Zzzzzzzzzzzz...

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!