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Dr William Morton And The Impact Of Anesthesia

The person of historical interest that I chose for the subject of my final paper is Doctor William T. G. Morton and his contributions of anesthesia to surgery of today. We all know that anesthesia has come a long way since the beginning of medicine. The impact of Doctor Morton’s work is still recognized today in 21st century anesthesia and surgery. The in-depth surgeries of today were made possible by the forward thinking and risks taken by a dentist in the 1800’s by the name of Doctor William Morton. The contributions to the medical community by Doctor Morton were the use of ether as a surgical anesthetic (Porter, 2006). Anesthesia was not entirely new at this time, and earlier, medicine had always, used analgesics. Early societies were aware of the pain-deadening qualities of many plants and substances (Porter, 2006). In the early years of surgery and medicine, opium, hashish or Indian hemp, and alcohol were used as “painkillers” (Porter, 2006). Yet, most patients before the reign of Queen Victoria had to face serious surgery without any type of anesthesia or painkillers (Porter, 2006). Only a few attempts were made to deaden pain for patients about to undergo surgery. Many surgeons and doctors felt that a deeply drugged or drunk patient could be more difficult to handle and hold still in a surgical procedure than an alert patient suffering acute pain (Porter, 2006).

To provide some background on William Morton, he was a son of a farmer born in the early 1800’s in Carlton, Massachusetts (Ash, 1985). Growing up into adulthood, William Morton tried his hand at many jobs before attending any type of medical/dental school or medical training, He once worked as a clerk, a printer and a salesman in local Boston business houses. He became very restless and dissatisfied with his work and realized this was not the life and job he wanted for himself. William Morton did not find his work at the business houses to be challenging nor satisfying. He had trouble making a living and found this type of work in the business world not to be very lucrative either. With his ambitious nature and inquisitive mind, he decided to study medicine and dentistry.

Striving for more satisfaction in his career in 1840, Morton enrolled at the world’s first dental school, Baltimore College of Dental Surgery (Shampo et al., 1987). Although he was interested and loved dentistry, he left after only two years without graduating. Instead, after the two years of dental school, in 1842, Morton became a pupil and then business partner of Hartford dentist, Doctor Horace Wells (Ash, 1985). Doctor Wells would be the doctor whom later introduced Morton to his experiments with nitrous oxide (Porter, 2006). Unfortunately, the partnership between Wells and Morton had many problems. Six months after the partnership was formed, it was dissolved. With his thirst for knowledge, William Morton was still searching for satisfaction in a career.

Searching for another path in life, William Morton became a student at Harvard Medical School in 1844 (Ash, 1985). History tells us that Morton signed up for medical school partly to increase his medical knowledge, but mainly to impress the parents of the woman he loved and wanted to marry. Her parents objected to Morton’s profession and lack of a degree and only agreed to their marriage after Morton promised to study medicine. During 1844, Morton lived in Boston while he studied and attended the chemistry lectures of Doctor Charles T. Jackson at the Harvard Medical School. Doctor Jackson was the one who introduced Morton to the anesthetic properties of ether and the many chemical properties of gases (Deranian, 1997). Once again, unfortunately, William Morton did not complete this degree in medicine at Harvard.

At this time, after dropping out of school, William Morton went back into the world of dentistry. By 1845, Morton had begun to work on many different dental projects. Morton had invented easily manufactured dentures, which he planned to market and become the great success he always wanted to be. However, these dentures required the removal of all of the patient's teeth. Usually, removing a patient’s entire mouth of teeth was an extremely painful process. Many patients did not want the pain involved in the tooth extraction process, so it was hard to have them consider the dentures. This was a problem in the success of Morton’s business. This problem encouraged Morton to investigate anesthesia. As history recalls, anesthesia, had been introduced to Morton earlier in his medical career, by Doctor Charles T. Jackson. Combining his knowledge and observations of anesthesia and observations of nitrous oxide from years of study with Doctor Wells, he had an idea for patients whom would be undergoing surgery. He had studied Wells’s work with nitrous oxide and observed Wells’s failures of anesthesia at Massachusetts General Hospital in 1845. Finally, Morton consulted Doctor Charles Jackson about the gases available for experimentation. According to Morton, Jackson suggested he try sulfuric ether, which was known as ether, which had a localized painkilling effect.

This would be the major stepping-stone in medical history. September 30, 1846, became an important day in medical history. A patient needing a tooth extraction came to William Morton’s office terrified at the thought of pain. Motivated by fear of pain, the patient agreed to try Morton's painkiller invention. The subsequent extraction, which utilized sulfuric ether, was painless. A few weeks later, Morton performed another painless tooth extraction after administering ether to another willing patient. Upon reading a favorable newspaper account of this event, a successful Boston surgeon arranged for a now-famous demonstration of ether being utilized on a patient during surgery (www.azzazianesthesia.com). On October 16, 1846, in a surgery observation lab at a Boston hospital, the procedure was completed (Ash, 1985). At this demonstration, another well- respected doctor painlessly removed a tumor from the neck of a willing patient. The patient during the entire surgery was operated on while painlessly unconscious (www.azzazianesthesia.com). William Morton was promptly proclaimed the inventor of anesthesia by the Boston medical community of this time (www.azzazianesthesia.com).

For the next 20 years Morton invested his time and money acquiring and defending patents (azzazianesthesia.com). At first he called the ether gas "Morton's letheon" and refused to reveal what the substance actually was (www.azzazianesthesia.com). Morton kept trying to hide the identity of the substance that the patient in the Boston had inhaled. He would stay with referring to the substance as "Letheon", but it soon was found to be ether. After it was found to be simple ether, his patents with Congress were impossible to defend (www.azzazianesthesia.com).

