Prior to the development of anaesthetics, the most important skill a surgeon could possess was speed. Modern anaesthetics, which induce unconsciousness in a patient, allow surgeons to perform more accurate and less painful procedures.
Before modern anaesthetics, herbs, alcohol, opium or narcotics were used to cause unconsciousness, but they were not always effective, or in some cases were so effective that the patient died from overdose. Chinese practitioners used acupuncture to anaesthetise patients. By 1804 in Japan, Seishu Hanaoka developed a very effective form of general anaesthetic using herbs.
Nitrous oxide , or laughing gas, was discovered in 1772 by Joseph Priestley. In 1799 another British scientist, Humphry Davy, discovered that it made him laugh, and feel less pain - hence its nickname of ‘laughing gas’. Nitrous oxide was first used as an anaesthetic in 1845. Unfortunately, the patient woke during the procedure and so its use was abandoned. Ether was tried the following year. It was difficult to use but was an effective anaesthetic. James Simpson pioneered the use of chloroform as an anaesthetic and it quickly replaced ether. Both ether and chloroform were administered by inhalation - local anaesthetics were not introduced until 1877.
By the 1920s intravenous anaesthetics were being used, which enabled patients to fall asleep very quickly. Muscle relaxants were introduced in the 1940s and as the century progressed, systems to monitor patients were also developed further so that the administration of anaesthetic was far safer than it had been in the 1800s.
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S J Snow, Operations without pain: The Practice and Science of Anaesthesia in Victorian Britain (Basingstoke: Palgrave Macmillan, 2006)
S J Snow, Blessed Days of Anaesthesia: How Anaesthetics Changed the World (Oxford: OUP, 2008)
Nitrogen oxide. A colourless, odourless gas that is used as an anaesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.