Tuesday, July 28, 2009


It wasn’t an easy weekend around my house, with my son having scheduled surgery and my husband an unscheduled (and painful) trip to the emergency room, but it got me thinking about how we deal with pain in the early 21st century and how 19th century people dealt with it.

My son had his impacted wisdom teeth removed. He had general anesthesia during the surgery, novocaine to deaden the immediate post-operative pain, and oxycodone (an opiate derivative) to take care of the pain after that. He had hi-tech gel packs that can either be frozen or heated in the microwave to keep on his cheeks and jaw to reduce swelling, and antibiotics and a sterilizing mouthwash to keep infection at bay. Impressive stuff...now, what would a 19th century dentist or doctor be able to give his patients to control pain during surgical procedures?

The answer is, during the earlier decades of the century, not much. There was ingesting large amounts of alcohol, or there was laudanum, which is opium dissolved in an alcohol base and which had been in use since the 16th century…but the problem with using these during surgery is that it’s extremely difficult to judge how much the patient should get to remain unconscious during the entire procedure. Surgeons usually had several strong men on hand during operations to hold the patient down in case he or she woke up partway through!

Surgery wasn’t a common practice, and it was usually a last resort treatment because of the problems of dealing with pain. But what about medical events that weren’t surgical—like childbirth? Unfortunately, medical professionals did not feel that alleviating women’s pain during labor and birth was necessary or even desirable; some took the phrase in Genesis "in sorrow thou shalt bring forth children" to mean that women should suffer while giving birth, as punishment for Eve’s transgressions.

But starting in the 1840s, that began to change. Advances in the study of chemistry in the 18th and early 19th centuries led to the study of gases, among them ether and nitrous oxide. American doctors in Boston and in Georgia began experimenting with using ether during surgery, with growing success. Nitrous oxide, after some initial problems (during its first public use in a dental procedure the patient woke up too soon and began to scream) came into wide use. But it was the development and use of chloroform that really opened the field of pain control in surgery. It was developed in 1847 by a Scottish obstetrician named James Young Simpson who wanted to find an anesthetic to give women in labor. Although many doctors fought against its use because of that supposed biblical injunction, its popularity and widespread use were guaranteed after Queen Victoria chose to use it during the births of her son Leopold in 1853 and daughter Beatrice in 1857 and was vocal in its praise, even in the face of censure from Britain's premier medical journal, The Lancet. After having born seven children without the benefit of anesthesia, she knew what she was talking about!


QNPoohBear said...

Thank goodness for modern medicine and thank you Queen Victoria! Did anyone see the HBO mini series John Adams? His daughter, Nabby, had a mastectomy without anesthesia in the early 19th century! :shudders:

I recently read a diary where the doctor performed surgery on the diarists' two little boys using cocaine as an anesthetic in the early 20th century!

Dara said...

I remember getting wisdom teeth out...I couldn't take the oxycodone after; it made me violently ill. So, I pretty much used ibuprofen, which was better than nothing.

I am thankful that there's pain meds for childbirth now--I can't fathom why some women want to go natural--give me the pain killers!

Regina Scott said...


I chose to go natural with my first son. I have a lot of allergies to various medicines, so didn't want to risk that my tendencies had been passed on to my son and the pain killers would hurt him. I felt very virtuous making it through the five and a half hours of labor (which is a pittance compared to some ladies!). I intended to do the same with my second son, but after a half hour of labor I begged for drugs! Unfortunately, the labor was progressing so quickly (1.5 hours!) that the doctor assured me there was no point taking them!

So, yeah, thank you Queen Vic from all the ladies who would prefer not to give birth in pain!

Marissa Doyle said...

I also chose to go without anesthesia for my children's births...until it became clear I needed a c-section for my second twin!

I'm so glad women have the choice now--to have anesthesia or not--without someone else making the decision for them.

QNPoohBear, the late 18th-early 19th century novelist Fanny Burney also underwent a mastectomy without anesthesia. I just can't imagine.

Dara said...

I admire you both even more for going natural. I have to admit: I am a wimp when it comes to pain, at least when it comes to thinking about having kids.