Editing Anesthesia (section)

== History ==
{{Main|History of general anesthesia|History of neuraxial anesthesia}}
{{See also|Hua Tuo}}
[[File:Statue of Hua Tuo in GDMU.jpg|thumb|right|A statue in Guangdong Medical University in honor of Hua Tuo]]
The first attempts at general anesthesia were probably [[herbalism|herbal remedies]] administered in [[prehistory]]. [[Ethanol|Alcohol]] is one of the oldest known [[sedative]]s and it was used in ancient [[Mesopotamia]] thousands of years ago.<ref name=Powell1996>{{cite book |title= The origins and ancient history of wine (Food and nutrition in history and anthropology) |edition=1 |volume=11 |chapter= Chapter 9: Wine and the vine in ancient Mesopotamia: the cuneiform evidence |pages= 96–124 |vauthors = Powell MA |veditors= McGovern PE, Fleming SJ, Katz SH |publisher= Gordon and Breach Publishers |location= Amsterdam |year=1996 |isbn=978-90-5699-552-2 |chapter-url= https://books.google.com/books?id=aXX2UcT_yw8C&pg=PA97 }}</ref> The Sumerians are said to have cultivated and harvested the [[opium]] poppy (''[[Papaver somniferum]]'') in lower Mesopotamia as early as 3400 [[BCE]].<ref name=Neligan1927>{{cite journal | vauthors = Evans TC |title= The opium question, with special reference to Persia (book review) |journal= Transactions of the Royal Society of Tropical Medicine and Hygiene |volume= 21 |pages= 339–40 |year= 1928 |doi= 10.1016/S0035-9203(28)90031-0 |quote= The earliest known mention of the poppy is in the language of the Sumerians, a non-Semitic people who descended from the uplands of Central Asia into Southern Mesopotamia&nbsp;... |issue= 4 }}</ref><ref name=Booth1996>{{cite book |title=Opium: A History |chapter=The discovery of dreams |page=[https://archive.org/details/opiumhistory00boot/page/15 15] | vauthors = Booth M |publisher=Simon & Schuster, Ltd. |location=London |year=1996 |isbn=978-0-312-20667-3 |chapter-url=https://books.google.com/books?id=8XHV8JAoAi4C&q=Opium:+A+History |url=https://archive.org/details/opiumhistory00boot/page/15 }}</ref> The ancient Egyptians had some surgical instruments,<ref name="Ebers1889">{{cite book |title=Papyrus Ebers|edition=1 |volume=2 | vauthors = Stern LC | veditors=  Ebers G |publisher= Bei S. Hirzel |location= Leipzig |language= de |year= 1889 |oclc= 14785083 |url= https://archive.org/details/papyrusebersdie00ebergoog |access-date= 2010-09-18 |editor-link= Georg Ebers}}</ref><ref name="Pahor1992I">{{cite journal | vauthors = Pahor AL | title = Ear, nose and throat in ancient Egypt | journal = The Journal of Laryngology and Otology | volume = 106 | issue = 8 | pages = 677–87 | date = August 1992 | pmid = 1402355 | doi = 10.1017/S0022215100120560 | s2cid = 35712860 }}</ref> as well as crude analgesics and sedatives, including possibly an extract prepared from the [[Mandragora (genus)|mandrake]] fruit.<ref name="Sullivan1996">{{cite journal | vauthors = Sullivan R | title = The identity and work of the ancient Egyptian surgeon | journal = Journal of the Royal Society of Medicine | volume = 89 | issue = 8 | pages = 467–73 | date = August 1996 | pmid = 8795503 | pmc = 1295891 | doi = 10.1177/014107689608900813 }}</ref>

In China, [[Bian Que]] ([[Chinese character|Chinese]]: 扁鹊, [[Wade–Giles]]: ''Pien Ch'iao'', {{circa|300 BCE}}) was a legendary Chinese [[Internal medicine|internist]] and surgeon who reportedly used general anesthesia for surgical procedures.<ref>{{cite journal |last1=Guo |first1=Qulian |date=December 2004 |title=Anesthesia in mainland China: its past and present |journal= The Hong Kong College of Anaesthesiologists |volume=13 |issue=4 |page=4}}</ref> Despite this, it was the Chinese physician [[Hua Tuo]] whom historians considered the first verifiable historical figure to develop a type of mixture of anesthesia, though his recipe has yet to be fully discovered.<ref>{{cite book|last=Mair|first=Victor H.|author-link=Victor H. Mair|year=1994|chapter=The Biography of Hua-t'o from the "History of the Three Kingdoms"|title=The Columbia Anthology of Traditional Chinese Literature|editor=Victor H. Mair|publisher=Columbia University Press|pages=688–96}}</ref>

