Pain and Anesthetics
1. Remarks about pain
2. Relief of pain – anesthetics
3. Pain research
Some people do not experience pain – it’s called congenital analgesia. They often can
feel touch but not always temperature.
Francis Thompson 1859 – 1907 drug addict wrote a remark about pain
Emily Dickinson wrote about pain
1/5 persons suffer from chronic pain
¼ persons over age of 65 suffer from chronic pain
No device to measure pain. It is what the person says it is.
Acute pain: results from disease, inflammation or injury – confined by time
Chronic pain: persists – representing the disease itself.
The more the pain, the longer it takes to recover
“think of pain as a disease”
The spinal cord “rewires” itself when there is pain. Pain can become permanent.
10 point pain scale in hospitals
Lebenswecker redirects the pain.
o Needles at the end
Classic drug for pain: morphine – Morpheus (God and dreams)
o Not addictive if given for pain (usually)
o From poppy, contains opium, a narcotic
Thomas DeQuincey: Confessions of an Opium Eater (1822)
“surgical” methods prevailed for pain relief where morphine was unavailable.
Orthopedic surgeons were far many years all male. Now 5-10% are female. (before it
required a lot of strength: the saw)
Anesthetics were needed
First anesthetic: ether
o Raymundus Lullius from Spain 1275 produced sweet vitriol. H SO 2 4
o Vallerius Cordus from Germany 1540s also produced sweet vitriol
Paracelsus born 1493. Kept records associated with ether. Wrote in a special code
CH -3H -O2H: ethanol. Heated in the presence of an acid, water is lost, ether is formed.
Ether: CH 3H -O2CH CH 2 3
Joseph Priestley 1772 created N 2
o Ammonium nitrate (a fertilizer, an explosive, a crystalline solid) is heated to
create N2O and water. November 15
o “laughing gas”
o Gave a high and then pass out
o Propellant for whipped cream
Dr. Crawford Williamson Long 1842 credited for ether. 2 tumours removed.
Late 1800s nitrous oxide routinely used for dentists
William T. G. Morton 1846 used ether. He called it Letheon. Lethe was a river in Hell. If
drunk, one would forget all and spend eternity remembering nothing of life.
Ether was bottled. Quite volatile.
John Collins Warren 1846 contacted by Morton; Massachusetts General Hospital.
o Ether Dome
Two main operations of this era: