthesia, for all its apparent initial perfection, is not without its shortcomings and side effects and therefore requires constant monitoring by a specialist anesthesiologist. An anesthesiologist in any operating room is equally important character, as well as the operating surgeon himself.

At the end of the 20th century. Russian scientists have developed a method for using xenon anesthesia. Xenon is a non-toxic gas, which makes it an extremely suitable means for general anesthesia. There are new developments and new discoveries ahead, new victories over man’s eternal companion, pain.

In the first year after the successful operations of Inozemtsev and Pirogov, 690 were performed in Russia. surgical interventions under anesthesia. And three hundred of them are on the account of Nikolai Ivanovich Pirogov.

I. Repin. Portrait of N. I. Pirogov. 1881

2 years after the failure that befell Wells, his student dentist Morton, with the participation of the chemist Jackson, used diethyl ether for pain relief. Soon the desired result was achieved.

In the same Boston surgical clinic where Wells' discovery was not recognized, ether anesthesia was successfully demonstrated on October 16, 1846. This date became the starting point in the history of general anesthesia.

Professor John Warren operated on the patient in a Boston surgical clinic, and medical student William Morton euthanized the patient using his own method.

When the patient was placed on the operating table, William Morton covered his face with a towel folded in several layers and began to sprinkle liquid from a bottle he had brought with him. The patient shuddered and began to mutter something, but soon calmed down and fell into a deep sleep.

John Warren began the operation. The first cut is made. The patient lies quietly. The second one was made, and then the third one. The patient is still fast asleep. The operation was quite complicated - a tumor in the patient’s neck was removed. A few minutes after it ended, the patient came to his senses.

They say it was at this moment that John Warren uttered his historic phrase: “Gentlemen, this is not a hoax!”

Subsequently, Morton himself told the story of his discovery as follows: “I purchased Barnett’s ether, took a bottle with a tube, locked myself in the room, sat down in the operating chair and began to inhale the vapors. The ether turned out to be so strong that I almost suffocated, but the desired effect was not came. Then I wet the handkerchief and brought it to my nose. I looked at the clock and soon lost consciousness. I felt as if I were in a fairy-tale world. I would have renounced the world if anyone had come to this. minute and woke me up. next moment I believed that, apparently, I would die in this state, and the world would greet the news of this stupidity of mine only with ironic sympathy. Finally, I felt a slight tickling in the phalanx of the third finger, after which I tried to touch it with my thumb, but could not. On the second attempt I managed to do it, but the finger seemed completely numb. Little by little I was able to raise my hand and pinch my leg, and found that I hardly felt it. Trying to get up from the chair, I fell back on it. Only gradually did I gain control over parts of my body, and with it full consciousness. I immediately looked at my watch and found that I had been insensible for seven or eight minutes. After that, I rushed to my office shouting: “I found it! I found it!”

Anesthesiology, especially during its development, had many opponents. For example, the clergy were especially vehemently opposed to pain relief during childbirth. According to biblical legend, expelling Eve from paradise, God commanded her to give birth to children in pain. When obstetrician J. Simpson in 1848 successfully used anesthesia to relieve labor pain in Queen of England Victoria, this caused a sensation and further intensified the attacks of the clergy. Even the famous French physiologist F. Magendie, Claude Bernard's teacher, considered anesthesia "immoral and takes away self-awareness and free will from patients and thereby subjugates the patient to the arbitrariness of doctors." In a dispute with the clergy, Simpson found a witty way out: he declared that the very idea of ​​anesthesia belonged to God. After all, according to the same biblical tradition, God put Adam to sleep in order to cut out his rib from which he created Eve. The scientist's arguments somewhat calmed the fervor of the fanatics.

The discovery of anesthesia, which turned out to be very effective method surgical anesthesia has aroused widespread interest among surgeons around the world. Skepticism about the possibility of painless surgical interventions quickly disappeared. Soon anesthesia received universal recognition and was appreciated.

In our country, the first operation under ether anesthesia was performed on February 7, 1847 by Moscow University professor F.I. Inozemtsev. A week after this, the method was used equally successfully by N.I. Pirogov in St. Petersburg. Then a number of other major domestic surgeons began to use anesthesia.

Much work on study and propaganda in our country was carried out by the anesthesia committees created shortly after its opening. The most representative and influential among them was the Moscow one, which was headed by Prof. A.M. Philamothite. The result of the generalization of the first experience of using ether anesthesia in the clinic and in experiment were two monographs published in 1847. The author of one of them (“Practical and physiological studies on ethicization") was N.I. Pirrgov. The book was published on French counting not only on domestic, but also Western European readers. The second monograph (“On the use of sulfuric ether vapor in operational medicine”) was written by N.V. Maklakov.

Having perceived ether anesthesia as a great discovery in medicine, leading Russian surgeons not only did everything possible to widely use it in practice, but also sought to penetrate into the essence of this seemingly mysterious condition and to find out the possible adverse effects of ether vapor on the body.

The greatest contribution to the study of ether anesthesia at the stage of its development and later when chloroform anesthesia was introduced into practice was made by N.I. Pirogov. In this regard, V. Robinson, the author of one of the most informative books on the history of surgical anesthesia in 1945, wrote: “Many of the pioneers of pain management were mediocre. As a result of accidental circumstances, they had a hand in this discovery. Their quarrels and petty envy left an unpleasant mark on science. But there are figures of a larger scale who participated in this discovery, and among them the most important person and researcher should be considered, first of all, N.I.

About how purposefully and fruitfully N.I. worked. Pirogov in the area under consideration is evidenced by the fact that a year after the discovery of anesthesia, in addition to the mentioned monograph, he published: the articles “Observation of the effect of ether vapor as an analgesic in surgical operations” and “Practical and physiological observations of the effect of ether vapor on animals organism." In addition, in the “Report on a trip to the Caucasus”, also written in 1847, there is a large and interesting section “Anesthesia on the battlefield and in hospitals.

After the first use in patients with H.I. Pirogov gave the following assessment of ether anesthesia: “Ether steam is a truly great remedy, which in a certain respect can give a completely new direction to the development of all surgery.” Giving this description of the method, he was one of the first to attract the attention of surgeons to other complications that can arise during anesthesia. N.I. Pirogov undertook a special study to find a more effective and safe method anesthesia In particular, he tested the effect of ether vapor when injected directly into the trachea, blood, gastrointestinal tract. The method of rectal anesthesia with ether that he proposed received wide recognition in subsequent years, and many surgeons successfully used it in practice.

In 1847 Simpson as narcotic drug successfully tested chloroform. The interest of surgeons in the latter quickly increased, and chloroform became the main anesthetic for many years, pushing diethyl ether to second place.

In the study of ether and chloroform anesthesia, the introduction of these drugs into widespread practice in the first decades after their development, in addition to N.I. Pirogov, many surgeons of our country made a significant contribution. A.M. was especially active in this area. Filamofitsky, F.I. Inozemtseva, A.I. Polya, T.L. Vanzetti, V.A. Karavaeva.

From foreign doctors to study, improve and promote anesthesia methods in the second half of the 19th century. D. Snow did a lot. He was the first who, after the discovery of anesthesia, devoted all his activities to surgical anesthesia. He consistently defended the need for specialization of this species medical care. His works contributed to the further improvement of anesthesiological support for operations.

After the discovery of the narcotic properties of diethyl ether and chloroform, an active search began for other drugs that have an analgesic effect. In 1863, the attention of surgeons was again drawn to nitrous oxide. Colton, whose experiments at one time gave Wells the idea of ​​​​using nitrous oxide for pain relief, organized an association of dentists in London who used this gas in dental practice.