Throughout Europe, Asia, and the Americas, a variety of ''[[Solanum]]'' species containing potent [[tropane alkaloid]]s was used for anesthesia. In 13th-century Italy, [[Theodoric Borgognoni]] used similar mixtures along with opiates to induce unconsciousness, and treatment with the combined alkaloids proved a mainstay of anesthesia until the 19th century.  Local anesthetics were used in [[Inca civilization]] where [[Shamanism|shamans]] chewed [[coca]] leaves and performed operations on the skull while spitting into the wounds they had inflicted to anesthetize.<ref name=Ruetsch2001>{{cite journal | vauthors = Ruetsch YA, Böni T, Borgeat A | title = From cocaine to ropivacaine: the history of local anesthetic drugs | journal = Current Topics in Medicinal Chemistry | volume = 1 | issue = 3 | pages = 175–82 | date = August 2001 | pmid = 11895133 | doi = 10.2174/1568026013395335 }}</ref> [[Cocaine]] was later isolated and became the first effective local anesthetic.  It was first used in [[eye surgery]] in 1884 by [[Karl Koller (ophthalmologist)|Karl Koller]], at the suggestion of [[Sigmund Freud]].<ref name=Koller1884>{{cite journal| vauthors = Koller K |author-link=Karl Koller (ophthalmologist)|title=Über die Verwendung des Kokains zur Anästhesierung am Auge|trans-title=On the use of cocaine for anesthesia on the eye|language=de|journal=Wiener Medizinische Wochenschrift|volume=34|pages=1276–309|year=1884}}</ref> German surgeon [[August Bier]] (1861–1949) was the first to use cocaine for [[intrathecal]] anesthesia in 1898.<ref name=Bier1899>{{cite journal| vauthors = Bier A |author-link=August Bier|title=Versuche über cocainisirung des rückenmarkes|trans-title=Experiments on the cocainization of the spinal cord|language=de|journal=Deutsche Zeitschrift für Chirurgie|volume=51|issue=3–4|pages=361–69|year=1899|doi=10.1007/BF02792160|s2cid=41966814|url=https://zenodo.org/record/1428422}}</ref> Romanian surgeon Nicolae Racoviceanu-Piteşti (1860–1942) was the first to use [[opioid]]s for intrathecal analgesia; he presented his experience in Paris in 1901.<ref name=Brill2003>{{cite journal | vauthors = Brill S, Gurman GM, Fisher A | title = A history of neuraxial administration of local analgesics and opioids | journal = European Journal of Anaesthesiology | volume = 20 | issue = 9 | pages = 682–89 | date = September 2003 | pmid = 12974588 | doi = 10.1017/S026502150300111X | s2cid = 46735940 }}</ref>

The "soporific sponge" ("sleep sponge") used by Arabic physicians was introduced to Europe by the [[Schola Medica Salernitana|Salerno school of medicine]] in the late 12th century and by [[Ugo Borgognoni]] (1180–1258) in the 13th century. The sponge was promoted and described by Ugo's son and fellow surgeon, [[Theodoric Borgognoni]] (1205–1298). In this anesthetic method, a sponge was soaked in a dissolved solution of opium, [[mandrake|mandragora]], hemlock juice, and other substances. The sponge was then dried and stored; just before surgery the sponge was moistened and then held under the patient's nose. When all went well, the fumes rendered the individual unconscious.<ref>{{Cite journal |title=The Ancestors of Inhalational Anesthesia: The Soporific Sponges (XIth–XVIIth Centuries): How a Universally Recommended Medical Technique Was Abruptly Discarded |last1=Juvin |first1=Phillippe |last2=Desmonts |first2=Jean-Marie |url=https://pubs.asahq.org/anesthesiology/article/93/1/265/491/The-Ancestors-of-Inhalational-Anesthesia-The |date=July 2000 |access-date=2023-01-15 |journal=Anesthesiology |volume=93 |issue=1 |pages=265–269|doi=10.1097/00000542-200007000-00037 |pmid=10861170 |s2cid=4867308 |doi-access=free }}</ref>

