Pirogov is considered the greatest Russian surgeon and one of the greatest military surgeons of all time. He was among the first in Europe to employ ether anesthesia. He served in the Crimean campaign and was responsible for the introduction there of female nursing of the wounded. This edition in German predates the first edition in Russian.

The most popular textbook on the subject for many years. Erichsen was surgeon to University College Hospital, London, and Lister served as his house surgeon.

Pravaz invented galvanocautery.

Middeldorpf improved the galvano-cautery and introduced it in major surgery.

Sims, famous American gynecologist, introduced a silver wire suture, in order to avoid sepsis. See No. 6037.

Chassaignac, who introduced india-rubber tubes to drain abscesses, put the whole subject of surgical drainage on a scientific and methodical footing.

A profound intellect in 19th-century American surgery, Gross was both a surgical innovator and an outstanding author of numerous works that became classics. This massive treatise containing nearly 2500 pages was intended to be “the most elaborate, if not the most complete treatise in the English language”. 

Billroth, professor of surgery at Zürich and Vienna, was the founder of the Vienna School of Surgery. He has also been called the founder of modern abdominal surgery, and he was one of the first to introduce antisepsis into the Continental operating room. The above work, which placed him in the front rank, was translated into ten languages. English translation from the 4th edition as General surgical pathology and therapy, N. Y., 1871, and from the 8th German edition, 2 vols., London, New Sydenham Society, 1877-78. Biography by K. B. Absolon, 3 vols., Lawrence, Kansas, 1979-1987.

Hilton, surgeon to Guy’s Hospital, suggested that symptoms are disordered reflexes. He advocated complete rest in the treatment of surgical disorders of all parts of the body. Second and later editions were entitled On rest and pain. The timeless aspect of Hilton's basic advice that rest frequently eliminates pain, and that much pain will pass if the afflicted part of the body is rested, caused the book to remain in print for more than a century.

Rizzoli was Professor of Surgery at Bologna and an outstanding operative surgeon. He introduced a compressor for aneurysms, a tracheotome, cystotome, lithotrite, enterotome, osteoclast, and performed acupressure as early as 1854. Digital facsimile from the Wellcome Library, Internet Archive at this link.

Esmarch bandage for surgical hemostasis. English translation New Sydenham Society, 1876.

Introduction of forcipressure in the control of hemorrhage. Republished in book form, 1875.

Verneuil, Paris surgeon, introduced forcipressure in hemorrhage (see No. 5612), dry bandaging, and iodoform in the treatment of abscesses. All his works are included in his Mémoires.

Paquelin introduced a thermocautery (“Paquelin’s cautery”).

Spencer Wells forceps.

“Volkmann’s ischemic contracture” first described. English translation in Bick, Classics of orthopaedics.

Introduction of iodoform dressing in surgery.

Rosenbach proved that streptococci and staphylococci are distinct and differentiated two strains of staphylococci (“aureus” and “albus”). He cultured cocci from a considerable range of septic conditions, thus more accurately defining their pathological signficance for humans, and confirmed Pasteur’s prediction that acute osteomyelitis was a “furuncle of the bone marrow” (Foster).

Kocher introduced silk sutures.

Senn made important experimental studies on air embolism, introduced a method of diagnosing intestinal perforation by means of insufflation of hydrogen (see No. 3494), and used X-rays in the treatment of leukemia. He was professor of surgery at Rush Medical College.

The most comprehensive trade catalogue of medical and surgical instruments and equipment published in America during the 19th century. Reprinted with introduction by James M. Edmondson and F. Terry Hambrecht, San Francisco: Norman Publishing & Boston: The Printers’ Devil, 1989.

Discovery of Staph. epidermidis (albus) and its relation to the infection of wounds.

Crile saw and recorded elevations in systemic and portal venous pressures under experimental shock.

An encyclopedic work that described illustrated and analysed the entire range of instrumentation employed in medical and surgical practice at the end of the 19th century. Reprinted with introduction by James M. Edmonson: San Francisco, Norman Publishing, 1988.

First description of the “Fowler position”. Reprinted in Med. Classics, 1940, 4, 551-80. Fowler was preceded in this innovation by Charles White. See No. 6270.

Crile made important contributions to knowledge regarding shock. He originated the theory that it is due to exhaustion of the vasomotor center. (See also No. 5629.)

Chapter V:  On the physiologic action of cocain and eucain when injected into tissues. (pp. 88-162). Crile developed anesthetic blocking of nerve trunks.

Digital facsimile from the Hathi Trust at this link.

