Ether

Ether is a colorless, transparent, and very volatile (readily vaporizable) liquid. It has a characteristic odor and is highly flammable. Ether is used as a general anesthetic for surgery.

Ether (from the Latin "aether" and the Greek "eithr," or "the upper and purer air") is believed to have been first synthesized about 1540 by German botanist and chemist Valerius Cordus (1515-1544), who called his discovery "sweet oil of vitriol" and praised its medicinal properties. Paracelsus (1493-1541), a contemporary of Valerius, noted that the "oil" induced sleep in chickens when added to their feed. Frobenius (Froben) named the liquid "ethereal spirits" or "ether" in 1730.

History of Surgical Anesthesia

Only a few surgical procedures were available before the mid-1800s. Little was known about diseases or how to prevent infection. There was also no satisfactory anesthesia available to put the patient into a deep sleep and allow doctors to perform unhurried operative procedures. Certain means of reducing surgical pain had been available since ancient times, however. These included such drugs as alcohol, hashish, and opium derivatives.

Also available were rudimentary physical methods of producing analgesia (insensitivity to pain). These included packing a limb in ice or applying a tourniquet. Another technique used, although an extreme one, was to induce unconsciousness, either by inflicting a blow to the head or by strangulation. Most often, however, the patient was simply restrained by physical force, thus making surgery a last resort.

As more and more was learned about anatomy and surgical procedures, the need to find safe methods to prevent pain became more urgent. With the advent of professional dentistry, this need became even more urgent because of the sensitivity of the mouth and gums. Indeed, dentists were largely responsible for the introduction of both nitrous oxide and diethyl ether.

Nitrous Oxide and Anesthesia

In 1772 the English chemist Joseph Priestley (1733-1804) discovered nitrous oxide gas. Soon people, especially medical students, began to whiff this "laughing gas" at "revels" for social amusement and for the euphoria ("high") it produced. Ether "frolics," in which participants inhaled ether, also became popular in the United States.

Joseph Priestley discovered nitrous oxide gas, a close associate of ether, in 1772.

Dr. Crawford W. Long (1815-1878) of Georgia may have been the first person to apply his social experiences with ether to surgery. A graduate of the University of Pennsylvania, Crawford is said to have observed a participant at a frolic take a heavy fall but show no indication of pain. In 1842 Long performed three minor surgeries using sulfuric ether, a form of ether with chemical properties similar to those of diethyl ether. Long apparently did not realize the medical significance of what he had done and failed to publicize his discovery. He published his results only after anesthesia had been hailed as a major breakthrough.

Attention next returned to nitrous oxide. Horace Wells (1815-1848), a Hartford, Connecticut, dentist, learned about the effects of nitrous oxide in 1844. He decided to test the gas by having one of his own teeth removed while under the influence of the gas. He was delighted with the results and soon began using the gas on his patients. He also told his friend and former partner, William T. G. Morton (1819-1868), a student at Harvard Medical School, about his discovery.

Morton was interested in the possibilities of anesthesia but began to look for a more potent agent than nitrous oxide. He began experimenting with sulfuric ether. Pleased with the results in his dental practice, he contacted Dr. John C. Warren (1778-1856) of Harvard University in 1946 and arranged for a public demonstration of surgery without pain. News of this event spread rapidly, and a new era for surgery began. Oliver Wendell Holmes later coined the term anesthesia to describe the condition brought on by ether.

The knowledge of ether as an anesthetic spread rapidly. The medical establishment and the public quickly and gratefully accepted the use of ether inhalation for painless surgery. Within months, surgery using ether anesthesia was being performed in England. In Germany Johann Friedrich Dieffenbach (1795-1847), a pioneer in plastic surgery, wrote: "The wonderful dream that pain has been taken away from us has become reality. Pain, the highest consciousness of our earthly existence, the most distinct sensation of the imperfection of our body, must now bow before the power of the human mind, before the power of ether vapor."

Other advances in anesthesia soon followed. In 1847 Russian Nicolai Ivanovich Pirogoff (1810-1881) devised a method of administering ether vapor via the rectum. Marc Dupuy investigated the same technique that year in Paris, France. In 1915 American surgeon George Crile began combining local anesthetics with ether inhalation to block pain impulses more completely.