Thursday, 5 December 2019

The Pain of Preanesthetic Surgery


John Evelyn, the writer diaried : 

That morning my Chirurgeon cut off a poore creaturs Leg,a little under the knee,first cutting the living and untainted flesh above the Gangreene with a sharp knife,and then sawing off the bone in an instant;then with searing and stoopes stanching the blood,which issued abudantly;the stout and gallant man,enduring it with incredible patience,and that without being bound to his chaire,as is usual in such painefull operations,or hardly making a face or crying oh.

- 1672 



John Evelyn
Surgery gaits crippled without anaesthesia today.However,there was a period of preanesthetic surgery - where chopping and drilling were done on patients with intact sensation and pain receptivity.

The patients got tied down,sometimes in a chair with strong assistants immobilising them.

Before the use of ether or chloroform in the mid-19th-century, soporifics were used to dampen the awareness of the patient.

Survivors of preanesthetic surgery : 



(1) In 1823,Surgeon Robert Liston ( pic above ) excised a scrotal tumour which measured 107 cm in circumference and weighed 20 kg.The estimated blood loss was massive that it rendered the patient pulseless.He later had himself treated with a pint of strong whiskey ( which acts as a positive inotrope ) that recovered him.Three weeks later,he walked out of the hospital

(2) Fanny Burney,a novelist underwent mastectomy for breast cancer.She describes : 

When the dreadful steel was plunged into the breast - cutting through the veins - arteries - flesh - nerves - I needed no injunctions not to restrain my cries.I begana scream that lasted unintermittingly during the whole time of incision - and I almost marvel that it rings not in my Ears still ! so excruciating was the agony.


(3) McDowell ( pic above ) ,a US country surgeon removed a pathological ovary of Mrs Crawford using his kitchen table to operate on ! She recited psalms and hymns during this 25 minute procedure where her abdomen was cut and explored..She survived and lived up to 78.

The pain of getting butchered alive would be more traumatising than the disease itself.Let us take a moment of gratitude to the discovery of anesthesia.

The People's Journal of London in 1847 quotes : 

Oh,what a delight for every feeling heart to find a new year ushered in with the announcement of this noble discovery of the power to still the sense of pain,and veil the eye and memory from all the horros of an operation .. WE HAVE CONQUERED PAIN.

Team and I during 4th year MBBS with Dr Prabha - Anaesthesiologst


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