Do you know that...

The invention and widespread introduction into medical practice of a plaster cast for bone fractures is one of the most important achievements of surgery in the last century. And it was N.I. Pirogov was the first in the world to develop and put into practice a fundamentally new method of dressing impregnated with liquid gypsum.

It cannot be said that before Pirogov there were no attempts to use gypsum. Known are the works of Arab doctors, the Dutchman Hendrichs, Russian surgeons K. Gibental and V. Basov, a surgeon from Brussels Seten, a Frenchman Lafargue and others. However, they did not use a bandage, but a solution of gypsum, sometimes mixing it with starch, adding blotting paper to it.

An example of this is the Basov method proposed in 1842. The broken arm or leg of the patient was placed in a special box filled with alabaster solution; the box was then attached to the ceiling through a block. The victim was essentially bedridden.

In 1851, the Dutch doctor Mathyssen had already begun to use a plaster cast. He rubbed strips of cloth with dry gypsum, wrapped them around the injured limb, and only then wetted them with water.

To achieve this, Pirogov tries to use various raw materials for dressings - starch, gutta-percha, colloidin. Convinced of the shortcomings of these materials, N.I. Pirogov proposed his own plaster cast, which is used almost unchanged at the present time.

The fact that gypsum is just the most best material, the great surgeon made sure after visiting the workshop of the then-famous sculptor N.A. Stepanov, where "... for the first time I saw ... the effect of a gypsum solution on the canvas. I guessed," writes N.I. Pirogov, "that it can be used in surgery, and immediately applied bandages and strips of canvas soaked with this solution , on a complex fracture of the lower leg. The success was remarkable. The bandage dried up in a few minutes: an oblique fracture with a strong blood streak and perforation of the skin ... healed without suppuration ... I was convinced that this bandage could find great application in military field practice, and therefore published a description of my method.

For the first time, Pirogov used a plaster cast in 1852 in a military hospital, and in 1854 - in the field, during the defense of Sevastopol. Wide use the method of immobilization of bones created by him made it possible to carry out, as he said, "saving treatment": even with extensive bone injuries, not to amputate, but to save the limbs of many hundreds of the wounded.

The correct treatment of fractures, especially gunshot ones, during the war, which N.I. Pirogov figuratively called "traumatic epidemic", was the key not only to the preservation of the limb, but sometimes the life of the wounded.

Portrait of N.I. Pirogov by artist L. Lamm

October 16, 1846 is a famous date not only in surgery, but also in the history of mankind. On this day, for the first time, a major surgical operation was performed under full ether anesthesia. Complete anesthesia was achieved, muscles were relaxed, reflexes disappeared. The patient fell into a deep sleep with loss of sensation. At the end of the 18th century, the inhalation of ether was used to relieve pain from consumption and intestinal colic. However scientific rationale problems of anesthesia belongs to Nikolai Ivanovich Pirogov, then to Russian scientists A.F. Filomafitsky, dean of the medical faculty of Moscow University, and anatomist L.S. Sevryuk. they tested the effect of ether on nervous system, on blood, we checked the dosage, the duration of the action of ether anesthesia. Like any innovation, ether anesthesia immediately found both overly ardent adherents and prejudiced critics. Pirogov did not join any camp until he tested the properties of ether in laboratory conditions, on dogs, on calves, then on himself, on his closest assistants, and, finally, on a mass scale on the wounded on the Caucasian front. Here is how B.L. Mogilevsky describes the work of N.I. Pirogov in the Caucasus: “... a military fire was burning in the Caucasus. Shamil waged a "Holy War" against Russia ... Nikolai Ivanovich managed to deploy a field infirmary near the Salty fortress ... Among the few wounded Cossacks was the centurion Yuri Gagarin, who was wounded in the leg. An operation under anesthesia saved his life. They brought the first wounded murids. Clenching their teeth, the mountaineers silently endured the terrible pain of their wounds. Seeing that no amount of persuasion could convince the Murids to undergo surgical operations, Pirogov resorted to a trick. He approached one of the most suffering mountaineers and asked in all seriousness: “Would you like to rest a little, kunak (friend)? I have a medicine that can temporarily transfer you to heaven, to the heavenly houris. Just say the word and I will keep my promise." There was a nod of the head in agreement.

