Humphry Davy's Contribution to the Introduction of Anesthesia: A New Perspective

HUMPHRY DAVY'S CONTRIBUTION TO THE INTRODUCTION OF ANESTHESIA: A NEW PERSPECTIVE NORMAN A. BERGMAN* Introduction In 1800 Humphry Davy wrote Researches, Chemical and Philosophical Chiefly concerning Nitrous Oxide and published the book [I]. This work detailed Davy's exhaustive chemical experiments on nitrous oxide. Also included were descriptions of studies involving other gases and related subjects. In addition, he described effects of breathing nitrous oxide and several other gases in animals and man. Almost all of this work was done at the Medical Pneumatic Institution in Bristol, where Davy had been appointed medical superintendent. In this capacity, Davy's sponsor and mentor was Dr. Thomas Beddoes, who had opened this medical facility in 1798 [2]. Nitrous oxide had been discovered in 1774 by Joseph Priestley and had attracted modest attention from several chemists. Davy described how he initially became interested in this gas: A short time after I began the study of chemistry, in March 1798, my attention was directed to the dephlogisticated nitrous gas of Priestley, by Dr. Mitchill's theory of Contagion. [1, p. 453] The Dr. Mitchill mentioned was Samuel Latham Mitchill (1768-1823), an American physician of New York City, who had studied with Joseph Black in Edinburgh and who was well versed in chemistry [3]. He had proposed that nitrous oxide was a pestilential aeroform substance, inhalation of which caused fevers and plague—the epidemics of yellow fever that ravaged the port cities of the United States in the 1790s [4]. Davy disproved Mitchill's theory by performing a number of experiments *Department of Anesthesiology, Oregon Health Sciences University, Portland, Oregon 97201.© 1991 by The University of Chicago. AU rights reserved. 003 1-5982/9 1 /3404-0730$0 1 .00 534 Norman A. Bergman · Introduction ofAnesthesia with nitrous oxide, including his personal breathing of the gas. Davy's early trials of nitrous oxide inhalation are good examples of his cavalier attitude toward self-experimentation—which almost cost him his life on more than one occasion when he attempted to breath carbon monoxide [1, p. 467] and subsequently also nitric oxide [1, p. 475]. One of the effects of nitrous oxide noted by Davy was its ability to ameliorate pain. He specifically described relief of discomfort from an erupting tooth [1, p. 465] and of a bothersome headache [1, p. 464]. The section of Davy's "Researchers" in which he described his conclusions contains the following sentence: As nitrous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations in which no great effusion of blood takes place. [Lp. 556] On the basis of this sentence, Sir Humphry Davy has been given varying degrees of recognition by several historians of medicine for a humane concern with easing operative pain and mitigating patient suffering during surgical interventions—or even for discovering anesthesia . To present-day readers, this statement by Davy certainly suggests that he was proposing the use of nitrous oxide as an anesthetic in the modern sense of the word. This would generally involve rendering patients unconscious and insensible to pain during surgical operations. The motive for this has been tacitly assumed to be a merciful concern with suffering during operative procedures. However, consideration of the publications of Davy and those professionally associated with him, as well as certain events in his life, strongly suggests that compassionate thoughts of patient comfort during surgical operation probably never crossed his mind at any stage of his life. Careful reading of Davy's writings within the context of their presentation and with attention to certain beliefs of late eighteenth-century medical practitioners supplies a probable reason why he recommended the use of nitrous oxide during surgery. Such consideration also could explain the curious restriction by Davy of nitrous oxide to "operations in which no great effusion of blood takes place." The Brunonian System ofMedicine In order to understand Davy's probable reasoning in proposing use ofnitrous oxide during surgery, we must first consider briefly the system of medical practice proposed by John Brown (1735-1788). This Brunonian (or Brownonian) system was widely taught and accepted by the medical community in the late eighteenth century and displaced...