For most of human existence,  if you needed major surgery,   there was a solid argument for you to just say, “No thanks, I’ll just take my chances with  this rotten tooth or cancerous tumor”.

Sure, we had some methods of pain  relief…like super addictive opium,   also addictive alcohol, and a bucket of ice, or hypnosis. But a lot of the time, surgeons just didn’t bother.

The best they could do was get  in and out as fast as possible. And then, anesthesia came along. To both numb the pain and knock you unconscious.

Anesthesia changed surgery forever, even if  we’re still a little hazy on how it works. But the man who introduced it to the  world wasn’t a celebrated scientist. In fact, you could say he  put the con in unconscious. [♪ INTRO]

On October 13, 1804, a Japanese surgeon named Seishū Hanaoka  removed a tumor from a woman’s breast.

To dull her senses and put her to sleep, he gave  her an herbal concoction called Mafutsusan. And this wasn’t just something he threw together,  he had been working on this recipe for years. To many medical historians,   this was the first documented use of  a surgery performed with anesthesia.

But around the same time Hanaoka was experimenting  with his solution to the surgery problem,   a brazen young research assistant in  England was laying the groundwork for   the global anesthesia revolution…which  wouldn’t happen for another four decades. Which brings us to nitrous  oxide, a.k.a. laughing gas. Although our Script Editor JD can testify  that…when she had to inhale a bunch prior   to her wisdom teeth extraction…she  didn’t utter as much as a chuckle.

The discovery of nitrous oxide is  usually credited to Joseph Priestley,   based on some experiments he ran in 1772. But since he was a chemist, not a doctor,   his discovery was really only celebrated in  a “cool, this molecule exists” kind of way. Certainly not in a “This is a  medical marvel” kind of way.

Nearly three decades later, Humphrey Davy  did what scientists liked to do back then. By which I mean he experimented on himself,  huffing a bunch of different gases to help   his boss at the Pneumatic Medical Institution  find something that could help cure diseases. Yes John, including tuberculosis.

Davy was playing a gaseous  game of Russian roulette. But compared to the corrosive  nitric oxide and poisonous   carbon monoxide that he’d already  sampled, nitrous oxide was a win. He described the experience as  “thrilling”...including how in the   middle of his high, he exclaimed  “Nothing exists but thoughts!” Which is certainly a thought.

With such a high Yelp review, of course  all his friends wanted to give it a try. You know, for “science”. And Davy, ever the researcher,  collected and published almost 20   accounts from the people participating  in their own personal “experiments”.

With that many people trying it, Davy finally   noticed the symptom most important for  this episode: the drug could ease pain. In his book published in 1800,   Davy reports nitrous oxide relieving  his own head and tooth aches. He also wrote that the gas might have a future  in surgery, but he never followed up on that.

Instead, people dabbled in nitrous oxide for both  recreational and scientific whims until 1844,   when it caught the eye of a  dentist named Horace Wells. Or rather, a man high on laughing  gas caught his eye…who had injured   himself on a bit of furniture,  and walked away none the wiser. Wells was immediately inspired.

The next morning, he sourced  some of the gas for himself,   and had one of his teeth  extracted by a dental student. He called it the “greatest discovery ever made”. After using it on his own dental  patients, Wells was so gassed up   about its potential that he approached one  of the most famous surgeons in the country:   John Warren, at Massachusetts General Hospital.

He wanted a public demonstration to  show how great nitrous oxide was. Warren agreed, but the details of this  1845 demonstration are a bit murky. Doctors and dentists were apparently  not the best record keepers at the time.

And some of the first-hand  accounts that historians   rely on come from decades after the actual event. But the thing all sources agree on  is that it was…a phenomenal disaster. Since Wells only had so many teeth  of his own…and he also had to run the demo…  a student volunteered to have one extracted.

In front of a large audience,  Wells then administered the gas,   the procedure began, and then…according  to reports…the student shouted in pain. The audience was not forgiving. They criticized the entire affair, and after  that, Wells kind of slinks out of our story.

He tried to explain that he’d simply failed  to administer enough gas, but it's pretty   tough to recover from such a blunder in  front of so many medical professionals. Enter, William

Morton: a dentist  and medical student in Boston. He had both trained under and worked with Wells,   and by some accounts helped  organize the demonstration. But that failed demo didn’t stop Morton from   picking up right where Wells left  off… just not with nitrous oxide. Morton was putting his money on sulfuric ether.

Which, despite the name, doesn't actually have any sulfur in it. But to make it, you can mix  sulfuric acid and ethanol. I’ll just call it “ether” from now on.

In Morton’s day, the word “ether” all by itself  just vaguely meant any super volatile liquid. If a compound readily vaporized,  then it was dubbed an ether. But these days, when people say “ether”,   they almost always mean the stuff  that Morton was experimenting with.

Now, sulfuric ether was far from a new drug. First documented in the 1500s, it  acts on receptors in the central   nervous system to slow the brain down  and induce calm, euphoria, and sedation. With that combo of effects, it was immediately  clear this had to be used in surgery… Just kidding.

It was quickly adopted as a party  drug, and used for miscellaneous   medical needs like headaches, respiratory  infections, convulsions, and childbirth. Exactly what inspired Morton to turn to  ether as an anesthetic is up for debate. He said it was all his own idea.

