Pharmacy Fact: Before Modern Anesthesia, Knocking People Unconscious Was Hit Or Miss

Unlike movies and television, knocking someone out in real life takes quite a bit more than a well-timed punch in the face or a Vulcan nerve pinch. Before the advent of modern anesthesia, humans tried multiple avenues for effectively rendering other people unconscious before surgeries. Medical practitioners experimented with many potential solutions over the millennia before finding results that worked while also not killing their patients in the process, although they did a bit more of the latter prior to finding the answer.

Some cultures over the years found certain drugs that had a similar benefit as anesthesia, such as hashish in Ancient China and opium in Ancient Egypt. Later in Europe during the Middle Ages, physicians used a method they referred to as the “soporific sponge,” which involved soaking a sponge in opium, hemlock, henbane, and mandrake, and then letting it dry in the sun. After that, they would rinse it in hot water before squeezing it and stuffing it firmly under a patient’s nose.

The problem with many of these cures was the amount of drug needed were also the quantities needed to poison someone. Due to these problems, some health care professionals resorted to instead surprising their patients by whacking them over the head in order to knock them unconscious before surgery. This method was recorded as being used in pre-modern China, with varying results.

As another alternative to whacking patients over the head, the British physician Henry Hill Hickman in the 19th century tried the method of suffocation in order to render patients unconscious. Due to his awareness that suffocation can also lead to death, he first tested his theory on puppies to assess its potential efficacy.

“I took a puppy a month old…and placed a glass cover so as to prevent the access of atmospheric air; in ten minutes, he showed great marks of uneasiness, in 12 respiration became difficult, and in 17 minutes ceased altogether, at 18 minutes I took off one of the Ears…and the animal did not seem to be the least sensible of pain,” Hickman wrote in an article.

Unfortunately, not all of Hickman’s test subjects survived this ordeal, which Hickman did not believe to be as much of a problem as his colleagues did. His published conclusions regarding his (subjectively) positive results at using suffocation as a form of anesthesia were not well received by pretty much anyone.

In one review of Hickman’s research published in The Lancet titled “Surgical Humbug,” the author, who signed his name “ANTIQUACK” in the article, explained that the medical community would “laugh him to scorn if he were to recommend a man who was about to have a tooth drawn to be previously hanged, drowned, or smothered for a few minutes, in order that he may feel no pain during the operation.”

However, Hickman was not the first to recommend this method of anesthesia pre-surgery. Some writing from Assyria suggest that they may have strangled children into unconsciousness to perform circumcisions. This was also recorded as a method to knock out children before circumcisions in 17th century Italy as well.

For other physicians, the discovery of a drug’s ability to work as an anesthesia was accidental during a more primary investigation into its potential recreational use. The 19th century Scottish physician James Young Simpson was attempting to get his buzz on with colleagues by sniffing random chemicals in their vicinity, when they observed that sniffing chloroform resulted in quite exceptional results.

They found that the sickly sweet smell first resulted in a giddiness, accompanied by buzzing in the ears, proceeded by their limbs beginning to feel heavy as the effects progressed. They then noticed they all started conversing excessively before suddenly being knocked unconscious.

After they awoke, they noted the unexpected results, and then decided to try it a few more times to (presumably) confirm their findings. One of the physician’s brought their niece on board, who exclaimed, “I’m an angel! Oh, I’m an angel!” before passing out on the dining room floor.

In light of chloroform’s potential success as an anesthesia, Simpson began championing the drug for its use before surgeries among other health care professionals. Additionally, in a less professional capacity, he continued to enjoy its more recreational effects. During the mid-19th century, the drug began to spread for use at parties by enthusiasts of the similar ether sniffing craze.

Chloroform began to show up in a lot of other pharmaceutical products, with some less medical in nature than others. People—laymen and pharmaceutical manufacturers alike—associated chloroform’s ability to make them feel nice as being a sign it was also beneficial to their health. This led to chloroform being sold at pharmacies in the forms of Gibson’s Linseed Licorice, Chloroform Lozenges, and Bee Brand White Pine and Tar Cough Syrup. The manufacturers claimed that these products cured all manner of illnesses associated with the throat and lungs, while additionally curing tuberculosis.

Unfortunately, chloroform is in fact an irritant to these parts of the body, and it accomplished very little for patients with tuberculosis besides making them feel giddy before knocking them out. Additionally, chloroform is also sometimes deadly, with the term “sudden sniffer’s death” being coined due to the frequency of this issue among patients who died inexplicably following chloroform use.

Modern medicine has more recently been able to identify some of the reasons “sudden sniffer’s death” may have occurred, as chloroform is now understood to cause liver and kidney toxicity, while also likely being a carcinogen. For this reason, chloroform fell out of favor as both an anesthesia and a recreational drug due to its toxicity profile. However, it remains in the zeitgeist due its primary use of effectively knocking people unconscious, while also somewhat less effectively being used for murder.

REFERENCE

Kang L, Pedersen N. Quackery: A Brief History of the Worst Ways to Cure Everything. New York, NY: Workman Publishing; 2017.