One of the permanent displays at the museum is the hospital room. It is full of old medical equipment, some of it from the local hospital ward, some of it from an old dental clinic and an optometrist, both of which closed over the past few decades.
It is a curious room that is likely to bring back less than fond memories for those who remember, for example, the era of foot powered dental drills.
A few weeks ago our volunteers started a stocktake of the objects on display in the medical room – a process through which we make sure that collection items are located where our database say they should be, and check their condition and decide whether preservation activities are needed. This is one of the many tasks our volunteers undertake behind the scenes of the museum, to manage and care for the collection.
One of the objects that was identified as needing some maintenance work was a old anaesthetic inhaler. The inhaler recently featured in our Mystery Object series on the Museum's social media, and quite a few people guessed its use correctly. When we looked into the history of he inhaler for the social media post we ended up on a goose chase of a research journey which will be the subject of this blog post.
An Old-Fashioned Anaesthesia Nose Piece
First a little about the object itself. The inhaler is made to fit over the nose of a patient to administer anaesthetic gas, most likely nitrous oxide. The patient’s nose is fully covered, allowing them to inhale the anaesthetic gas, while mouth remains free so that the dentist can carry out dental procedures. The hardware of the inhaler is made of stainless steel, while the nose piece is made of synthetic rubber.
In terms of dating the object, the synthetic rubber, and the shape and condition of the nose piece suggest it was in use around 1950-1970.
The lucky patient who was able to enjoy the pain relief of laughing gas through this particular nose piece while having a tooth extracted probably didn’t fully appreciate what a remarkable and important medical advancement anaesthesia really was. Not only were tooth extractions without pain relief the unpleasant reality for thousands of humans throughout the vast majority of human existence. For most of human history medical practitioners were also severely limited in how they could assist patients because they were unable to manage or alleviate the pain their patients experience during any kind of invasive procedure.
Surgeons in particular, were bound by these limits. They had to be very fast to have a chance of being successful, and patients had to be restrained for the procedure. This meant that only the most straightforward procedures were possible, and it was all but impossible to operate on the torso, the abdomen or the skull. Effective sedation that would render the patient relaxed and unconscious was a holy grail for surgeons and dentists, who would then not only be able to take their time, but also perform a wider range of procedures that required minute precision on a perfectly still patient.
The Curious History of the Invention of Anaesthesia
Inhalation anaesthesia like that administered through this nose piece was first used in the 1840s. In 1842, Crawford Williamson Long removed a cystic tumour from the back of the neck of a patient who was sedated using ether. In 1844, Horace Wells used nitrous oxide for a dental extraction, and in 1846 the use of ether for sedation just about exploded in use across the English and European world after Thomas Morton performed a public demonstration of surgery on an etherised patient.
It took not only knowledge of the chemistry of gases and vapours to get to this point, but also developments in pneumatics and an understanding of the respiratory system. Like with all scientific discoveries, it depended on a wide variety of scientists making a large number of small discoveries and improvements to arrive at a place where inhalation of gases could be harnessed for medical purposes.
Curiously, however, sedation in itself was actually achieved much earlier, in 1804. While the credit for inventing inhalation anaesthesia goes to American surgeons, the first medical sedation for surgical purposes actually occurred in Japan.
Towards the end of the 18th century, the Japanese surgeon Hanaoka Seishū began experimenting with the use of herbal mixtures to induce a state of general anesthesia. Hanaoka was inspired by the 2nd century Chinese surgeon Hua Tuo, who allegedly developed a compound he called mafeisan, which had anesthetic and sedative properties. The recipe of mafeisan disappeared after Hua Tuo’s death, but more than 1600 years later Hanaoka Seishū managed to recreate a compound with the same effects. He named it tsūsensan, and used it first in 1804 to perform a partial mastectomy on a woman suffering from breast cancer.
Hanaoka operated on around 150 people under sedation, and his students continued to use the compound after his death. Our mystery this time is that despite the importance of the discovery, and to the detriment of many thousands of patients in the first few decades of the 19th century, the invention had no apparent impact in the world at large, and it would take the Western world another four decades before inhalation anaesthetic was made possible in America, Europe, and the colonies of the British Empire.
The most likely reason Hanaoka’s method didn’t spread is the Japanese state’s isolationist policy. This was in place from 1603 to 1868, and it prevented Japanese citizens from leaving the country, and foreigners were not allowed to enter. As a result, innovation didn't easily spread beyond Japan's borders.
While Hanaoka’s discovery has remained arcane knowledge, Thomas Morton’s method of ether sedation spread from the US to Europe and the British colonies within months. 180 years later, inhalation anaesthesia is the dominant form of general sedation, and our little nose piece is just one of many small stepping stones in a long journey of medical development.
References:
Crawford W. Long’s Discovery of Anesthetic Ether: Mesmerism, Delayed Publication, and the Historical Record Presentation in the Key Barkley Symposium on the History of Psychology Southern Society for Philosophy and Psychology, April, 17, 2003, Atlanta, GA.
The Development of Inhalation Anaesthesia
With Special Reference to the Years 1846-1900
Patel, Arjun. "The Independent Inventions of General Anesthesia in 19th century Japan and United States: Why the Latter Revolutionized Surgery while the Former was Forgotten." University of Western Ontario Medical Journal 90, no. 1 (2021).
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