[[File:Anaesthesia exhibition, 1946 Wellcome M0009908.jpg|thumb|Sir [[Humphry Davy]]'s ''Researches chemical and philosophical: chiefly concerning nitrous oxide'' (1800), pp. 556 and 557 (right), outlining potential anesthetic properties of [[nitrous oxide]] in relieving pain during surgery]]
The most famous anesthetic, [[Diethyl ether#history|ether]], may have been synthesized as early as the 8th century,<ref name=Barash>{{cite book | vauthors = Toski JA, Bacon DR, Calverley RK | chapter = The history of Anesthesiology |edition=4th |publisher=Lippincott Williams & Wilkins |year=2001 |isbn=978-0-7817-2268-1 |page=3 | veditors = Barash PG, Cullen BF, Stoelting RK | title = Clinical Anesthesia}}</ref><ref name=Lullus>{{cite book |vauthors = Hademenos GJ, Murphree S, Zahler K, Warner JM |title=McGraw-Hill's PCAT |publisher=McGraw-Hill |page=39 |url=https://books.google.com/books?id=8MwxkLP87IUC&pg=PA39 |isbn=978-0-07-160045-3 |date=2008}}</ref> but it took many centuries for its anesthetic importance to be appreciated, even though the 16th century physician and polymath [[Paracelsus]] noted that chickens made to breathe it not only fell asleep but also felt no pain. By the early 19th century, ether was being used by humans, but only as a [[recreational drug]].<ref name=Fenster2001>{{cite book| vauthors = Fenster JM |title=Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It|publisher=HarperCollins|location=New York|year=2001|chapter=Power Struggle|pages=[https://archive.org/details/etherdaystranget00fens/page/106 106–16]|isbn=978-0-06-019523-6|chapter-url=https://archive.org/details/etherdaystranget00fens|url=https://archive.org/details/etherdaystranget00fens/page/106}}</ref>

Meanwhile, in 1772, English scientist [[Joseph Priestley]] discovered the gas [[nitrous oxide]]. Initially, people thought this gas to be lethal, even in small doses, like some other [[nitrogen oxide]]s. However, in 1799, British chemist and inventor [[Humphry Davy]] decided to find out by experimenting on himself. To his astonishment he found that nitrous oxide made him laugh, so he nicknamed it "laughing gas".<ref name="Davy">{{cite book| vauthors = Hardman JG |title=Oxford Textbook of Anaesthesia|date=2017|publisher=Oxford University Press|page=529}}</ref> In 1800 Davy wrote about the potential anesthetic properties of nitrous oxide in relieving pain during surgery, but nobody at that time pursued the matter any further.<ref name="Davy"/>

On 14 November 1804, [[Hanaoka Seishū]], a Japanese doctor, became the first person to successfully perform surgery using [[General anaesthesia|general anesthesia]].<ref>{{cite journal |last1=Izuo |first1=Masaru |title=Medical history: Seishu hanaoka and his success in breast cancer surgery under general anesthesia two hundred years ago |journal=Breast Cancer |date=November 2004 |volume=11 |issue=4 |pages=319–324 |doi=10.1007/BF02968037 |pmid=15604985 |s2cid=43428862 }}</ref> Hanaoka learned traditional Japanese medicine as well as [[Rangaku|Dutch-imported]] European surgery and Chinese medicine.  After years of research and experimentation, he finally developed a formula which he named tsūsensan (also known as mafutsu-san), which combined [[Datura stramonium|Korean morning glory]] and other herbs.<ref>{{cite journal |last1=Ogata |first1=Tomio |title=Seishu Hanaoka and his anaesthesiology and surgery |journal=Anaesthesia |date=November 1973 |volume=28 |issue=6 |pages=645–652 |doi=10.1111/j.1365-2044.1973.tb00549.x |pmid=4586362 |s2cid=31352880 }}</ref>

