Introduction

Abstract

It is unnecessary to describe the horror of surgery prior to the demonstration of ether anaesthesia at Massachusetts General Hospital in 1846. It was clearly a nightmare for patients and must have been little better for the medical personnel involved in so terrifying an undertaking. What is less obvious is that the introduction of anaesthesia accomplished far more than the abolition of intraoperative pain. The solution of the problem of pain enabled the evolution of virtually all of modern surgical therapeutics. Prior to this development, the major characteristic of a technically brilliant surgeon was speed — the ability to do a below-thek-nee amputation in less than a minute made or unmade reputations. Intra-cavitary surgery; operations in the chest, abdomen or skull were largly unthinkable and when attempted, commonly led to the death of the patient, not because of pain per se, but because the surgeon had no time in which to think and take deliberate action.