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MOST IMPORTANT SCIENTIFIC DISCOVERIES
Anesthesia. History and essence of scientific discovery
Directory / The most important scientific discoveries People have been looking for victory over pain for centuries. History has preserved references to painkillers from the Assyrians and the ancient Egyptians. It is known that the Egyptians used crocodile fat and powder from its skin for this purpose. Homer tells in the eleventh song of the Iliad how Patroclus, having cut an arrow from the body of a wounded hero, sprinkled the wound with a bitter, worn root, "which completely quenched his pain." The Greeks and Romans prepared painkillers from the mandrake. The historian Pliny says about them: "They drink with snake bites, as well as before incisions and punctures, so as not to feel pain." In one of the old Russian "healers" it is written: "... They give the roots of mandrake ailing threads or yasti, in which a scorching fire inflames and they sleep so soundly that they do not feel when the doctor cuts off or cuts off their ouds." Narcotic substances (opium, Indian hemp, alcohol), which in safe doses did not cause pain relief, and in large doses often led to death; squeezing of the nerves or vessels of the neck; sharp cooling with the help of ice and snow - all this was just wandering on very distant approaches to the "divine", according to Hippocrates, "the art of destroying pain." The rapid development of chemistry, which began at the end of the XNUMXth century, helped in a short time to take a giant step towards the goal - one step that was worth thousands of years of previous searches. "In 1800," writes V.I. In his youth he was a surgeon's apprentice, but then he did not think about using his discovery in medicine.After eighteen years, Michael Faraday, the great disciple of Davy, discovered that the vapors of sulfuric ether can lead to the same condition as nitrous oxide. Faraday even published a work on this subject. The doctors passed by again. Ten years later, the London surgeon Gickman repeated Davy's experiments. A professional doctor, he understood the importance of the discovery and rushed off with a report to the Paris Academy of Surgery. He was ridiculed. Only old man Larrey supported him warmly. "Laughing gas" (that's how Davy called nitrous oxide) did not find shelter in operating rooms, but was taken "in service" by itinerant artists and magicians, and became a frequent and favorite guest of fair booths. It was here that the American dentist Horace Wells met him. The next day, he asked another dentist, John Riggs, to extract his tooth, but before the operation he inhaled "laughing gas" in the tent of the itinerant preacher Colton. The effect exceeded expectations. It happened in 1844 in the American town of Hartford. "A new era is dawning in dentistry!" Wells exclaimed. He did not understand that he was on the verge of a new era in all of medicine. This was understood by the famous Boston surgeon Warren. He provided Wells with his clinic to demonstrate his public experience. But the unexpected happened: as soon as the dentist began to pull the tooth, the lulled patient screamed. Loud laughter from the audience - and Wells was shown to the door. After a public failure, Wells still continued to experiment - after all, he had a promising experience on himself behind his back. But in some way he was mistaken: further experiments did not bring success. Desperate, thirty-nine-year-old Wells committed suicide. His fate is tragic. He went the right way and really could get the title of "discoverer" of anesthesia. Surgery still returned to nitrous oxide, however, much later, in the sixties. "Laughing gas" was thrown out of the way for a while, this was facilitated by the failures of Wells and the victorious march of ether and chloroform. Dental technician William Morton decided to study medicine with Dr. Charles Jackson, who was also a professor of chemistry. Jackson told the student a lot about the action of the ether, in which Morton showed great interest. Before sulfuric ether vapors were given citizenship in surgery, they were the favorite pastime of chemistry students. Young servants of science now and then applied to the bottles of ether, sniffed, got drunk and laughed heartily when someone, "grabbing a surplus", began to stagger and talk nonsense. Jackson's knowledge turned out to be quite extensive. He conducted, in particular, a successful experiment on himself, and also designed devices for inhaling ether vapors. Fishing out new information about the ether from a gullible mentor, Morton made experiments on dogs at home, euthanized himself several times. Diligently keeping the secret, he hurriedly walked towards the goal. In the autumn of 1846, after a