In fact, this began the well-publicized growing controversy over who discovered anesthesia. The United States government annulled Morton’s patent in 1862 until the matter could be settled (Ash, 1985). The patent and the controversy were never settled. Morton's long time dreams of wealth from his discovery of anesthesia never materialized for him. William Morton died penniless in New York City of a stroke, never to claim fame to his discovery and experiments of ether or anesthesia (www.azzazianesthesia.com).

Never before or since has a medical discovery generated such debate and confusion in the medical community. By 1849 the controversy over who discovered anesthesia had become such a public issue that the U.S. Congress was called on to resolve the matter. However, even Congress was unable to make a decision on the matter and became dead-locked over the issue (Deranian, 1997). The controversy became centered on the definition of what discovery actually means. The following questions needed to be asked and answered. Is a discovery of a medical process simply the mental conceptualization of the process, or does it also require a practical application of the process? And does a medical discoverer have to publicize and show his invention to the medical profession and the world in order to be awarded credit?

Morton supporters deny that Morton was carrying on the work of either Wells or Jackson. A larger part of the medical community, at that time, claimed that Morton did his own independent research on ether and anesthesia. Doctor Jackson was just part of the many specialists he interviewed for his research. Jackson was the doctor who mentioned that ether had been used as a localized painkiller. Morton took these ideas and suggestions from various sources and combined them into discovering and publicly demonstrating anesthesia to the world.

Supporters of Morton’s work also claim to denounce Doctor Jackson’s contributions to the discovery of the painkillers for surgical means. They assert that he was merely an attention-seeker who tried to take credit for the accomplishments of everyone he came into partnership with or met. In actuality, Doctor Jackson was just a chemist who gave Morton technical advice on ether and it’s properties (Deranian, 1997). Research shows that Morton supporters of the time period, deny any claims that Morton was Jackson's assistant. It was known to be a fact in the medical community that Doctor Jackson advised against the experiments and refused to be associated with Morton's Massachusetts Hospital demonstration (Deranian, 1997). Doctor Jackson thought the procedure was too dangerous and did not want any part of the surgical experiment (Deranian, 1997).

Only after Morton had been acknowledged as the true discoverer of anesthesia, did the other doctors and chemists publish their results and their arguments. Morton advocates and supporters maintain that Morton conceptualized, implemented, demonstrated, and presented anesthesia to the world (www.azzazianesthesia.com).

The process of bringing anesthesia to surgery apparently required qualities that William Morton possessed. Doctor Morton, would prove himself to be exactly the right man to bring anesthetic gases to the front. He was everything that Wells or Jackson was not: aggressive, savvy, selfish enough to be fearless, downright greedy, and lucky (Shampo, 1987).

Morton later swore that Wells’s tip had nothing to do with his own search for a surgical painkiller; he maintained that he had heard the narcotic properties of sulfuric ether mentioned in one of his Harvard lectures and thought out the possibilities of its use in surgery all on his own. According to others, though, when Morton was on the verge of losing a very good job of dental surgery due to the patient being afraid of the

pain, he recalled Wells’s experience and asked Jackson for a supply of nitrous oxide; in an offhanded way Jackson said that he was all out of nitrous oxide but that ether would work just as well.

Elective surgery was performed very infrequently prior to the advent of effective anesthesia. From 1821 to 1846, the annual reports recorded 333 surgeries, representing barely more than one case per month. Surgery was once considered a last and desperate resort. Reminiscing in 1897 about preanesthesia surgery, one elderly Boston physician could only compare it to the Spanish Inquisition. He recalled “yells and screams, most horrible in my memory now, after an interval of so many years” (http://neurosurgery.mgh.harvard.edu/history/beforeth.htm). Over the centuries, numerous techniques had been used to dull sensation for surgery. Sleep-inducing and awareness-dulling agents and narcotics were prepared from a wide range of plants, including marijuana, belladonna and jimsonweed. Healers attempted to induce a psychological state of anesthesia by mesmerism or hypnosis. Distraction could be provided by rubbing the patient with counterirritants such as stinging nettles. A direct but crude way of inducing a state of insensitivity was to knock the patient unconscious with a blow to the jaw. The fact that a half century passed between the discovery of the anesthetic effects of the inhalational drugs and their widespread clinical use is remarkable and tragic. The accounts and recollections of surgery before the days of effective anesthesia are gruesome. Remarkably, they were reality only a few generations ago. Today, it is easy to forget the burden of surgical pain. Here in 2010, we can think back to the first public demonstration of anesthesia, and we can reflect proudly on the achievement of Morton and others like him who have advanced the art and science of anesthesiology.

Today the discipline of anesthesiology has expanded far beyond the operating room, as reflection of today’s medical and science fields. In the core area of general anesthesia, better drugs, improved monitoring and specialized training have been responsible for great improvements in patient safety and comfort during and after surgery.

Ether has long been replaced by newer and safer agents that allow more precise control of consciousness and result in fewer side effects like nausea. Anesthetic drugs that quickly disappear from the bloodstream allow many patients to go home within hours of certain surgical procedures. A collaborative program involving anesthesiologists, neurologists and other specialists are now formed for the patient’s safety and comfort.

Even more from the days of William Morton and his experiments with nitrous oxide have pioneered the use of the gas nitric oxide to improve lung function in several life-threatening conditions of infants and adults.

The changes we see in hospital care today, in collaboration with experts in surgery, medicine, nursing, and other disciplines, we as a society will continue advancing ways to keep all patients as safe, healthy and comfortable as possible before, during, and after surgery.

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