This section is from "Scientific American Supplement Volumes 275, 286, 288, 299, 303, 312, 315, 324, 344 and 358". Also available from Amazon: Scientific American Reference Book.
[Footnote: Read before the Philadelphia County Medical Society, May 12, 1880, by W. G. A. Bonwill, M.D., D.D.S., Philadelphia.]
Through the kind invitation of your directors, I am present to give you the history of "rapid breathing" as an analgesic agent, as well as my experience therein since I first discovered it. It is with no little feeling of modesty that I appear before such a learned and honorable body of physicians and surgeons, and I accept the privilege as a high compliment. I trust the same liberal spirit which prompted you to call this subject to the light of investigation will not forsake you when you have heard all I have to say and you sit in judgment thereon. Sufficient time has now elapsed since the first promulgation of the subject for the shafts of ridicule to be well nigh spent (which is the common logic used to crush out all new ideas), and it is to be expected that gentlemen will look upon it with all the charity of a learned body, and not be too hasty to condemn what they have had but little chance to investigate; and, of course, have not practiced with that success which can only come from an intelligent understanding of its application and modus operandi.
Knowing the history of past discoveries, I was well prepared for the crucible. I could not hope to be an exception. But, so far, the medical profession have extended me more favor than I have received at the hands of the dental profession.
My first conception of the analgesic property of a pain obtunder in contradistinction to its anaesthetic effect, which finally led to the discovery of the inhalation of common air by "rapid breathing," was in 1855 or 1856, while performing upon my own teeth certain operations which gave me intense pain (and I could not afford to hurt myself) without a resort to ether and chloroform. These agents had been known so short a time that no one was specially familiar with their action. Without knowing whether I could take chloroform administered by myself, and at the same time perform with skill the excavation of extremely sensitive dentine or tooth-bone, as if no anaesthetic had been taken, and not be conscious of pain, was more than the experience of medical men at that time could assure me. But, having a love for investigation of the unknown, I prepared myself for the ordeal. By degrees I took the chloroform until I began to feel very plainly its primary effects, and knowing that I must soon be unconscious, I applied the excavator to the carious tooth, and, to my surprise, found no pain whatever, but the sense of touch and hearing were marvelously intensified. The small cavity seemed as large as a half bushel; the excavator more the size of an ax; and the sound was equally magnified. That I might not be mistaken, I repeated the operation until I was confident that anaesthetics possessed a power not hitherto known--that of analgesia. To be doubly certain, I gave it in my practice, in many cases with the same happy results, which saved me from the risks incident to the secondary effects of anaesthetics, and which answered for all the purposes of extracting from one to four teeth. Not satisfied with any advance longer than I could find a better plan, I experimented with the galvanic current (to and fro) by so applying the poles that I substituted a stronger impression by electricity from the nerve centers or ganglia to the peripheries than was made from the periphery to the brain. This was so much of a success that I threw aside chloroform and ether in removing the living nerve of a tooth with instruments instead of using arsenic; and for excavating sensitive caries in teeth, preparatory to filling, as well as many teeth extracted by it. But this was short-lived, for it led to another step. Sometimes I would inflict severe pain in cases of congested pulps or from its hasty application, or pushing it to do too much, when my patient invariably would draw or inhale the breath very forcibly and rapidly. I was struck with the repeated coincidence, and was led to exclaim: "Nature's anaesthetic." This then reminded me of boyhood's bruises. The involuntary action of every one who has a finger hurt is to place it to the mouth and draw violently in the air and hold it for an instant, and again repeat it until the pain is subdued. The same action of the lungs occurs, except more powerfully, in young children who take to crying when hurt. It will be noticed they breathe very rapidly while furiously crying, which soon allays the irritation, and sleep comes as the sequel. Witness also when one is suddenly startled, how violently the breath is taken, which gives relief. The same thing occurs in the lower animals when pain is being inflicted at the hand of man.
This was advance No. 3, and so sure was I of this new discovery, that I at once made an application while removing decay from an extremely sensitive tooth. To be successful, I found I must make the patient take the start, and I would follow with a thrust from the excavator, which move would be accomplished before the lungs could be inflated. This was repeated for at least a minute, until the operation was completed, I always following immediately or synchronously with the inhalation.
This led to step No. 4, which resulted in its application to the extracting of teeth and other operations in minor surgery.
Up to this time I had believed the sole effect of the rapid inhalation was due to mere diversion of the will, and this was the only way nature could so violently exert herself--that of controlling the involuntary action of the lungs to her uses by the safety valve, or the voluntary movement.
The constant breathing of the patient for thirty seconds to a minute left him in a condition of body and mind resembling the effects of ether and chloroform in their primary stages. I could but argue that the prolonged breathing each time had done it; and, if so, then there must be some specific effect over and above the mere diversion by the will. To what could it be due? To the air alone, which went in excess into the lungs in the course of a minute! Why did I not then immediately grasp the idea of its broader application as now claimed for it? It was too much, gentlemen, for that hour. Enough had been done in this fourth step of conception to rest in the womb of time, until by evolution a higher step could be made at the maturity of the child. Being self-satisfied with my own baby, I watched and caressed it until it could take care of itself, and my mind was again free for another conception.