Ochsner was professor of clinical surgery at the University of Illinois. The above is reprinted in Med. Classics, 1940, 4, 600-26.

Bier introduced hyperemia, active and passive, as an adjuvant in surgical therapy. English translation, Chicago, A. Robertson, 1905. Digital facsimile of the English translation from the Internet Archive at this link.

Crile advanced the anoci-association concept in which local and general anesthesia are combined in a sequence to eliminate pre-operative fear and tension.

Experimental shock produced by histamine and shown to be similar to traumatic and surgical shock.

Dunhill’s operation for the removal of intrathoracic tumors.

First of a series of papers in the Archives. See also No. 5630.3.

Blalock “demonstrated that surgical shock is not due to the elaboration of toxins nor to reflex neurologic mechanisms, but … to decrease in circulating the blood volume” (M.M. Ravitch). He wrote many papers on the subject, principally experimental studies; Ravitch considered this paper from 1930 the most important (see Johns Hopk. med. J., 1977, 140, 57-67, for bibliography).

Introduction of amnioplastin.

During the Spanish Civil War (1935-38) Trueta adopted as standard treatment for gunshot wounds and compound fractures the closed plaster method originated by the American surgeon H. Winnett Orr. Trueta called this the biological treatment of wounds. The treatment consisted of débridement and wound excision followed by packing the wound open and immobilizing the limb in a plaster dressing. Also in 1938 the same publisher issued Trueta's book in Trueta's native Catalan as El tractament de les factures de guerra. Whether the Catalan or Spanish edition preceded the other, or whether they might have been issued simultaneously, is unknown. English translation: Treatment of war wounds and fractures: with special reference to the closed method as used in the war in Spain, London, 1939.

First chlorine solution for disinfecting purposes. English translation, 1826.

Lister’s work on the antiseptic principle in surgery. He believed that bacteria could enter wounds and cause suppuration and putrefaction and that it was necessary to kill the bacteria already in wounds and to apply dressings impregnated with some bactericidal substance. He finally hit on carbolic acid for this purpose. When this work was done it had not yet been proved that bacteria were the cause of disease. The above work is reprinted in Med. Classics, 1937, 2, 28-71.

Having realized the significance of Pasteur’s work on fermentation, Lister evolved the idea of the antiseptic prevention of wound infection. This and the preceding entry represent two of the most epoch-making contributions to surgery. The paper in reprinted in Med. Classics, 1937, 2, 72-83.

Lucas-Championnière, eminent French surgeon, was one of the first to adopt the principles of Listerism. He wrote the first authoritative work on antiseptic surgery and introduced antisepsis into France. First edition in English, Portland, Maine: Loring, Short, and Harmon, 1881.

Koch showed that mercuric chloride was superior to carbolic acid, and that live steam surpassed hot air in sterilizing power.

The first attempts at asepsis were made by Neuber. Digital facsimile from the Internet Archive at this link.

Bergmann was a pioneer in the evolution of asepsis. He gradually merged the corrosive sublimate method of antisepsis into steam sterilization of instruments and dressing material, demonstrating its superiority to chemical antisepsis. He was also an early adopter of the "white coat".

Tarnier was the first to adopt Listerism in obstetrics. In the discussion following a paper in Trans. int. med. Congr., London, 1881, 4, 390-391, he showed that he was the first to employ carbolic acid solution in obstetrics.

Halsted’s operation invariably excised the pectoralis major muscle in radical mastectomy. His operation, modified by the retention of the pectoral muscles, remains the cornerstone of surgical treatment of carcinoma of the breast. Plate 12 shows the first use of rubber gloves during an operation. See No. 5640. Reprinted in Med. Classics, 1938, 3, 441-509.

Depicts the use of rubber gloves during an operation by Halsted. In a later paper (J. Amer. med. Ass., 1913, 60, 1123-24) he gives some account of this, from which it appears that he was responsible for this innovation. In Johns Hopk. Hosp. Rep., 1891, 2, 308-10, he advised the assistant to use rubber gloves while treating wounds. Halsted originally developed rubber gloves to protect the hands of his operating room nurse, who was allergic to the antisepsis chemicals. That nurse later became Mrs. Halsted. Also published in Ann. Surg., 1894, 20, 497-555. See also No. 5777.

Introduction of the gauze face mask, October 1897.

