Imagine living in 1800 and needing to have a medical operation.
This is a time before modern anesthesia and before the age of antibiotics.
Pain, like infection, is such a significant issue that some operations are avoided and
the development of surgical practice is stunted.
Anesthesia technically exists by this time, such as with opium, but it's not applied in
the US and Europe as one would hope.
Though only a couple hundred years ago, this a primitive time.
Patients are often held down, forced to deal with pain through grit, not pharmacology.
The germ theory of disease hasn't even developed, creating a slew of other problems whenever
surgery is needed.
Penicillin wouldn't be on the scene until the following century and surgeons carried
out operations without proper handwashing.
After an operation was complete, it was common to have painful complications in the aftermath.
Though a proper anesthetic couldn't fix everything, it could drastically improve the state of
1800s medicine.
This brings us to Horace Wells, whose life should have ended with fame and respect, but
instead ended with tragedy.
Horace Wells first encountered nitrous oxide in December 1844, though the drug's origin
story is decades older.
The gas had been around since at least 1772, when Joseph Priestley isolated it.
For more than 70 years it was regarded as either a recreational drug or a horrific cause
of disease and destruction.
Samuel Mitchill, an American physician, believed Nitrous Oxide was a highly toxic gas responsible
for many diseases.
He called it "the contagion of the plague," a substance capable of causing the "sudden
extinction of life."
Indeed, this is the way some medical professionals thought in the 1700s.
Needless to say, I'm glad things are continuously improving.
Before Wells learned of the gas, Humphry Davy, a chemist in his early 20s, proved the critics
of Nitrous oxide were wrong.
He found it offered pleasant effects and, as long you used it wisely, was free of physical
harm.
Davy triumphantly announced he had "completely overturned...Mitchill's theory of contagion"
in 1799.
In addition to causing brief periods of euphoria, Davy found it alleviated headaches and tooth
pain.
But no one realized Davy had described a potential analgesic and anesthetic.
More than a century later, a 1965 paper discussed how if things went differently, Davy's employer,
The Pneumatic Institution, "could have evolved into the first Anaesthetic Research Institution."
But alas, that's not how things went.
Even the famous surgeon Astley Cooper didn't realize Nitrous Oxide's potential when he
inhaled the gas in 1800.
Who knows how much pain Cooper's patients could have been sparred if more attention
was given to Davy's description.
The gas was relegated to public entertainment for many years.
Due to ignorance, not malice, surgical pain would go untouched by the relief of Nitrous
Oxide.
Traveling showmen toured the United States demonstrating nitrous oxide's properties in
the first half of the 1800s.
Among those showmen was Samuel Colt, designer of one of the first revolvers, and...more
relevant to our story...
Gardner Quincy Colton, a dentist.
On December 10, 1844, Colton organized an entertainment event in Hartford, Connecticut's
Union Hall.
Horace Wells, an American dental surgeon, was in the audience.
He watched as one of the participants in the show, Samuel Cooley, inhaled nitrous oxide.
As he staggered around, Cooley injured his leg, yet he was seemingly oblivious to the
pain.
Wells immediately took notice.
The next day, he insisted he receive the gas while having one of his teeth extracted.
Colton was reluctant, but he agreed to serve as the anesthesiologist while a dentist, Dr.
John Riggs, removed a wisdom tooth.
When he emerged from the anesthesia having experienced no pain, Wells proclaimed it was
a "new era in tooth pulling,"
Within a month, Wells performed 12 to 15 successful trials of nitrous oxide during dental procedures.
He had no intention of keeping the gas' utility to himself, so he started planning a trip.
After debating between Boston and New York, he decided to visit the medical community
of Boston in January 1845.
He advertised a public test of nitrous oxide in local papers.
The Boston Bee reported, "A dentist in Hartford, (Conn.) has adopted the use of nitrous oxide
gas, in teeth pulling.
It is said that after taking this gas the patient feels no pain."
And posts in the Daily Evening Transcript called on local dentists to provide patients
for Wells to work on.
Though he knew nitrous oxide worked, most of the medical practitioners in Boston who
voiced their opinion didn't believe him.
Before his public test, Wells addressed students of the famous surgeon John Collins Warren
at Mass General Hospital.
After speaking to the students, Wells may have given them nitrous oxide, though the
details aren't entirely known.
Later that evening was the fateful experiment.
Near Mass General, likely at Quincy Hall, Phoenix Hall, or Boylston Hall, Wells prepared
to operate on a patient in front of local physicians and students.
Unlike in his earlier trials, the patient let out a cry, suggesting he was in pain.
Some of the onlookers immediately dismissed everything Wells had claimed.
They even "laughed and hissed," according to some reports.
While the experiment didn't go as planned, the patient still reported the pain was "not
as much as usually attends the operation."
Further, one account claims the patient reported no pain at all upon waking up.
Yet a single vocalization was seemingly enough to sink Wells' chance of convincing the Boston
medical community.
These kinds of standards, however unreasonable though perhaps well-intentioned, have a tendency
to stand in the way of progress.
Wells looked back on the test and determined he may have simply withdrawn the nitrous oxide
bag too soon.
But that didn't matter to the onlookers.
He was laughed out of Boston, not embraced.
For many years, people focused on other inhaled anesthetics like ether and chloroform.
It wasn't long before Wells' health turned for the worse.
He became ill after the Boston trip, possibly in connection with a strong sense of humiliation.
Rather than enhance his reputation, the visit was a failure.
And rather than improve his business, he lost his dental practice back in Connecticut.
"The excitement of this adventure immediately brought on an illness, from which I did not
recover for many months; being thus obliged to relinquish, entirely, my professional business.”
Wells continued to seek public and official recognition as the discoverer of anesthesia.
He largely failed.
Though, to be fair, that title could be misleading.
Earlier doctors who utilized opioid and anticholinergic mixtures surely were practicing some form
of anesthesia long before Wells became entranced by nitrous oxide.
But it's also clear Wells deserved recognition for the kind of anesthesia he successfully
trialled and attempted to promote.
Three years after the Boston incident, Wells' life was a disaster.
While staying in New York City, he threw sulfuric acid on two women.
This was done under the influence of chloroform, a drug that initially gained more attention
than his nitrous oxide.
For his crime, he was arrested and committed to prison.
That same month, on January 23, 1848, feeling ashamed of his actions, Wells committed suicide
by inhaling chloroform and cutting his left femoral artery.
He died unaware of the fact that a few weeks earlier, the Parisian Medical Society, had
officially recognized him as the inventor of anesthesia and made him an honorary member.
It wouldn't be fair to blame his mental state entirely on the humiliation he suffered in
Boston.
But the response he encountered played a notable role in his tragic story.
It took until the 1860s for nitrous oxide to become an established part of dentistry.
The man who helped it gain more attention was none other than Gardner Quincy Colton,
who had introduced Wells to the gas two decades earlier.
From my perspective, this story highlights the need for creative thinkers.
People who can stare at the same thing as everyone else and notice something different.
Though there were hints of people recognizing nitrous oxide's potential, it took decades
to enter medicine.
Horace Wells was utilizing the gas 70 years after its isolation by Priestley.
Those 70 years were filled with pain and suffering than never needed to exist.
Had the medical establishment of 1845 Boston been more open-minded, perhaps it wouldn't
have taken an additional 20 years to enter medicine.
Yet instead of being open-minded, there was a desire among Wells' critics to fully dismiss
nitrous oxide primarily because it was new to them.
Let's hope this kind of mindset stands in the way of fewer innovations in the coming
years.
If you have any questions, feel free to put them in the comments.
You can also email me.
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