Throwing a mask over the mountaineer's face, Pirogov irrigated it with ether. The wounded man quickly fell asleep. The operation was carried out at lightning speed - a bullet was removed from the leg and crushed fingers were taken away from the hand. The time of action of anesthesia passed, and the murid woke up. He warmly thanked Pirogov for the fact that he did not deceive him and reduced the suffering from pain. After this incident, the wounded mountaineers vying with each other asked the wonderful doctor to operate on them. While the West was arguing about whether it is possible or not to use anesthesia in surgical practice, Nikolai Ivanovich Pirogov performed seven hundred operations under anesthesia on the battlefield.

The invention of the plaster cast

Among the many merits of Pirogov to medicine, in particular to military medicine, one cannot help but point out the plaster cast invented by him, which was first used in the field in 1854. Pirogov did not immediately come up with the idea of ​​​​using plaster: first, in his surgical work, he replaced wooden overlays with starch bandage. Here's how it happened.

The first expedition to clear the Salt region of the enemy was followed by a second, also successful. There were terrible hand-to-hand fights. Bayonets, daggers, sabers were used. The positions of the detachment were held at a high price. Three hundred killed and wounded Russian soldiers and officers remained on the battlefield. For Pirogov, the fighting began. He worked twelve hours a day, forgetting about food. The surgeon widely used ether anesthesia in a combat situation. In the same days, the brilliant scientist made another remarkable discovery. For the treatment of bone fractures, instead of linden bast (bark), he began to use a starch motionless bandage. Starch-soaked long pieces of canvas were laid layer upon layer on the broken limb. The starch solidified, and in a calm state, the bone grew together over time. A strong callus formed at the site of the fracture. Here, to the whistle of the path flying over the tents of the infirmary, Nikolai Ivanovich realized what a huge benefit a medical scientist can bring to soldiers.

In 1854, Pirogov came up with the idea to replace the not quite comfortable starch dressing with plaster. Gypsum (calcium sulphide) is a very fine powder with high hygroscopicity. When mixed with water, it hardens within 5-10 minutes. Before Pirogov, gypsum was used by builders, architects, and sculptors. In medicine, Pirogov used a plaster bandage to fix and consolidate injured tissues. Plaster bandages were widely used during transportation and in the treatment of the wounded. Not without feelings of national pride, N.I. Pirogov recalls that “the beneficence of anesthesia and this bandage in military field practice was investigated by us before other nations.”

This year marks the 200th anniversary of the birth of Nikolai Ivanovich Pirogov - his name is inscribed in golden letters in the history of world medicine. The current government approached the celebration of this event very responsibly.

So, back in early May, President Viktor Yanukovych instructed the government to form an Organizing Committee to prepare for the celebration of the anniversary. In particular, he will organize a complex of works for the improvement of the Pirogov National Museum-Estate, holding thematic conferences in medical universities and scientific medical institutions and round tables, as well as ensuring the publication of Pirogov's scientific works in Ukrainian and foreign languages. This will once again remind Ukrainian citizens of who Mykola Ivanovich was and what contribution he made to medicine.

Honest Aesculapius

Much was said and written about Pirogov during his lifetime. For example, the writer Nikolai Nekrasov in the Sovremennik magazine called him “a man marked by the stamp of a genius, who at the same time combines highest development best properties of human nature. And the Russian scientist Ivan Pavlov wrote about the great surgeon: "With the clear eyes of a man of genius, at the very first time, at the first touch of his specialty - surgery, he discovered the natural science foundations of this science - in a short time he became the creator of his field."

Indeed, for the powerful and unusually inquisitive mind of Pirogov, there were no limits and boundaries in the field of knowledge. His searches and discoveries in the field of surgery and anatomy, his brilliant operations and the unusual gift of teaching, his most valuable scientific works became the property of not only Russia, Ukraine, but the whole of Europe, having a huge impact on the further development of all medicine.

Nikolai Ivanovich was born in 1810 in Moscow. The grandson of a serf, he recognized the need early. His father served as treasurer, major of the food depot, was a commission agent of the 9th class. Ivan Ivanovich Pirogov had fourteen children, most of them died in infancy. Of the six survivors, Nikolai was the youngest.