Hanaoka's success in performing this painless operation soon became widely known, and patients began to arrive from all parts of Japan. Hanaoka went on to perform many operations using tsūsensan, including resection of [[Malignancy|malignant]] [[tumor]]s, extraction of [[Urolithiasis|bladder stones]], and extremity amputations.<ref>{{cite book |last1=Hyodo |first1=M. |last2=Oyama |first2=T. |last3=Oyama |first3=Tsutomu |last4=Swerdlow |first4=Mark |title=The Pain Clinic IV: Proceedings of the Fourth International Symposium, Kyoto, Japan, 18-21 November 1990 |date=1992 |publisher=VSP |isbn=978-90-6764-147-0 }}{{pn|date=March 2024}}</ref> Before his death in 1835, Hanaoka performed more than 150 operations for breast cancer. However, this finding did not benefit the rest of the world until 1854 as the [[Sakoku|national isolation policy]] of the [[Tokugawa shogunate]] prevented Hanaoka's achievements from being publicized until after the isolation ended.<ref>{{cite journal |last1=Toby |first1=Ronald P. |title=Reopening the Question of Sakoku: Diplomacy in the Legitimation of the Tokugawa Bakufu |journal=Journal of Japanese Studies |date=1977 |volume=3 |issue=2 |pages=323–363 |doi=10.2307/132115 |jstor=132115 }}</ref> Nearly forty years would pass before [[Crawford Long]], who is titled as the inventor of modern anesthetics in the [[Western world|West]], used general anesthesia in [[Jefferson, Georgia]].<ref>{{cite journal |last1=Long |first1=C. W. |title=An Account of the First Use of Sulphuric Ether by Inhalation as an Anæsthetic in Surgical Operations |journal=Survey of Anesthesiology |date=December 1991 |volume=35 |issue=6 |pages=375 |doi=10.1097/00132586-199112000-00049 |url=https://journals.lww.com/surveyanesthesiology/citation/1991/12000/an_account_of_the_first_use_of_sulphuric_ether_by.49.aspx }}</ref>

Long noticed that his friends felt no pain when they injured themselves while staggering around under the influence of diethyl ether. He immediately thought of its potential in surgery. Conveniently, a participant in one of those "ether frolics", a student named James Venable, had two small tumors he wanted excised. But fearing the pain of surgery, Venable kept putting the operation off. Hence, Long suggested that he have his operation while under the influence of ether. Venable agreed, and on 30 March 1842 he underwent a painless operation. However, Long did not announce his discovery until 1849.<ref name="Long1849">{{cite journal| vauthors = Long CW |author-link=Crawford Long|title=An account of the first use of Sulphuric Ether by Inhalation as an Anesthetic in Surgical Operations|journal=Southern Medical and Surgical Journal|volume=5|pages=705–13|year=1849}}</ref>
[[File:Southworth & Hawes - First etherized operation (re-enactment).jpg|thumb|right|Historic image of an early [[diethyl ether|ether]] operation conducted at Massachusetts General Hospital.  The daguerreotype was taken by Southworth & Hawes on July 3, 1847.]]
[[File:Ether inhaler, c. 1846, developed by William T. G. Morton - National Museum of American History - DSC06167.JPG|thumb|Morton's ether inhaler]]
[[Horace Wells]] conducted the first public demonstration of the inhalational anesthetic at the [[Massachusetts General Hospital]] in [[Boston]] in 1845. However, the [[nitrous oxide]] was improperly administered and the person cried out in [[pain]].<ref name="NMAH">{{cite web|url=http://americanhistory.si.edu/collections/object.cfm?key=35&objkey=113|title=Miniature Portrait of Horace Wells|publisher=National Museum of American History, Smithsonian Institution|access-date=2008-06-30}}</ref> On 16 October 1846, Boston dentist [[William T. G. Morton|William Thomas Green Morton]] gave a successful demonstration using [[diethyl ether]] to medical students at the same venue.<ref>{{cite web | vauthors = Morkel H | title=The painful story behind modern anesthesia | url=https://www.pbs.org/newshour/rundown/the-painful-story-behind-modern-anesthesia/ |publisher=pbs.org| date=16 October 2013 }}</ref> Morton, who was unaware of Long's previous work, was invited to the [[Massachusetts General Hospital]] to demonstrate his new technique for painless surgery. After Morton had induced anesthesia, surgeon [[John Collins Warren (surgeon, born 1778)|John Collins Warren]] removed a tumor from the neck of [[Edward Gilbert Abbott]]. This occurred in the surgical amphitheater now called the [[Ether Dome]]. The previously skeptical Warren was impressed and stated, "Gentlemen, this is no humbug." In a letter to Morton shortly thereafter, physician and writer [[Oliver Wendell Holmes Sr.]] proposed naming the state produced "anesthesia", and the procedure an "anesthetic".<ref name="Fenster2001"/>