Carrel–Dakin treatment of wounds. With J. Daufresne and M. Dumas.
Carrel & Dehelly expanded this into a monograph entitled Le traitement des plaies infectées. Paris: Masson et Cie, 1917. That was rapidly translated into English by Herbert Child as The treatment of infected wounds. With an introduction by Sir Anthony A. Bowlby. New York: Paul B. Hoeber, 1917. Digital facsimile of the English translation from Google Books at this link.

Eusol and chloramine-T.

“Dakin’s solution” was employed by Carrel (No. 5642) in the Carrel–Dakin method of irrigation of wounds.

Introduction of “BIPP” in the treatment of wounds, an acronym for bismuth iodoform parafin paste.

Sulphonamide dressing of wounds. With L. W. Johnsrud and M. C. Nelson.

The first work after Avicenna to discuss the use of snow as an anesthetic.

Moore revived the ancient concept of nerve compression, developing a special clamp for its use. John Hunter used Moore’s clamp in a leg amputation in 1784 in which analgesia was successfully obtained.

Davy discovered the anesthetic properties of nitrous oxide and suggested its use during surgical operations. This suggestion was applied until 1844 when the American dentist Horace Wells volunteered to have the effects of nitrous oxide demonstrated on him by Gardner Quincy Colton, a member of a traveling circus. Wells felt nothing, and was the first patient to be operated on under anesthesia, having his tooth extracted later that year by his associate, John Riggs. See No. 5660. Digital facsimile of Davy's book from the Internet Archive at this link.

Hickman was the first to prove that the pain of surgical operations could be abolished by the inhalation of a gas. He rendered animals unconscious, first through partial asphyxiation by the exclusion of air, then by inhalation of carbon dioxide. He amputated limbs without pain and with good surgical results. His work, the first in the field of surgical anesthesia, was received with apathy, and no use was made of it. His “Letter” was reissued in the Hickman centenary volume, published by the Wellcome Historical Medical Museum, London, 1930.

Guthrie in America, Liebig in Germany, and Soubeiran in France discovered chloroform independently of one another. Guthrie discovered the modern method of making chloroform by distilling alcohol with chlorinated lime. The second paper has the title: On pure chloric ether.

Soubeiran, like Liebig and Guthrie, discovered chloroform; it is difficult to determine who was first, as each may have allowed an interval of time to elapse between discovery and publication.

Discovery, in 1831, of chloroform and chloral. Independently chloroform was discovered by Souberian and by Guthrie.

The original account of the first major operation performed in England using hypnosis as a form of anesthesia. The amputation was performed by Ward. Topham, a lawyer interested in mesmerism, performed the hypnosis. The controversy caused by this operation led to Elliotson’s book (No. 5650.2). Digital facsimile from Google Books at this link.

Elliotson was one of the first in England to perform surgical operations with the aid of hypnotism. He was a great friend of Dickens and Thackeray, but his views on hypnotism were bitterly opposed by Thomas Wakley, editor of the Lancet, whose onslaughts eventually led to his downfall.

Esdaile performed a variety of surgical operations on Hindus, upon many of whom he appears successfully to have induced hypnotic anesthesia. However, his similar attempts with Europeans were not so successful.

William T. G. Morton used ether as an anesthetic for the first time on 16 October 1846 during at operation by John Collins Warren to remove a benign angioma under the jaw of a patient at Massachusetts General Hospital. During the operation it was immediately recognized that inhalation of ether vapor produced complete anesthesia. Bigelow, a surgeon who witnessed the operation, left an excellent account in the above paper, which was read before the Boston Society of Medical Improvement on 9 November 1846, an abstract having been previously read before the American Academy of Arts and Sciences on 3 November. Bigelow's paper was first published in the Boston Medical and Surgical Journal on November 18, 1846. Digital facsimile from the Hathi Trust at this link.

Bigelow had offprints printed of this paper, presumably sometime after the original article appeared. The offprint version was printed from reset type and omitted the final seven paragraphs in which Bigelow referred to the patent for the use of ether in surgery that was shared by Morton and Charles Thomas Jackson. This had the effect of crediting Morton for the discovery while ignoring the key contributions to Charles T. Jackson, who shared credit with Morton on the patent. A digital facsimile of the offprint version is available from the Internet Archive at this link.

Unaware of Crawford Long’s results with ether, Morton, having been informed of the anesthetic effects of ether by Charles T. Jackson, promoted its anesthetic effects. To do so he published the above circular, in which he called his anesthetic by the name of “Letheon”. Henry Jacob Bigelow appreciated the significance of the discovery, and Bigelow's paper (No. 5651) soon spread the news throughout the medical world. Digital facsimile of the 5th edition from the Internet Archive at this link.