But his fellow dentist Wells, and another  colleague…a chemist, Charles Jackson… they both argued that they had discussed using ether  as anesthesia, too, and deserved some credit. Meanwhile, one Dr. Crawford Long had  been using it since 1842 in the state of Georgia.   So Morton definitely wasn’t the first to use ether for surgery,   but he sure delivered it to  fame with his showmanship.

Morton followed in the footsteps of  his former teacher, and requested a   public demonstration of ether's efficacy. Yes, with the same Dr. John  Warren presiding and everything.

It takes a special kind of person to see  Wells’s failure and think “I wanna do that”,   but Morton had a reputation for seizing any  opportunity he thought he could monetize. In the past, that usually meant forging letters  of recommendation or scamming creditors. In other words, he was a bit of a Con Man.

But he was willing to give peddling ether a try. Dr. Warren either loved to let  dentists embarrass themselves,   or really wanted to find an anesthetic that  worked, because he agreed to another demo.

He even raised the stakes, because instead of a tooth extraction, this time it was going to be a tumor removal from someone’s neck. According to records, Morton took  this responsibility super seriously,   as evidenced by the fact that he picked up a  glass inhaler the morning of the surgery…which   he special-ordered to conceal the fact that he  was using something as straightforward as ether. Also, he showed up late.

He didn’t even have time to  test the device beforehand. But Morton was a betting man. On October 16, 1846, he used  ether to put a patient to sleep   before Warren tagged in to remove a 3-inch tumor.

By all accounts, the  demonstration was a huge success. The patient didn’t react when he was  first cut into, and even during the   more invasive parts of surgery he only moved a  bit, later claiming to have felt minimal pain. More surgeries under ether were performed  at Mass General over the next few days.

None of them were perfect, but the patients fell  asleep, and reported far less pain than usual. Hospitals were quick to make the  use of ether in surgeries standard. And just one month after Morton’s demo,   it was rebranded as an anesthetic  by Oliver Wendell Holmes.

No, not the Supreme Court justice. That guy’s dad. Now, October 16th is celebrated as “Ether Day”,  or alternatively, “World Anaesthesia Day.” Even though it wasn’t the first use of  ether, it was its really first public debut.

And it marked a turning point where anesthesia   started being used in tons of  procedures around the world. Morton, meanwhile, got credit  for putting on the demonstration,   and proving that ether was  an effective anesthetic. But ether was public domain, as far as  intellectual property law was concerned.

So despite his best efforts to try and disguise  it, patent it, sell the flimsy inhaler,   and lobby the government for a reward, it didn’t  turn into the golden goose he’d hoped for. All his efforts strained his  relationships with Wells and Jackson,   and tarnished his reputation with  the greater medical community. Whatever his true intentions deep down inside, it  sure looked like he was just in it for the money.

Not, you know, trying to  alleviate people’s suffering. And speaking of suffering,  all three of these men…Morton,   Wells, and Jackson, all had pretty tragic endings. But I’ll spare you the details.

As for ether, it spent about  a century in the limelight,   as a ton of anaesthetic alternatives sprouted up. For example, chloroform was introduced just a year  after ether, by Scottish doctor James Simpson. He was looking for something to aid in childbirth.

In 1853, Queen Victoria received chloroform  during her own labor and delivery,   so it was quickly welcomed  into the surgical theater. But by the 1930s, it was clear that  chloroform posed a risk to heart health,   and wasn’t as safe as ether, so it was phased out. It was also around this time  that anesthesiology became a   proper scientific field, which encouraged  the development of more anesthesia drugs.

The gas cyclopropane was introduced in 1933. Patients could recover very quickly  from it, but it was super explosive,   so it didn’t improve much on ether’s dangers. Over the following decades, drugs like  halothane, xenon, and isoflurane were introduced.

Some of those are still used  in general anesthesia, today. There are also different  categories of anesthetics, now. Local anesthetics like lidocaine,   and then liquid anaesthetics delivered  via IV like propofol or ketamine.

You name ‘em, we got ‘em. We can also craft drug cocktails to make sure  patients have all the relief they require. General anesthesia usually involves a  combo of IV drugs and inhaled gases.

Anesthesia has come a long way. But what hasn’t really made nearly as much  progress is how anesthesia actually works. It’s not for lack of trying.

Scientists have spent a lot of time  investigating several different hypotheses. Like maybe anesthesia drugs reduce the signals  traveling between your brain’s neurons to the   point where there’s just not enough metaphorical  hands on deck to maintain consciousness. Or maybe, your brain is a delicate ecosystem of   signals saying things like  “Do this” and “Stop that”.

And it’s not a reduction of signalling,  but an imbalance that knocks you out. Studies also suggest your unconscious self might   remember things without ever sharing  the receipts with your conscious self. And none of this even touches on  what happens when anesthesia fails,   and a patient wakes up in the middle  of surgery but unable to move or speak.

But at least now people are going  to school and learning this stuff,   so you don’t have to rely on a  man who showed up late to your   surgery with a contraption meant  to hide a mysterious miracle gas. [♪ OUTRO]