In 1815, a collection of cartoons "A gift to children in memory of 1812" was published in Russia, which were distributed free of charge. Each caricature was explained by verses. According to these cartoons, Nikolai learned to read and write. And here to get a good education he was helped by an acquaintance of the family - a well-known Moscow doctor, professor of Moscow University E. Mukhin, who noticed the boy's abilities and began to work with him individually.

At the age of 17, Pirogov, having graduated from the medical faculty of Moscow University, received a medical degree, and five years later he defended his doctoral dissertation. The young scientist began to work in the city of Dorpat in Estonia. Then he moved to Berlin with the intention of learning everything new that the most prominent representatives of German medicine could give him.

But there he was soon severely disappointed. Medical science in Germany, in particular surgery, was divorced from its foundations - anatomy and physiology. Although from the first steps in science, Nikolai Pirogov realized that "there is no medicine without surgery, and there is no surgery without anatomy." That is why he returns to Dorpat, especially since they promised him the title of professor of surgery and asked him to head the corresponding department at the University of Dorpat.

The young professor very quickly got used to the new place - during the day he lectured, and in the evenings he worked enthusiastically. During this period, Nikolai Ivanovich created the publication "Annals of the Derpt Surgical Clinic". It was a medical confession of a young surgeon: he gave a harsh assessment of his own medical activities, described individual pathologies.

The “Annals” of Nikolai Pirogov outraged the entire medical community: the young surgeon broke the tradition that had existed among doctors for centuries - not to take out the garbage from the house.

Never and under no circumstances before him did the mistakes of doctors, which led to the complication of the disease, become the subject of wide discussion. So it's safe to say that Pirogov introduced honesty into medicine. In 1837-1839 he published two volumes of the Annals. The scientist Ivan Pavlov called these publications a feat, and the Russian neurosurgeon Nikolai Burdenko - an example of a sensitive conscience and a truthful soul.

"Sister, anesthesia!"

At the university where Pirogov taught, there was a fund designed for business trips of scientists. With his help, Nikolai Ivanovich decided to seek funds for a trip to Paris to inspect French hospitals. And at the age of 28 he succeeds - having received funds from the university, he went to the capital of France.

The second trip abroad, like the first, clearly showed him that medicine, and, in particular, surgery, in the most culturally developed countries Western Europe stays very low scientific level. It turned out that even at the beginning of his scientific career, Nikolai Pirogov was head and shoulders above famous foreign surgeons. Returning from Paris in frustrated feelings, Nikolai Ivanovich works a lot and fruitfully in a surgical clinic and anatomical theater.

When summer came and lectures at the university ended, the professor set about organizing a mobile surgical clinic. Messages were sent to the cities where he intended to go, and there they began to look forward to the arrival of the Aesculapius. In the first city he performed fifty operations, in the second sixty. Such annual summer trips supplemented the scientific and pedagogical work of the autumn and winter months at Dorpat University, and also brought popularity to the young surgeon.

Soon his fame spread throughout Europe. And when he came to the famous Parisian professor Velpo to learn from him, he replied that he himself needed to learn from Pirogov. But Nikolai Ivanovich at that time was not even thirty.

The speed with which the great surgeon operated was legendary. For example, he did a lithotomy (extraction of stones) in two minutes. Each of his operations gathered a lot of spectators who, with watches in their hands, followed its duration. It was said that while the observers were pulling watches out of their pockets in order to mark the time, the operator was already throwing out the extracted stones. If we take into account that at that time there was still no anesthesia, it becomes clear why the young surgeon achieved this saving speed.

By the way, it was Pirogov who was one of the first to operate under anesthesia. This happened on February 14, 1847. Convinced of the effectiveness of operations under anesthesia, Nikolai Ivanovich performed 300 such operations during the year and analyzed each one at the same time. He was the first to develop the so-called "savings treatment", invented and applied a starch, and then a plaster bandage for complex fractures.

Concerned about accuracy in studying the structure of organs, Pirogov invented "ice anatomy" and published an Atlas of cuts and sections of frozen bodies of the dead, providing it with a thousand drawings. At the same time, he headed the department, studied at the Anatomical Institute he created, treated patients in the clinic, operated, designed and manufactured medical instruments, fought cholera, wrote books, articles, and performed eleven thousand autopsies! Indeed, not a single medical institution could keep up with him - he alone worked for everyone.

