Did an interesting operation at the Hospital this morning while the Patient was under the influence of Dr. Morton’s preparation to prevent pain – the Substance employed was Sulphuric Ether –
In this understated diary entry for 16 October 1846, Dr. John Collins Warren gave an account of his role in a world-changing event that had taken place at the Massachusetts General Hospital—the first widely publicized operation using anesthesia.
October 2016 marks the 170th anniversary of a revolution in medicine. Physicians had long sought a method to perform surgical procedures without pain, but anesthesia had far-reaching consequences beyond the relief of human suffering. It no longer was necessary to operate quickly to prevent shock, so surgeons could perform more dramatic and intrusive operations. Ironically, because the introduction of anesthesia predated antiseptic methods by many years, surgery remained very dangerous. Physicians continued to operate in their street clothes using unsterilized instruments and unwittingly causing infections in their patients.
William T. G. Morton, a young Boston dentist, had provided the preparation for the operation and, perhaps of more importance, an inhalation device that reliably produced insensibility—if not unconsciousness—in the patient. Ether had long been known to produce unusual behavior: young people participated in "ether riots"—parties at which they inhaled the gas and lost all inhibitions. Dentists had experimented successfully with both nitrous oxide and ether to perform painless dental procedures and Dr. Crawford Long of Georgia had performed unpublicized operations using ether, but it was the operation on 16 October 1846, performed at Boston's most advanced hospital by its most distinguished surgeon, John Collins Warren—then at the culmination of his distinguished career—that changed everything. Even this was not the first experiment in Boston: Dr. Warren is reported to have turned to the physicians gathered to witness the operation and declared, "This is no humbug." He was referring to a recent, failed attempt by Horace Wells, a dentist from Connecticut, to demonstrate the use of nitrous oxide as an anesthetic that had been dismissed as a "humbug."
The most important outcome of the operation was what happened next—the 16 October operation was immediately and successfully repeated and news of it quickly transmitted to the international medical community. News of anesthesia, a term suggested by Dr. Oliver Wendell Holmes of Boston, quickly spread throughout the United States, on to Europe, and elsewhere in the world. Within a few months of Dr. Warren's public demonstration in Boston, ether was being used by surgeons in Scotland and England, and within a year under battlefield conditions in the Mexican War.
Dr. John Collins Warren was born in Boston in 1778, the son of Dr. John and Abigail Collins Warren, and the nephew of the revolutionary hero, Dr. Joseph Warren. John Collins attended Boston Latin School and Harvard College and then studied medicine with his father, a founder of the Harvard Medical School.
The younger Warren continued his medical education in Europe, studying at hospitals in London, Edinburgh (where he received an honorary medical degree), and Paris before returning to Boston where he assisted his father at the Harvard Medical School and succeeded him as professor of surgery.
Dr. John Collins Warren was a key figure in the founding of the Massachusetts General Hospital (1821) and of the Boston Medical and Surgical Journal. He also had wide-ranging literary, social reform, and scientific interests. He was the president of the Boston Society of Natural History and on "Ether Day" (as 16 October 1846 would come to be known) more of his diary entry is devoted to his efforts to reassemble the skeleton of a mastodon than to his role in an enormously important medical breakthrough. Warren died in 1856. A son, Dr. Jonathan Mason Warren, followed in his footsteps as a surgeon, and Jonathan Mason would be followed in turn by succeeding generations of the Warren medical dynasty.
For his part in the events of Ether Day, William T. G. Morton (1819-1868) was hailed as a benefactor of mankind, but chemist and geologist Charles T. Jackson (1805-1880) soon came forward to claim that he had discovered the anesthetic properties of ether and brought them to Morton's attention; Morton had studied with Jackson and been a boarder in his home. While they attempted to file a joint patent for the "invention" of ether, Morton and Jackson soon fell into a bitter dispute over credit for the discovery. For the rest of their lives, they published claims and counterclaims, eventually drawing almost all of Boston's leading physicians and notable citizens into the controversy.
In 1850, the Academy of Sciences of the French National Institute made a Solomon-like decision to avoid the dispute by awarding both men the prestigious Montyon medal for medicine and surgery and dividing the award between them.
The prize consisted of a gold medal and a cash award. Morton took the medal and then used his portion of the cash award to make an enormous gold collar for his medal. Professor Jackson took his share of the prize entirely in cash, thereby losing an important round of the bitter public relations battle over credit for the "discovery": he had no enormous medal to display. Both men continued to solicit testimonials and awards from scientific organizations and foreign governments until Morton's death in 1868. Jackson lived on until 1880, continuing his crusade for public recognition, but he spent his last years confined to a psychiatric hospital.
Following the example set by Paris, in 1867 Boston raised the first monument in its new public garden not to Morton or Jackson but to the "Good Samaritan"—the relief of human suffering offered by ether. Dr. Oliver Wendell Holmes, a skilled physician who also was a poet and satirical writer, noted that the Ether Monument credited neither Morton nor Jackson, but rather was dedicated to "either."
Edward Gilbert Abbot (1825-1855) is truly the unsung hero of Ether Day. A young Boston housepainter, he entered the Massachusetts General Hospital to have a tumor removed from his neck, but then found himself at the center of an epochal event in the history of medicine when John Collins Warren chose his relatively uncomplicated procedure for the ether experiment. Abbot was questioned many times about the operation and reported that he had not been completely unconscious, but that he had felt no sensation of pain.
John Collins Warren's diary entry for 16 October 1846 and William Morton's Montyon medal are on display at the Massachusetts Historical Society as part of the Society's exhibition, Turning Points in American History. The exhibition examines fifteen decisive moments where the world suddenly changed, or a process began that would change what followed, as described by participants or observers of the events; Ether Day is one of those decisive moments. Turning Points in American History is on display until 25 February 2017. The exhibition is open to the public without charge, Monday through Saturday, 10 AM to 4 PM.
Fenster, Julie M. Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. New York: HarperCollins Publishers, 2001.
Jackson, Charles T. Charles T. Jackson Papers, 1839-1922. Massachusetts Historical Society.
Correspondence and affidavits relating to Dr. Charles T. Jackson's claim to the discovery of the anesthetic use of either.
Morton, William T. G. W. T. G. Morton Papers, 1846-1876. Massachusetts Historical Society.
Papers and testimonials related to Morton's claim that he was the sole discoverer of the use of ether as an anesthetic.
The Russell Museum at the Massachusetts General Hospital in Boston exhibits artifacts and historical materials that describe and explain the history of the hospital and its role in landmark medical breakthroughs including Ether Day
Truax, Rhoda. The Doctors Warren of Boston: First Family of Surgery. Boston: Houghton Mifflin, 1968.
Warren, John Collins. John Collins Warren Papers, 1738-1926. Massachusetts Historical Society.
The John Collins Warren Papers consists of the papers of four generations of the Warren family—many of whom were distinguished physicians including John Collins Warren's father and uncle, John and Joseph Warren, and his son and grandson, Jonathan Mason and John Collins Warren II.
Wolfe, Richard J. Tarnished Idol: William Thomas Green Morton and the Introduction of Surgical Anesthesia, a Chronicle of the Ether Controversy. San Anselmo, California: Norman Publishing, 2001.
Wolfe, Richard J. and Richard Patterson. Charles Thomas Jackson: "The Head Behind the Hands": Applying Science to Implement Discovery and Invention in Early Nineteenth Century America. Novato, California: HistoryofScience.Com, 2007.