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Richard J Wolfe
672 pp Price $125 ISBN 0-939495-81-1 (h/b)
San Anselmo, California: Norman, 2001 (PO Box 2566, San Anselmo, CA 94979-2566 [e-mail: moc.namronj@sredro ]) .
Surgical anaesthesia is surely one of the greatest benefactions to humankind. William Morton's place in its history is clear; he was the first to show how ether could be used to allay the pain of operations. This was at a public demonstration to the surgeons of the Massachusetts General Hospital, Boston, on 16 October 1846, for John Collins Warren to excise a tumour from a patient's neck. Equally clear is that he was neither the inventor nor the discoverer of anaesthetics.
It is sad that such an epoch-making event should have been followed by 20 years of acrimony, vituperation and litigation between three contestants each claiming to have originated anaesthesia, though none of the three was actually the earliest. Morton immediately patented ether, hoping to retain its use exclusively for himself. Later he made repeated appeals to the American Congress for financial recompense for his ‘invention’. Morton's instructor, the chemist and geologist Charles Thomas Jackson, said it was he who had made the discovery and had suggested that Morton should try it out. Horace Wells, the dentist from Hartford, Connecticut, put forward his well-substantiated claim to have produced anaesthesia two years earlier with nitrous oxide.
This much has been well known for the last century and a half. Wolfe's contribution is to have revisited everything, published and unpublished, that has relevance to these events. As librarian and for 45 years curator of manuscripts at both Harvard University's Francis A Countway Library of Medicine and the Boston Medical Library, he is well equipped to do so. He has studied a huge archive in Boston, New York and Washington, much previously unknown. He presents a very different picture from the standard view of the post-anaesthesia events. His book is long and detailed; no stone remains unturned and his findings are recounted exhaustively. Nevertheless he writes fluently, graphically and with touches of dry humour, the latter noticeably in his chapter titles.
Wolfe believes, and many would agree with him, that if any single individual originated the idea of anaesthesia it was Wells and that he should receive the credit. He had already propounded this view in 1994 in his Festschrift for Wells' sesquicentennial entitled I Awaken to Glory. He regards Jackson as an able and well-respected scientist, more sinned against than sinning, who seems only to have wanted the honour of the discovery, though noting that Jackson was notoriously keen on litigation and had already shown a tendency to adopt others' work as his own.
Wolfe finds no redeeming features whatsoever in his tarnished idol. He clearly regards Morton as an unmitigated villain who from his teenage years was unscrupulously fraudulent. After a series of failed enterprises Morton eventually settled into the business of making dentures in partnership with Wells in Boston. Wolfe considers that Morton was intellectually incapable of realizing the significance of anaesthesia and used his role opportunistically, purely as a means of reaping a financial reward by being the only person who could extract teeth painlessly. This became a lifelong obsession with him and he stopped at little to achieve it.
Two sidelines I found particularly interesting. First, the role of Henry Bigelow, then junior surgeon at the Massachusetts General. Wolfe feels that it was Bigelow who foresaw the potential of anaesthesia for patients and surgeons alike when he published the first account in the Boston Medical and Surgical Journal and local newspapers. Wolfe shows that Bigelow gave unwavering support to Morton for many years, regardless of the latter's disreputable activities, and hints that his reputation also emerges a little tarnished. Or I wonder was Bigelow merely guilty of poor judgment? After all, years later when senior surgeon at the Massachusetts General he was on record as opposing attempts to improve the education of the Harvard medical students. Second, Wolfe gives a fascinating insight into the political, social and medical attitudes of the time. It is surprising that so many eminent people, both within Congress and elsewhere, could take up such polarized positions and waste so much of their time during a momentous period in American history.
In the ‘Afterword’ Wolfe gives away a secret—that after writing his book on Wells he had solemnly promised himself not to make a serious study of Morton. Is it possible that, for all his attempts at impartiality, his views on Morton were just a little coloured by his conclusions about Wells? In spite of himself he did study Morton, comprehensively and exhaustively, and surely this work will stand as the final account, so it is helpful that he changed his mind. The general reader may baulk at the sometimes tedious and repetitive detail—though one has to say in mitigation that Morton's life was tedious and repetitive. Historians on the other hand will admire the author's scholarship and dedication and will welcome the opportunity to draw their own conclusions.