Doctor, teacher, social worker

However, his innovations were not immediately accepted. So, when Pirogov demanded that Russian surgeons operate in white boiled coats, because their ordinary clothes could carry dangerous microbes, his colleagues hid him in a lunatic asylum. However, he was released three days later without finding any mental disorder.

In 1854 began Crimean War. Pirogov was at that time in the besieged Sevastopol, thanks to this, many wounded were saved on the battlefields, and order was established in local hospitals. Nikolai Ivanovich introduced medical sorting of the wounded at dressing stations, together with the squads of nurses he created, he achieved the creation of prefabricated front-line hospitals, developed a surgical conveyor, and, finally, developed a gentle evacuation system for the wounded with hot food and a warm overnight stay. “There is no soldier near Sevastopol (we are not talking about officers), there is no soldier or sailor who would not bless the name of Pirogov,” Sovremennik wrote in those days.

But, being at the top of his fame, the great anatomist and surgeon suddenly decided to end his medical career and retire. This act plunged the whole of progressive Russia into amazement. Some believed that Pirogov could no longer endure the inertia and routine at the Medico-Surgical Academy, of which he was a professor, others said that he decided to treat a sick society. Both of them were right in a way. But only Pirogov knew the truth.

Being engaged in medicine and being, according to Pavlov's definition, a rare example of a teacher and doctor, Nikolai Ivanovich now and then faced the consequences of the shortcomings and vices of educating young people. Rightly believing that upbringing decides the fate of a person, he sought to put into practice his thoughts on upbringing and the reform of education in Russia.

He had many ardent supporters, especially after appearing in the press with the article "Questions of Life." He always believed that the title of a doctor obliges to be a public figure, and he was never aloof from the pressing issues of life.

Therefore, when in 1856 Pirogov was offered the position of trustee of the Odessa educational district in the department of public education, he, full of hopes and ideas, immediately set to work ardently. Since that time, the life and work of this brilliant man has become inextricably linked with Ukraine.

Lost a bad habit

The new trustee impressed everyone with his extraordinary capacity for work, ease of handling and democracy. He managed to turn the administrative position of an official into a creative laboratory of scientific and pedagogical activity.

Having then taken the post of trustee of the Kyiv educational district, Pirogov was carried away by the creation of free Sunday schools, which appealed not only to the poor class, but also to student teachers. In 1859, the first Sunday school was opened in Kyiv on Podil, which was a great success. Forgetting about everything in the name of the cause, the new trustee broke many established orders and traditions, behind which stood the powers that be. As a result, he had to retire. According to Leskov, “darkness gathered to see Pirogov off, he really was a beloved person, with whom it was painful and hard for people to part.”

Pirogov settled in Vyshnia near Vinnitsa, on his wife's estate, but he did not even think of resting.

The famous surgeon did not change his habitual fast pace of life: as before, he received free of charge patients who flocked to him from all over Russia, as before, he performed many successful operations. He resettled the operated patients in huts, monitored their condition, and supplied them with medicines. I have been abroad three times. At the age of 67, during the Russian-Turkish war, he was at the front for six months as a consultant on medical support for the army. After that, the book “The Beginnings of General Military Field Surgery” appeared, which at that time had no equal in scientific value.

knowing so much about bad habits and their impact on health, Nikolai Pirogov, however, was a passionate smoker, because of this, already at a very advanced age, he discovered cancer in himself. An incurable disease took the life of the famous surgeon on November 23, 1881. In memory of the great scientist, the first All-Russian Congresses of Doctors were called Pirogov.

Interestingly, shortly before his death, the great scientist made another discovery - he proposed a completely new way of embalming the dead. To this day, the body of the famous surgeon embalmed in this way is kept in the church of the village of Cherry. And on the territory of the estate today there is a museum of a brilliant doctor and an ascetic of science.

Prepared by Maria Borisova,
according to materials:

The word "anesthesia" comes from the Greek word meaning "stupor", "numbness".

Anesthesia is necessary to block pain signals from the affected organs to the brain. Too strong a signal can overexcite one part of the brain so much that the work of the rest will go wrong. As a result, cardiac or respiratory arrest may occur.

