Humphrey Davy and Nitrous from the Age of Wonder

 Yet there was one major scientific discovery which hovered tantalisingly close to Davy's grasp. Had he fully seized it, he would have made himself, Beddoes and the Pneumatic Institute famous forever. Though nitrous oxide could not cure physical disease, it could do something just as valuable: it could temporarily suspend physical pain, or at least the sensation of pain. The gas profirided the key to an entirely new science, that of anaesthetics: literally, 'the negation or blocking of feelings'. Characteristically, Davy pounced upon the new concept, asserting in his laboratory notebook that the gas could certainly be used for suppressing even 'intense physical pain'. He speculated on the physiological mechanism: 'Sensible pain is not perceived after the powerful action of nitrous oxide because it produces for the time a momentary condition of other parts of the nerve connected with pleasure.'  He successfully tried treating his own toothache from impacted wisdom teeth with nitrous oxide. 'The pain diminished after the first four or five inspirations.' But the effect did not last, and he did not take the next logical step of having the offending teeth removed while under the influence of nitrous oxide. The gas was seen as blotting out the consciousness of pain with pleasure, rather than suspending consciousness itself. Yet in many of his extreme experiments Davy had deliberately pushed himself into unconsciousness, and he knew this could be done without harm. Later, writing up his experiments for Researches, he more explicitly stated the gas's surgical potential: 'As nitrous oxide in its extensive oper-ation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations in which no great effu-sion of blood takes place:131 He added the caution about bleeding not to limit the gravity of operations in which anaesthesia might be applied, but because he believed nitrous oxide was only absorbed through venous blood. It might therefore become ineffective during a major operation when extensive haemorrhaging took place. Part of Davy's originality was simply to conceive of the radical idea of pain-free surgery. He later had long discussions with Coleridge about the nature and significance of human pain. Coleridge wondered, for exam-ple, why God might have created a world in which human childbirth, one of the great productive aims of nature, was so painful as well as so dangerous for women.  This was a prophetic speculation, as it turned out, for nitrous oxide mixed with oxygen eventually became one of the standard anaesthetic procedures used during labour, especially if difficult or prolonged. When he read Researches in December 1800, sent to him by Longman with the new edition of Lyrical Ballads, Coleridge wrote to Davy wondering if he had had further communication with the leading London surgeon Sir Anthony Carlisle, 'concerning Pain, as they had all once discussed it during his London visit. 'It is a subject which exceedingly interests me — I want to read something by somebody expressly on Pain, if only to give arrangement to my own thoughts, though if it were well treated, I have little doubt it would revolutionise them.' He later urged Davy himself to write such a philosophical treatise on pain. Many standard operations in the early nineteenth century — being cut for kidney stone, having teeth removed, or a wounded limb amputated — were unimaginably painful. The pain also caused shock, which itself could kill. The only known form of painkiller — the soldier's use of alcohol — was largely a method of controlling terror and deadening shock, not true anaesthesia. But having made his momentous suggestion, Davy failed to pursue it. Characteristically, he rushed impetuously on to other discoveries. Although he published his conclusions, neither he nor Beddoes saw that the immense possibilities of anaesthesia were taken up. The loss to human well-being, in the alleviation of terror and suffering on the operating table for another two generations, was incalculable. Fanny Burney's account of her own mastectomy — having a breast removed, without anaesthetics, by a military surgeon in her Paris apartment in 1811 — is perhaps more shattering than any account of a limb amputated on the battlefield during the Napoleonic Wars. It would seem that Davy missed the greatest medical opportunity of his early career. As late as 1831, his polemical biographer J.A. Paris dis-missed the whole nitrous oxide experiment as absurd. 'It will be admit-ted that there must have been something singularly ludicrous in the whole exhibition. Imagine a party of grave philosophers, with bags of silk tied to their mouths, stamping, roaring and laughing about the apartment. ' Nitrous oxide only began to be tried again experimentally some forty years later. This was in America, when Dr Horace Wells had a tooth extracted under the gas during a demonstration lecture in Connecticut in December 1844. Wells awoke, announced that he had not felt `a pin-prick, and proclaimed 'a new era in tooth-pulling'. But it was quite another chemical, ether, that provided the first true anaesthesia for major operations. The American surgeon William Thomas Morton successfully amputated a man's leg under ether at the Massachusetts General Hospital on 16 October 1846. Two months later, on 31 December, a British surgeon, Mr Lansdowne, performed a similar amputation at the Bristol General Hospital. Thereafter anaesthesia by ether was used widely in both the Crimean and the American Civil War. But the final acceptance of anaesthesia in Britain did not really come until Queen Victoria admitted to having taken a whiff of chloroform during the birth of her son Prince Leopold in April 1853.