Wednesday, November 7, 2012

The Most Important Article In The History Of NEJM Is...

This is really amazing news, especially for somebody like me who loves reading about history. After a survey of its readers, the New England Journal of Medicine has declared that the most important article in its two hundred year history is the description of the first ether anesthetic ever published. What's even better is that NEJM has made the article available for download in its entirety in pdf format.

The article is titled, "Insensibility During Surgical Operations Produced By Inhalation." It was published on November 18, 1846 in The Boston Medical and Surgical Journal, the precursor to NEJM.  It was written by Henry Jacob Bigelow, M.D., described as "one of the Surgeons of the Massachusetts General Hospital." Dr. Bigelow starts the article with a brief description of the first public demonstration of ether by Dr.William Morton on October 16, 1846, which to this day has been immortalized as Ether Day.

He goes on to describe the history of ether and the various experiments in its development. I find it interesting that in his far ranging discussion of ether's development, he even quotes a French journal. How many American physicians even know French, much less read French medical literature? Dr. Bigelow then lists several case studies, including a patient who apparently received an overdose of ether. The patient's heart rate was noted to drop while his pulse became weaker and his hands grew cold. As there was little knowledge about how to revive patients who received too much ether, they revived the patient the only way they knew how--they treated him like an unconscious drunk. The doctors put a cold towel on his head, sprayed water into his ears, and held ammonia under his nose. When that failed to revive the patient, they hoisted the patient up and walked him around the room. Eventually the ether wore off and the patient woke up after about an hour. You can't make this stuff up. A modern hospital's ethics committee would have a stroke if such incidents were happening today.

By all means you should download this article and read about the birth of anesthesia. Then you can appreciate how wondrous anesthesia has humanized medicine, without which we would truly still be in the stone age of medicine. It truly deserves to be considered the most important article in the illustrious history of the New England Journal of Medicine.

1 comment:

  1. Apparently the first record we have of ether anesthesia being administered is from a med student named William Clarke (source)!