This 44-page pamphlet was the first American manual on the administration of anesthesia. In it Morton announced that his method of producing anesthesia was obtained by the inhalation of sulphuric ether. He subsequently devoted himself to the study of surgical anesthesia and to the dissemination of information concerning it, with the expectation of enriching himself through a government grant, after the patent that he obtained together with Charles Thomas Jackson concerning the discovery proved unenforceable. Digital facsimile from the Internet Archive at this link. See No. 5660. 

On 8 March 1847, Flourens announced that chloroform had an anesthetic effect analogous to that of ether. Little notice seems to have been taken of his paper, but later in the year Simpson independently demonstrated the value of chloroform.

Pirogov was the first to practise rectal etherization, suggested by Roux earlier in 1847.

Pirogov, the great military surgeon, was with Syme the first in Europe to adopt ether anesthesia, and he left an interesting account of his experiences with it. Digital facsimile from the Hathi Trust at this link.

In an attempt to find an anesthetic less irritating than ether, Simpson discovered the advantages of chloroform. He had previously used ether with great benefit in midwifery, but now substituted chloroform, being the first to do so. Preliminary announcements in Lond. med. Gaz., 1847, n.s. 5, 906.

The first textbook of ether anesthesia, published in March, 1847. Robinson, a British dentist, was the first to use anesthesia in England, after receiving information from Henry Jacob Bigelow and Francis Boott. Digital facsimile from the Internet Archive at this link. Facsimile edition, with historical introduction, Park Ridge, Illinois, 1983.

Includes an account of Snow’s regulating inhaler, the first to control the amount of ether vapor by the patient. This pamphlet, which appeared in October 1847, was the second treatise on ether anesthesia, after Robinson who pubiished in March, 1847.
Snow first published a description and illustration of the regulating inhaler in Lond. med. Gaz., 1847, n.s. 4, 745-52, 923-29. 

Syme was, with Pirogov, the first in Europe to adopt ether anesthesia in surgical operations.

First application of ether anesthesia for plastic operations. Dieffenbach made his first use of the anesthetic in reconstructing a nose. He modified Morton’s inhaler. Dieffenbach’s work helped bring about the early acceptance of anesthesia in Germany.

In 1844 Wells, a Hartford dentist, successfully used nitrous oxide as a dental anesthetic. To publicize his discovery, he arranged a demonstration at Harvard Medical School in January 1845, but this proved a fiasco. Wells discussed his discovery with a former pupil, W.T.G. Morton (Nos. 5652-53). Morton got the idea of using ether instead of nitrous oxide from Charles Thomas Jackson (1805-80). After Morton and Jackson patented the us of ether as an anesthetic, Morton attempted to discredit Jackson's contribution, but Jackson continued to assert his key role in the discovery. Jackson also played an essential role in the discovery of the American magnetic telegraph, by describing to Samuel F. B. Morse its essential features, leading to Morse's invention. Wells, who was not in very good mental health, eventually committed suicide by opening a vein in his arm and at the same time inhaling ether vapor. Digital facsimile of Wells's pamphlet from Google Books at this link.

Channing was an early advocate of anesthesia in obstetrics. In his book, and in several earlier papers, he brought the importance of this branch of anesthesia into the foreground.

Introduction of ethyl chloride in anesthesia.

Snow’s chloroform inhaler.

There is no doubt that Long was the first successfully to use ether vapor as an anesthetic. This was on 30 March 1842, at Jefferson, Georgia. Unfortunately he did not publish his results until others, notably Morton, had independently introduced it. See also the biography of Long by Frances Long Taylor, New York, 1928.

Snow attempted carbon dioxide absorption.

Snow, the first specialist in anesthesiology, delivered Queen Victoria with the aid of chloroform in 1853 and 1857. This work was edited for publication after Snow's premature death by Richardson, who included a biography of Snow. Snow's final book, which consisted of 538pp. compared to only 88pp. in his first book on anesthesia published in 1847, put the administration of chloroform and ether on a scientific basis. Snow also investigated amylene, which he was the first to administer. Digital facsimile of William T. G. Morton's copy in the Countway Library of Medicine from the Internet Archive at this link.

Discovery of trichlorethylene by Emil Fischer while working on the preparation of tetrachloroethylene. 

Junker’s chloroform inhaler.

Andrews advocated the use of an oxygen-nitrous mixture.

Endotracheal anesthesia by means of a tracheostomy.

Labbe and Guyon developed pre-anesthetic medication.