Morton at first attempted to hide the actual nature of his anesthetic substance, referring to it as Letheon. He received a [[US patent]] for his substance, but news of the successful anesthetic spread quickly by late 1846. Respected surgeons in Europe including [[Robert Liston|Liston]], [[Johann Friedrich Dieffenbach|Dieffenbach]], [[Nikolay Ivanovich Pirogov|Pirogov]], and [[James Syme|Syme]] quickly undertook numerous operations with ether. An American-born physician, Boott, encouraged London dentist [[James Robinson (dentist)|James Robinson]] to perform a dental procedure on a Miss Lonsdale. This was the first case of an operator-anesthetist. On the same day, 19 December 1846, in Dumfries Royal Infirmary, Scotland, a Dr. Scott used ether for a surgical procedure.<ref>{{cite journal | vauthors = Baillie TW | title = The first European trial of anaesthetic ether: the Dumfries claim | journal = British Journal of Anaesthesia | volume = 37 | issue = 12 | pages = 952–57 | date = December 1965 | pmid = 5323141 | doi = 10.1093/bja/37.12.952 | doi-access = free }}</ref> The first use of anesthesia in the Southern Hemisphere took place in [[Launceston, Tasmania]], that same year. Drawbacks with ether such as excessive vomiting and its explosive [[flammability]] led to its replacement in England with [[chloroform]].{{citation needed|date=May 2019}}

Discovered in 1831 by an American physician Samuel Guthrie (1782–1848), and independently a few months later by Frenchman Eugène Soubeiran (1797–1859) and Justus von Liebig (1803–1873) in Germany, chloroform was named and chemically characterized in 1834 by Jean-Baptiste Dumas (1800–1884). In 1842, Dr [[Robert Mortimer Glover]] in London discovered the anaesthetic qualities of chloroform on laboratory animals.<ref>{{cite journal |last1=Defalque |first1=R. J. |last2=Wright |first2=A. J. |title=The short, tragic life of Robert M. Glover |journal=Anaesthesia |date=April 2004 |volume=59 |issue=4 |pages=394–400 |doi=10.1111/j.1365-2044.2004.03671.x |pmid=15023112 |s2cid=46428403 }}</ref>

In 1847, Scottish obstetrician [[James Young Simpson]] was the first to demonstrate the anesthetic properties of chloroform on humans and helped to popularize the drug for use in medicine.<ref name=eb>{{cite encyclopedia|title=Sir James Young Simpson|url=https://www.britannica.com/EBchecked/topic/545447/Sir-James-Young-Simpson-1st-Baronet|encyclopedia=Encyclopædia Britannica|access-date=23 August 2013}}</ref> This first supply came from local pharmacists, James Duncan and [[William Flockhart]], and its use spread quickly, with 750,000 doses weekly in Britain by 1895. Simpson arranged for Flockhart to supply [[Florence Nightingale]].<ref>{{Cite journal|last=Worlin|first=P. M.|date=1998|title=Duncan and Flockhart: the Story of Two Men and a Pharmacy|journal=Pharmaceutical Historian|volume=28| issue = 2 |pages=28–33|pmid=11620310}}</ref> Chloroform gained royal approval in 1853 when [[John Snow (physician)|John Snow]] administered it to [[Queen Victoria]] when she was in labor with  [[Prince Leopold, Duke of Albany|Prince Leopold]]. For the experience of child birth itself, chloroform met all the Queen's expectations; she stated it was "delightful beyond measure".<ref>{{cite news|title=Queen Victoria uses chloroform in childbirth, 1853|url=https://www.ft.com/content/1e2ce5d6-aad3-11dd-897c-000077b07658 |archive-url=https://ghostarchive.org/archive/20221210/https://www.ft.com/content/1e2ce5d6-aad3-11dd-897c-000077b07658 |archive-date=10 December 2022 |url-access=subscription|newspaper=Financial Times|date=28 November 2017}}</ref>  Chloroform was not without fault though. The first fatality directly attributed to chloroform administration was recorded on 28 January 1848 after the death of Hannah Greener.<ref>{{cite journal | vauthors = Wawersik J | title = [History of chloroform anesthesia] | journal = Anaesthesiologie und Reanimation | volume = 22 | issue = 6 | pages = 144–52 | date = 1997-01-01 | pmid = 9487785 }}</ref> This was the first of many deaths to follow from the untrained handling of chloroform. Surgeons began to appreciate the need for a trained anesthetist. The need, as Thatcher writes, was for an anesthetist to "(1) Be satisfied with the subordinate role that the work would require, (2) Make anesthesia their one absorbing interest, (3) not look at the situation of anesthetist as one that put them in a position to watch and learn from the surgeons technique (4) accept the comparatively low pay and (5) have the natural aptitude and intelligence to develop a high level of skill in providing the smooth anesthesia and relaxation that the surgeon demanded"<ref>{{Cite book| vauthors = Nagelhout J |title=Nurse Anesthesia|publisher=Elsevier|year=2018|isbn=978-0323443920|location=St. Louis Missouri|pages=2–4}}</ref> These qualities of an anesthetist were often found in submissive [[medical school|medical students]] and even members of the public.  More often, surgeons sought out nurses to provide anesthesia. By the time of the [[American Civil War|Civil War]], many nurses had been professionally trained with the support of surgeons.

