Ether Day (1846): The First Public Surgery Under Anaesthesia

Ether Day is the name given to 16 October 1846, when the Boston dentist William T. G. Morton anaesthetised a patient with ether vapour so that a surgeon could operate without causing pain, in front of an audience at Massachusetts General Hospital. It was the first public demonstration of surgical anaesthesia. News of the success spread around the world within weeks and changed surgery permanently, though it also began a bitter dispute over who deserved the credit.

Background: surgery before anaesthesia

Before the 1840s surgery meant extreme pain. Patients were held down by assistants, and surgeons relied on speed: a skilled operator could amputate a leg in a few minutes. Alcohol and opium gave only limited relief. In Japan the surgeon Hanaoka Seishū had operated under a herbal general anaesthetic in 1804, but his work was unknown in Europe and America. Fear of pain led many people to avoid surgery altogether, and complex, slow operations were almost impossible.

Substances that dull sensation were already known. Diethyl ether, a volatile liquid, had been made for centuries, and nitrous oxide (laughing gas) had been studied by Humphry Davy, who suggested in 1800 that it might be useful in surgery. Both gases were used for entertainment at “ether frolics” and laughing-gas shows, where people noticed that intoxicated volunteers could injure themselves without feeling it.

Earlier attempts

On 30 March 1842 Crawford Long, a doctor in Jefferson, Georgia, removed a small tumour from the neck of a patient, James Venable, after he had inhaled ether. Long used ether in several later operations but did not publish until 1849.

In December 1844 the Hartford dentist Horace Wells had a tooth extracted under nitrous oxide and began using the gas in his practice. In early 1845 he attempted a demonstration before medical students in Boston, but the patient cried out and the audience treated it as a failure. Wells’s former partner, William Thomas Green Morton, had followed his experiments.

The demonstration of 16 October 1846

Morton experimented with ether after advice from the chemist Charles T. Jackson, testing it on animals and himself and then using it to extract teeth. He arranged with John Collins Warren, senior surgeon at Massachusetts General Hospital, to give a demonstration.

On the morning of 16 October 1846, in the hospital’s domed operating theatre, Morton arrived late with a glass inhaler he had just had made. The patient, Edward Gilbert Abbott, a young printer, inhaled the ether vapour for a few minutes. Warren then removed a vascular tumour from the left side of Abbott’s neck. Abbott moved and murmured but did not show the usual signs of agony, and he later said he had felt no real pain.

Warren is widely reported to have told the audience, “Gentlemen, this is no humbug,” a reference to the failed demonstration and to fashionable quack remedies. A second operation under ether, on a different patient, followed the next day.

Spreading the news

Morton at first concealed the nature of his agent, calling it “Letheon” and adding aromatic oils to disguise the smell. In November 1846 he and Jackson obtained a US patent for it. Doctors objected that a medical discovery should not be kept secret, and Morton revealed that the substance was ether. Within weeks Boston dentists and surgeons were using it routinely, and in early November 1846 surgeons at Massachusetts General Hospital performed a leg amputation under ether, a far more serious test than the removal of a small tumour.

The surgeon Henry Jacob Bigelow published an account in the Boston Medical and Surgical Journal on 18 November 1846. On 21 November Oliver Wendell Holmes Sr. suggested the words “anaesthesia” and “anaesthetic” in a letter to Morton. Letters carried the news across the Atlantic, and on 21 December 1846 the surgeon Robert Liston amputated a leg under ether at University College Hospital in London. Within months surgeons across Europe were using it.

The battle for credit

The discovery brought its main claimants little happiness. Morton, Jackson, Wells and supporters of Long all argued their cases in pamphlets and before Congress, which debated a national reward but never paid one. Wells, who had turned to chloroform, died by suicide in a New York jail in January 1848. Morton spent years in litigation and debt and died in 1868. Jackson spent his last years in an asylum.

Key people

• William T. G. Morton (1819–1868): Boston dentist who gave the ether at the demonstration.
• John Collins Warren (1778–1856): senior surgeon who performed the operation.
• Edward Gilbert Abbott: the patient, a young printer of about twenty.
• Crawford Long (1815–1878): Georgia physician who used ether in surgery in 1842.
• Horace Wells (1815–1848): dentist who pioneered nitrous oxide for tooth extraction.
• Charles T. Jackson (1805–1880): chemist who advised Morton and later claimed the discovery.

Consequences and legacy

Anaesthesia made longer, more careful operations possible and spared countless patients from pain. It did not at first make surgery much safer, because infection remained the main danger. Real progress in survival came only with antiseptic methods such as Lister’s antiseptic surgery and growing understanding of contagion, foreshadowed by Semmelweis’s handwashing in Vienna.

In November 1847 James Young Simpson introduced chloroform in Edinburgh; it was easier to use than ether but more dangerous. Queen Victoria’s use of chloroform during childbirth in 1853 helped make pain relief in labour acceptable. The operating room at Massachusetts General Hospital, now called the Ether Dome, is preserved, and 16 October is still marked as Ether Day by anaesthetists.

Ether itself had advantages and drawbacks. It was relatively forgiving, with a wide gap between a dose that produced unconsciousness and one that stopped breathing, so it remained in use in many countries until the mid-twentieth century, especially where trained anaesthetists were scarce. It was also highly flammable, irritated the airways and often caused nausea. Newer agents such as halothane, introduced in 1956, gradually replaced it in richer countries. In Boston, the Ether Monument in the Public Garden, unveiled in 1868, commemorates the discovery without naming any of the rival claimants.

Myths and facts

• Myth: Morton invented anaesthesia. Ether’s effects were already known, and Crawford Long had used it in surgery in 1842. Morton’s achievement was the public demonstration that convinced the medical world.
• Myth: The patient felt nothing at all. Abbott moved and murmured during the operation, and early anaesthesia was often light and uneven. What mattered was that he did not experience the agony expected.
• Myth: Anaesthesia immediately made surgery safe. Death rates after major operations stayed high for decades, mainly because of infection, until antiseptic and later aseptic methods were adopted.

Timeline

• 1800: Humphry Davy suggests nitrous oxide might relieve surgical pain.
• 1842, 30 March: Crawford Long removes a tumour from James Venable under ether.
• 1844, December: Horace Wells begins using nitrous oxide for tooth extraction.
• 1845, January or February: Wells’s demonstration in Boston is judged a failure.
• 1846, 16 October: Morton’s ether demonstration at Massachusetts General Hospital.
• 1846, 18 November: Bigelow publishes the first medical report.
• 1846, 21 December: Robert Liston operates under ether in London.
• 1847, November: James Young Simpson introduces chloroform.

Why it matters

Ether Day marked the moment when painless surgery became a public, reproducible fact rather than a rumour. It opened the way for modern surgery, with its long and delicate operations, and made anaesthesia one of the defining medical advances of the nineteenth century.