particularly successful experience, Morton confidently offered his services to surgeon Warren of Boston. On October 16, 1846, an event occurred that meant a revolution in surgery. On this day, the first operation under anesthesia was performed. Dr. Warren painlessly removed the tumor on the patient's neck. William Morton, having lulled the patient, turned to the surgeon: "Go ahead, Mr. Warren. Your patient is already so far away!" Warren successfully completed the operation, exclaimed in amazement: "Gentlemen, this is not a hoax! .." Insulted, Jackson decided to challenge the championship. The litigation dragged on for two decades. As a result, Jackson died in an insane asylum, and Morton - a beggar on a New York street. In the meantime, having passed the first test, ether anesthesia resolutely marched around the world. At the beginning of 1847, it was already used by Malgen in France, Dieffenbach in Germany, Shu in Austria, Liston in England. Liston removed the nail of one patient under anesthesia, and then amputated the hip of another. Delighted, he turned to the audience: "Hurrah! Joy! Soon, without this, not a single operation will be done. Joy!" The first operation in Russia under ether anesthesia was performed by Fedor Ivanovich Inozemtsev in Moscow. On February 1847, XNUMX, he cut out a cancerous mammary gland from a petty-bourgeois Elizaveta Mitrofanova. Less than a week later, Inozemtsev performed new operations using anesthesia - he removed stones from the bladder of two boys. The physiologist Filomafitsky created special committees for the study of anesthesia, which carried out a whole series of important experiments on animals. During the year, six hundred and ninety operations were performed under anesthesia in thirteen cities of Russia. Three hundred of them made a great surgeon Pirogov. And most importantly, he answered many questions. In what ways do ether vapors act on the body? Is it possible to reduce to several types the diverse phenomena that occur after the introduction of anesthesia? Does the successful application of anesthesia depend on the technique of sedation? Are changes needed in the design of devices for "ethering"? Pirogov tried, for example, to achieve anesthesia not only by inhaling ether vapors, but also in other ways - by introducing anesthesia into the arteries, veins, trachea, and rectum. He was quickly ahead of time. Some of the methods he proposed for introducing anesthesia into the body began to be put into practice only decades later. "I am convinced," he wrote, "that the ethereal vapor is indeed a great remedy, which in a certain respect can give an entirely new direction to all surgery." On November 10, 1847, Simpson reported on the discovery of a new type of anesthesia - chloroform. The latter seemed to many more seductive than ether: its lulling effect was stronger, sleep after it came faster, its use did not require special devices - a handkerchief or a piece of gauze soaked in chloroform could replace the mask. Churchmen rebelled against Simpson, who used chloroform to anesthetize childbirth. "This is contrary to the Holy Scriptures," they repeated. "It says: 'Eve will bear children in pain.' Scientific arguments were not taken into account, but the resourceful obstetrician beat the enemy with his own weapon. He stated: "My adversaries forget the 21st verse of the second chapter of the book of Genesis. It mentions the first surgical operation in the history. So what? The Creator, before cutting out a rib from Adam to create Eve, plunged him into a deep sleep." This argument settled the dispute. Chloroform narcosis marched across the world even faster than ether narcosis. Russian surgeons adopted it just a month after Simpson's report. At the end of December 1847, on the way back from the Caucasus, Pirogov took up chloroform. By the beginning of 1849, he had already summed up the results of three hundred operations under chloroform, and after another five years their number had grown to more than two thousand. At the same time, Pirogov not only performed these two thousand operations, but also analyzed them. Moreover, for comparison, I compared it with the results of similar operations performed without anesthesia, for which I dismantled the archive of the Obukhov hospital for twenty years! And he finally concluded: “So, observation, experience, and figures speak in favor of anesthesia, and we hope that after our statistical calculations, made conscientiously and frankly, neither doctors nor sufferers will be carried away by mere assumptions and prejudices, to rebel against a new remedy so morally and therapeutically important." Today, almost no complex operation is performed without anesthesia. Author: Samin D.K.
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