Clover’s gas-ether inhaler.

First successful human intravenous anesthesia. Oré, professor of physiology at Bordeaux, reported the successful use of this method in animals in Bull. Soc. Chir. Paris, 1872, 3 sér., 1, 400-12. See also his monograph on the subject, Paris, 1875.

As early as 1864 Bernard discovered that chloroform anesthesia could be prolonged and intensified by the injection of morphine. J. N. von Nussbaum also observed this. English translation by B. Fink, Park Ridge, 1989.

Clover’s ether inhaler. See also the same journal, 1877, 1, 69. He invented an inhaler in 1862; this was described, but not by Clover, in Med. Times Gaz., 1862, 2, 149.

Anrep studied the action of cocaine and, like Moréno y Maïz, suggested that it might be used as a local anesthetic.

First administration of an anesthetic (chloroform) through a metal tracheal tube introduced by the mouth (endotracheal anesthesia).

Cyclopropane (trimethylene) first prepared.

Introduction of cocaine as a local anesthetic; this was the first local anesthetic employed (16 September 1884). Freud (No. 1880.1) is accredited by some with this innovation, but in this connection see the letter by Koller in J. Amer. med. Ass., 1941, 117, 1284. English translation by H. Knapp in Arch. Ophthal. (Chicago), December, 1884. 

The first experiments on local infiltration anesthesia were made by Halsted, who even produced anesthesia by the intradermal injection of water. Through the process of self-experimentation Halsted became addicted to cocaine for the remainder of his life. His addiction was kept a secret from all but his closest associates until after his death.

Spinal anesthesia introduced. Corning showed experimentally that cocaine exerts a prolonged anesthetic effect while arresting the circulation in the anesthetized area. He first described injection of cocaine between the spinous processes of the lower dorsal vertebrae in a dog (see his earlier paper in the same journal, 1885, 42, 317-19) and then in a human being.

The first textbook on local anesthesia.

Maximilian Oberst’s method of conduction anesthesia was first reported by Pernice, his pupil.

Hewitt, anesthetist to Edward VII, did much to develop the use of ether, and advanced our knowledge of the pharmacology of anesthetics. In 1892 he introduced the first practical gas and oxygen apparatus.

Includes description of Hewitt’s nitrous oxide/oxygen stopcock.

Infiltration anesthesia was developed by Schleich after pioneer work by Halsted (No. 5679) Schleich published a paper in English on the subject in Int. Clin., 1895, 5 ser., 2, 177-92.

Bier introduced the use of cocaine as a spinal anesthetic.

Synthesis of procaine (novocaine).

Meyer’s theory of narcosis.

Caudal anesthesia.

Crile made important contributions to knowledge regarding shock. He originated the theory that it is due to exhaustion of the vasomotor center. (See also No. 5629.)

Chapter V:  On the physiologic action of cocain and eucain when injected into tissues. (pp. 88-162). Crile developed anesthetic blocking of nerve trunks.

Digital facsimile from the Hathi Trust at this link.

Overton developed the lipid theory of narcosis.

William S. Halsted was first to use infiltration anesthesia (see No. 5679) and it was later developed by  Cushing.

Introduction of stovaine, 1903.

Braun’s important book on local anesthesia greatly stimulated the development of that subject. English translation, Philadelphia, 1914.

Procaine (novocaine), synthesized by Einhorn, was first used clinically by Braun.

Kuhn introduced the intratracheal insufflation method of anesthetization about 1900; he used a flexible metal tube and a curved introducer. He also experimented with positive and negative pressure insufflation.

Ombrédanne ether inhaler.

Meltzer and Auer experimented further with the intratracheal insufflation method introduced by Kuhn (No. 5693).

The clinical introduction of Meltzer and Auer’s method of intratracheal insufflation marks the beginning of modern endotracheal anesthesia. Also reported in Ann. Surg., 1910, 52, 23-29.

Introduction of trichlorethylene (“trilene”).

Intermittent gas-oxygen machine.

Boothby and Cotton’s flowmeter.

Gwathmey produced anesthesia by injection into the rectum of liquid ether with olive oil dissolved in it (synergistic anesthesia). Faulconer & Keys report that by 1930 Gwathmey was able to report 20,000 successful cases of the use of rectal ether in midwifery.

Gwathmey was one of the first physicians in the United States to specialize exclusively in anesthesiology. This work includes (p. 334) a description of his nitrous oxide-oxygen-ether apparatus.

Kelly’s intratracheal ether apparatus.

Shipway apparatus.