Cholera, Chloroform, and the Science of Medicine: A Life of John Snow

By Peter Vinten-Johansen; Howard Brody et al. | Go to book overview

Chapter 14
Further Developments in
Anesthesia

JOHN SNOW MAY HAVE BEEN THE FIRST physician to "specialize" in anesthesia.1 In principle if not always in practice, his approach mandated that anesthesia should be performed by a trained physician exclusively dedicated to its safe administration. A surgeon or dentist operating on a patient had too much to do to take on the responsibility of inducing, monitoring, and reviving the chloroformed or etherized patient. In the 1850s surgeons began performing longer and more complex procedures that could not have been done without anesthetics. Surgery without pain made surgery both more popular and more common. Procedures that were formerly an excruciating last resort—amputations, removal of tumors, abdominal surgery—were now offered and performed routinely and repeatedly. Snow worked frequently with William Fergusson, an early practitioner of conservative surgical interventions (such as excision of joints or removal of dead bone tissue) that would have been impossible without anesthesia. During a span of five Saturdays in the autumn of 1848, Snow gave chloroform four times to one little boy for repeated surgeries on an "un-united fracture" of the humerus requiring resection (CB, 22–26).2 Such a series of procedure would have been unimaginable two years earlier. Looking back on the impact of chloroform on surgery, Snow commented in On Chloroform that surgeon-patient relations were fundamentally altered because the surgeon could now obtain "the ready assent of his patient" for many painful operations in which previously "it would either not be obtained at all,

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