Narcosis traces its history back to anesthesia used in surgical operations in Assyria, Egypt, India, China and other countries of the Ancient World. The first painkillers were made from plants and used in the form of infusions, decoctions and "sleepy sponges" soaked in the juice of henbane, hemp, opium, and hemlock. The sponge was soaked in tincture or set on fire, resulting in the formation of vapors that lulled the sick. In addition, anesthesia was caused by squeezing the vessels of the neck and limbs, releasing a large amount of blood, giving the patient wine or alcohol, applying cold.

In the XII century. at the University of Bologna, about 150 prescriptions for painkillers were collected. Around 1200, R. Lull discovered ether, the painkillers of which were described in 1540 by Paracelsus.

Despite these studies, during operations, in order to cause loss of consciousness, a wooden mallet was often used, with which the patient was beaten on the head.

AT early XIX in. the English scientist G. Devi accidentally inhaled a large dose of nitrous oxide N 2 O. At the same time, he felt extremely excited and intoxicated, he danced like a madman. Having learned about the properties of "laughing gas", respectable ladies and gentlemen began to come to Devi's laboratory to breathe in an amazing substance. Laughing gas acted in different ways: some jumped on tables and chairs, others spoke incessantly, others got into a fight.

In 1844, the American dentist X. Wells used the narcotic effect of nitrous oxide for pain relief. He first asked his assistants to extract a tooth from him using this gas as an anesthetic. However, he did not feel pain at all. Later, he tried this anesthesia on his patients, but the public demonstration of tooth extraction ended in failure: the patient screamed loudly either from pain, or at the sight of medical instruments. Failure and ridicule drove the pioneering dentist to suicide.

On October 16, 1846, N. I. Pirogov for the first time performed an abdominal surgical operation under full ether anesthesia. During it, complete anesthesia was carried out, muscles were relaxed, reflexes disappeared. The patient was immersed in a deep sleep, having lost sensitivity.

On February 14, 1847, N. I. Pirogov performed the first operation under ether anesthesia in the 2nd military land hospital.

Having tested etherization (ether anesthesia) on healthy people, again on himself, and having the material after 50 operations under ether anesthesia (using it in hospital and private practice), Pirogov decided to use ether anesthesia directly when providing surgical assistance on the battlefield.

In the same year, Pirogov performed intracheal anesthesia - the introduction of an anesthetic directly into the windpipe.

July 8, 1847 Pirogov leaves for the Caucasus, where there was a war with the highlanders, in order to test the effect of ether anesthesia as an anesthetic on a large scale. On the way to Pyatigorsk and Temir-Khan-Shura, Pirogov introduced doctors to the methods of etherization and performed a number of operations under anesthesia. In Ogly, where there was no separate room for operations, Pirogov began to operate on purpose in the presence of other wounded, in order to convince them of the analgesic effect of ether vapors. Thanks to a clear example, other wounded were also fearlessly subjected to anesthesia. Arriving at the Samurt detachment, Pirogov conducted about 100 operations in a primitive "infirmary". Thus, Pirogov was the first in the world to use ether anesthesia on the battlefield. During the year, Pirogov performed about 300 operations under ether anesthesia (a total of 690 were performed in Russia from February 1847 to February 1848).

On November 4, 1847, the Scottish physician J. Simpson performed the first operation under chloroform sedation. The first operations under chloroform anesthesia in Russia were carried out: on December 8, 1847, Lossievsky in Warsaw; on December 9, 1847, Paul in Moscow; on December 27, 1847, in St. Petersburg at the Pirogov clinic.

Pirogov vigorously introduced anesthesia into clinical practice. He continuously worked on improving the methods and techniques of anesthesia. Pirogov proposed a rectal method of anesthesia (introduction of ether into the rectum). For this, the great surgeon designed a special apparatus and improved the design of existing inhalation devices.

While studying ether anesthesia, Pirogov also injected ether into the carotid and femoral arteries, into the internal jugular vein, femoral and portal veins. On the basis of experimental data, Pirogov came to the conclusion that when liquid ether is injected into a vein, instant death occurs.

The method of intravenous anesthesia with pure ether has not gained popularity. However, Pirogov's idea about the possibility of introducing drug directly into the blood was put into practice by Russian scientists N. P. Kravkov and S. P. Fedorov, who at the beginning of the 20th century. suggested to inject the hypnotic hedonal directly into the vein.

Along with general anesthesia, local anesthesia developed. For this, rubbing was used. various substances, compression of nerve trunks, etc.

