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.
Has it proven in my practice what has been claimed for it--a substitute for the powerful anaesthetics in minor operations in surgery? Most emphatically, yes! So completely has it fulfilled its humble mission in my office, that I can safely assert there has not been more than five per cent. of failures. I have given it under all circumstances of diseased organs, and have seen no other than the happiest results in its after effects. It may well be asked just here: Why has it not been more generally and widely used by the dental profession as well as the medical, if it is really what is claimed for it? The most satisfactory and charitable answer to be given is, the failure upon their part to comprehend the fact as existing in chloroform and ether that there is such a state as analgesia; or, in other words, that the animal economy is so organized, while the sense of touch is not destroyed, but rather increased, the mind of the subject fails to perceive a sense of pain when anaesthetics are given, and the effects are manifested in the primary stage. As I before intimated, such is the knowledge possessed by most of those who administer ether and chloroform. This was enough to cause nearly every one to look upon it as a bubble or air castle. Many gentlemen told me they tried it upon themselves, and, while it affected them very seriously by giddiness, they still retained consciousness; and, such being the case, no effect could be produced for obtunding pain. Others told me they were afraid to continue the breathing alarmed at the vertigo induced. And the practitioner who has adopted it more effectively than any other laughed at me when I first told him of the discovery; but his intimate association with me changed his views after much explanation and argument between us.
It was hardly to be expected that without this knowledge of analgesia, and without any explanation from me as to the modus operandi of rapid breathing, other than a few suggestions or directions as to how the effect was induced, even the most liberal of medical men should be able to make it effective, or have the least disposition to give it a preliminary trial upon themselves, and, of course, would not attempt it upon a patient. Notwithstanding, it found a few adherents, but only among my personal medical friends, with whom I had an opportunity to explain what I believed its physiological action, and the cases of success in my own practice. To this I have submitted as among the inevitable in the calendar of discoveries of all grades.
My own profession have attempted to ridicule it out of its birthright and possible existence, which style of argument is not resorted to by true logicians.
To all this I can truly say I have not for one moment faltered. I could afford to wait. The liberality of this society alone fully compensates for the seeming indisposition of the past, believing that it is proper that every advance should be confronted, and, if in time found worthy, give it God speed.
From its first conception I have diligently labored to solve its modus operandi, and the doubt in my own mind as to whether I could be mistaken in my observations. I asked the opinion of our best chemical teachers if air could have such effect. One attributed it to oxygen stimulation, and the other to nitrogen. Another gentleman told me the medical profession had come to the conclusion that it was possible for me to thus extract teeth, but it was due solely to my strong personal magnetism (which power I was not before aware I possessed).
Now, from what I have related of the successive and natural steps which finally culminated in this process or plan of analgesia induced by an excess of ordinary air taken forcibly into the lungs above what is necessary for life, and from what I shall state as to the apparently anomalous or paradoxical effects, with its physiological action, and the simple tests made upon each of my patients, I shall trust to so convince you of its plausibility and possibility that it will be made use of in hundreds of minor operations where ether and chloroform are now used.
Aside from my assertion and that of its friends, that the effects can be produced by air alone, you must have some light shed upon the causes of its physiological action, which will appeal to your medical reason.
To assign an action to any drug is difficult, and in the cases of ether and the other anaesthetics a quarter of a century still finds many conflicting opinions. This being true, you will deal leniently with me for the opinion I hold as to their analgesic action. Of course it will be objected to, for the unseen is, to a great extent, unknowable. Enough for my argument, however; it seems to suit the case very well without looking for another; and while it was based on the phenomenon resulting from many trials, and not the trials upon it as a previous theory, I shall be content with it until a better one can be found.
What is it I claim as a new discovery, and the facts and its philosophy?
I have asserted that I can produce, from rapidly breathing common air at the rate of a hundred respirations a minute, a similar effect to that from ether, chloroform, and nitrous oxide gas, in their primary stages; and I can in this way render patients sufficiently insensible to acute pain from any operation where the time consumed is not over twenty to thirty seconds. While the special senses are in partial action, the sense of pain is obtunded, and in many cases completely annulled, consciousness and general sensibility being preserved.
To accomplish this, each patient must be instructed how to act and what to expect. As simple as it may seem, there is a proper and consistent plan to enable you to reach full success. Before the patient commences to inhale he is informed of the fact that, while he will be unconscious of pain, he will know full, or partially well, every touch upon the person; that the inhalation must be vigorously kept up during the whole operation without for an instant stopping; that the more energetically and steadily he breathes, the more perfect the effect, and that if he cease breathing during the operation, pain will be felt. Fully impress them with this idea, for the very good reason that they may stop when in the midst of an operation, and the fullest effects be lost. It is obligatory to do so on account of its evanescent effects, which demand that the patient be pushed by the operator's own energetic appeals to "go on." It is very difficult for any person to respire more than one hundred times to the minute, as he will become by that time so exhausted as not to be able to breathe at all, as is evidenced by all who have thus followed my directions. For the next minute following the completion of the operation the subject will not breathe more than once or twice. Very few have force enough left to raise hand or foot. The voluntary muscles have nearly all been subjugated and overcome by the undue effort at forced inhalation of one hundred over seventeen, the normal standard. It will be more fully understood further on in my argument why I force patients, and am constantly speaking to them to go on.