John Snow of London published articles from May 1848 onwards "On Narcotism by the Inhalation of Vapours" in the London Medical Gazette.<ref>{{cite journal| vauthors = Zorab J |title=On Narcotism by the Inhalation of Vapours by John Snow MD|journal=Journal of the Royal Society of Medicine|date=June 1992|volume=85|issue=6|pages=371|pmc=1293529}}</ref> Snow also involved himself in the production of equipment needed for the administration of [[inhalational anesthetics]], the forerunner of today's [[anaesthetic machine|anesthesia machines]].<ref>{{Cite web|url=http://patinaa.blogfa.com/?p=2|title=Anesthesia LAND|website=patinaa.blogfa.com|access-date=2016-12-02|archive-url=https://web.archive.org/web/20161203123748/http://patinaa.blogfa.com/?p=2|archive-date=3 December 2016|url-status=dead}}</ref>{{unreliable source|date=December 2024}}

Alice Magaw, born in November 1860, is often referred to as "The Mother of Anesthesia". Her renown as the personal anesthesia provider for William and Charles Mayo was solidified by Mayo's own words in his 1905 article in which he described his satisfaction with and reliance on nurse anesthetists: "The question of anaesthesia is a most important one. We have regular anaesthetists [on] whom we can depend so that I can devote my entire attention to the surgical work." Magaw kept thorough records of her cases and recorded these anesthetics. In her publication reviewing more than 14,000 surgical anesthetics, Magaw indicates she successfully provided anesthesia without an anesthetic-related death. Magaw describes
in another article, "We have administered an anesthetic 1,092 times; ether alone 674 times; chloroform 245 times; ether and chloroform combined 173 times. I can report that out of this number, 1,092 cases, we have not had an accident". Magaw's records and outcomes created a legacy defining that the delivery of anesthesia by nurses would serve the surgical community without increasing the risks to patients. In fact, Magaw's outcomes would eclipse those of practitioners today.<ref>{{cite journal |last1=Goode |first1=Victoria |title=Alice Magaw: A Model for Evidence-Based Practice |journal=AANA Journal |date=February 2015 |volume=83 |issue=1 |pages=50–55 |pmid=25842634 |url=https://www.aana.com/docs/default-source/aana-journal-web-documents-1/alice-magaw-0215-pp50-55.pdf?sfvrsn=ccd848b1_4}}</ref>

The first comprehensive medical textbook on the subject, ''Anesthesia'', was authored in 1914 by anesthesiologist Dr. [[James Tayloe Gwathmey]] and the chemist Dr. [[Charles Baskerville]].<ref name=":1">{{cite journal | vauthors = Cope DK | title = James Tayloe Gwathmey: seeds of a developing specialty | journal = Anesthesia and Analgesia | volume = 76 | issue = 3 | pages = 642–47 | date = March 1993 | pmid = 8452281 | doi = 10.1213/00000539-199303000-00035 | s2cid = 7574462 }}</ref> This book served as the standard reference for the specialty for decades and included details on the history of anesthesia as well as the physiology and techniques of inhalation, rectal, intravenous, and spinal anesthesia.<ref name=":1" />

Of these first famous anesthetics, only nitrous oxide is still widely used today, with chloroform and ether having been replaced by safer but sometimes more expensive [[general anesthetic]]s, and cocaine by more effective [[local anesthetic]]s with less abuse potential.<ref>{{Cite web |title=Celebrating 75 years of Anaesthesia: our past, present and future {{!}} Association of Anaesthetists |url=https://anaesthetists.org/Home/Celebrating-75-years-of-Anaesthesia-our-past-present-and-future |access-date=2022-10-17 |website=anaesthetists.org}}</ref>