Jerry B. Vannatta, M.D.
University of Oklahoma College of Medicine

Stephanie J. Snow’s book, Blessed Days of Anaesthesia: How Anaesthetics Changed the World (Oxford, 2008), is an interesting addition to the collection of works detailing this history. Its subtitle—how anesthetics changed the world—makes a promise unique to the collection of histories already in existence. She is claiming that the discovery of pharmacological applications to treat and prevent pain changed the way Western civilization views the world. This historical perspective asserts anesthesia as a cause of cultural change as opposed to its effect, as claimed by most medical historians. Snow’s work delights the reader with a story of victory over pain through the unique lenses of religion, gender issues, and literary figures.

Other authors in this field—notably, Victor Robinson, M.D. and Thomas Keys, A.B., M.A—organize their texts around the primary scientific characters involved in the discovery and popularization of anesthesia, using development of specific techniques and equipment to tell the story.[1] René Fülöp-Miller presents the story framed by the author’s own experience with chronic pain.[2] W. Stanley Sykes discusses Victorian culture as a milieu in which this discovery was made and uses the example of gynecologic anesthesia as a meaningful example of success,[3] but Snow’s new book uniquely argues that anesthesia was an agent of change in the way Western culture viewed religion, in the way women gained power during the mid-nineteenth century, and the role literary figures had in “leading” the profession of medicine to its general acceptance. In addition, Snow’s story articulates clearly how mumpsimus—clinging tightly to beliefs that have been shown to be false with evidence—played an enormous role in delaying the use of anesthesia in the general population for decades after its discovery.

Snow argues that religion—specifically Christianity—played an important role in delaying the acceptance of the use of anesthesia to alleviate pain and suffering. In the introduction to the book she states, “In Christian theology, pain entered the world after Eve’s disobedience in the Garden of Eden and remained central to humanity” (15). In a Christian framework, suffering during childbirth was considered to be a necessary and permanent reminder of Eve’s sin. The biblical quote “in sorrow shalt thou bring forth children” (Gen. 3:16) was commonly enjoined as an argument to disallow the use of ether or chloroform in childbirth. Christian beliefs that to avoid pain was against God’s will were common, especially in rural America in the middle of the nineteenth century, and this too impeded the acceptance of anesthesia. Snow goes on to demonstrate that it was to a large extent women—requesting ether and chloroform during delivery—that facilitated a change in the interpretation of these biblical ideas and religious mores, ushering in an acceptance by not only society in general but the medical profession of this humane discovery.

Snow’s discussion of the role played by literary figures of the day in telling this history was for me among its most enjoyable features. She tells of Patrick Brontë, father of Charlotte, Anne, Branwell, and Emily, writing in the Leeds Mercury in 1847 of the “good tidings” of breathing “the vapor of ether” and how every friend of humanity should patronize it (53). Four years later, Charles Dickens extols the benefits of chloroform in his Household Words (1851). Fanny Longfellow, wife of poet Henry Wadsworth Longfellow, was the first woman to use ether in childbirth. Charles Darwin administered chloroform to his wife Emma during childbirth, keeping her unconscious for one and a half hours. He was a committed devotee to its use and wrote about it extensively. Chloroform and ether became common literary devices for these authors. Stories and novels by Charles Dickens (A Tale of Two Cities [1859]) and Sir Arthur Conan Doyle (“The Adventure of the Three Gables” [1926]) aided in spreading the news of this medical discovery and its potential benefit to the general public. Snow uses these and other literary examples to deliver the promise of the subtitle of the book—how anesthetics changed the world.

This author deftly uses the chapter “On Battlefields” to highlight the Crimean War as well as the Mexican–American War and the American Civil War. In an informative and entertaining discussion she explores the differences in adoption of ether and chloroform among American, French, and Russian military physicians. In doing so she exposes subtle differences in the culture and belief systems among these countries in the nineteenth century. This chapter discusses the influence of Florence Nightingale in the Crimean War and Clara Barton and Louisa May Alcott in the American Civil War, returning to the important role played by women in this history. Here also the author returns to a literary piece in a discussion of Alfred, Lord Tennyson’s 1854 poem “Charge of the Light Brigade,” inspired by the Battle of Balaclava and the slaughter of British soldiers in the Crimea.

Compared with the detailed treatment of the early development of anesthesia in the first six chapters, Snow rushes through the later developments of the field, especially the discoveries of the twentieth century. But overall, this book delivers what its title promises. Using an accessible discussion of nineteenth-century culture in the United States and Great Britain, it makes the argument that relief of pain in childbirth, with surgical and dental procedures, and on the battlefield, changed society’s attitudes and beliefs regarding pain. She argues that the relief of pain in surgery was central to the changing of the cultural understanding of pain. She articulates, I think convincingly, that anesthesia was a catalyst in the development of humanistic approaches to pain and suffering in general. It led to challenges of society’s paternalistic and religious ideas in such a profound way that Western culture was forever changed.

NOTES

[1]   See Victor Robinson, Victory Over Pain: A History of Anesthesia (New York, 1946), and T. E. Keys, A History of Surgical Anesthesia (New York, 1963).

[2]   René Fülöp-Miller, Triumph Over Pain, trans. Eden and Cedar Paul (Indianapolis and New York, 1938).

[3]   W. Stanley Sykes, Essays on the First Hundred Years of Anaesthesia (Edinburgh, 1960).