{review} blessed days of anaesthesia

Stephanie J. Snow Blessed Days of Anaesthesia: How Anaesthetics Changed the World (2008) 

 

I have had the pleasure of reading a couple of really astonishingly good non-fiction books so far this year. Stephanie Snow's popular history of anaesthetics is one of the best.

Life (and death) really sucked before anaesthetics, and the only thing that is really astonishing is how reluctantly it was embraced. Looking back, can we even imagine a time when it was thought that "pain was necessary and functional in surgery"?! If you have a strong stomach, try reading Fanny Burney's account of her mastectomy without pain relief: "…when the dreadful steel was plunged into the breast - cutting through veins - arteries - flesh - nerves - I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision - & I almost marvel that it rings not in my Ears still! so excruciating was the agony." (more here)

Anaesthesia challenged Victorian understandings of pain at the most fundamental level. What was its purpose? How could medical control of suffering be reconciled with the Christian view that human pain was God's will? Doctors, clergymen, and writers debated the subject passionately. Because inhaling ether and chloroform could be fatal, it struck deep into one of medicine's central questions: what were the risks versus benefits of medical intervention?

Snow has a great grasp of the big picture - how anaesthetic reforms filtered slowly downwards to change society as a whole:

Beyond medicine, anaesthesia became a touchstone for humanitarianism, fuelling public distaste of pain and concern about the morality of inflicting suffering. It is no coincidence that from the 1860s onwards public executions became private events, legislation was introduced to reduce cruelty to animals in scientific experiments, and ideas of pain in Christian doctrine were reworked.

Snow works her way through the slow development of various types of more or less (usually more) dangerous anaesthetics - from opium to laughing gas, ether, chloroform and then onto the modern drugs we take so much for granted. The tendency of innovators in the field to experiment on themselves and their friends is remarkably consistent throughout history:

Liston was convinced of ether's potential: it had 'the most perfect and satisfactory results' and was 'a fine thing for operating surgeons', he wrote… Then he hosted a celebratory dinner party at which he demonstrated the effects of ether on one of the guests.

The big breakthrough in anaesthetic PR was Dr John Snow's management of Queen Victoria's labour with chloroform in 1853, although this in itself should tip the reader off to the social inequalities that still continue in medical treatment. {Incidentally, John Snow is my medical hero for his work on cholera - REVIEW}

Even after announcements of the Queen's use of chloroform and the publication of Snow's article, Dr Sheppard, a physician living in the provinces, felt strongly enough to write to the Association Medical Journal saying he would not change his view of chloroform. 'No female for whom I have any regard shall ever, with my consent, inhale chloroform,' he vowed, 'I look upon its exhibition as a pandering to the weakness of humanity, especially the weaker sex.'

Anaesthetics, along with a better understanding of antisepsis and the development of endotracheal intubation, revolutionized surgery. Snow has written a really readable and sensible account of the history of anaesthetics and also the place of anaesthetics in the modern world.  

Rating: excellent. 

If you liked this… definitely Steven Johnson's The Ghost Map: A Street, an Epidemic and the Hidden Power of Urban Networks (2006), on John Snow, cholera and the Broad Street pump.