In 1859, cocaine, an alkaloid from the leaves of the coca bush, was discovered. Studies have shown that it has analgesic properties. In 1884, the Russian doctor V.K. Anrep proposed the use of cocaine as an anesthetic, and in 1884 the Austrian Keller used cocaine anesthesia for eye operations. But unfortunately, long-term use of cocaine caused painful addiction.

A new stage in local anesthesia began with the advent of novocaine, created on the basis of cocaine, but not addictive. With the introduction of novocaine solutions into practice, various methods of local anesthesia began to develop: infiltration, conduction and spinal anesthesia.

In the first half of the XX century. anesthesia, the science of pain relief, has become an independent branch of medicine. She is engaged in preparing the patient for surgery, conducting anesthesia and monitoring during surgery and in the postoperative period.

During anesthesia, the patient's condition is monitored using electroencephalography and monitoring of the pulse and blood pressure. An important stage is the exit from anesthesia, since reflexes in patients are restored gradually and complications are possible.

The use of anesthesia made it possible to carry out operations on the heart, lungs, brain and spinal cord, which were previously impossible due to a powerful pain shock. Therefore, the anesthesiologist is no less important than the surgeon.

Getting rid of pain has been the dream of mankind since time immemorial. Attempts to stop the suffering of the patient were used in ancient world. However, the ways in which the doctors of those times tried to anesthetize were, according to modern concepts, absolutely wild and themselves delivered pain to the patient. Stunning with a blow to the head with a heavy object, tight contraction of the limbs, squeezing of the carotid artery up to complete loss of consciousness, bloodletting to anemia of the brain and deep fainting - these absolutely brutal methods were actively used to lose pain sensitivity in the patient.

There were, however, other ways. Also in Ancient Egypt, Greece, Rome, India and China, decoctions of poisonous herbs (belladonna, henbane) and other drugs (alcohol to unconsciousness, opium) were used as painkillers. In any case, such "sparing" painless methods brought harm to the patient's body, in addition to the semblance of anesthesia.

History stores data on amputations of limbs in the cold, which were performed by the surgeon of the army of Napoleon Larrey. Right on the street, at 20-29 degrees below zero, he operated on the wounded, considering freezing to be sufficient pain relief (in any case, he still had no other options). The transition from one wounded to another was carried out even without prior washing of hands - at that time no one thought about the necessity of this moment. Probably, Larrey used the method of Aurelio Saverino, a doctor from Naples, who, back in the 16th-17th century, 15 minutes before the start of the operation, rubbed with snow those parts of the patient's body that were then subjected to intervention.

Of course, none of the listed methods gave the surgeons of those times absolute and long-term anesthesia. Operations had to take place incredibly quickly - from one and a half to 3 minutes, since a person can withstand unbearable pain for no longer than 5 minutes, otherwise a painful shock would set in, from which patients most often died. One can imagine that, for example, amputation took place under such conditions literally by cutting off a limb, and what the patient experienced at the same time can hardly be described in words ... Such anesthesia did not yet allow abdominal operations.

Further inventions of pain relief

Surgery was in dire need of anesthesia. This could give the majority of patients who needed surgery a chance of recovery, and the doctors understood this well.

In the 16th century (1540), the famous Paracelsus made the first scientifically based description of diethyl ether as an anesthetic. However, after the death of the doctor, his developments were lost and forgotten for another 200 years.

In 1799, thanks to H. Devi, a variant of anesthesia with the help of nitrous oxide (“laughing gas”) was released, which caused euphoria in the patient and gave some analgesic effect. Devi used this technique on himself during teething of wisdom teeth. But since he was a chemist and physicist, and not a physician, his idea did not find support among doctors.

In 1841, Long performed the first extraction of a tooth using ether anesthesia, but did not immediately tell anyone about it. In the future, the main reason for his silence was unsuccessful experience H. Wells.

In 1845, Dr. Horace Wells, having adopted Devi's method of anesthetizing by applying "laughing gas", decided to conduct a public experiment: extract a patient's tooth using nitrous oxide. The doctors who gathered in the hall were very skeptical, which is understandable: at that time, no one completely believed in the absolute painlessness of operations. One of those who came to the experiment decided to become a “subject”, but due to his cowardice, he began to scream even before anesthesia was given. When anesthesia was nevertheless carried out, and the patient seemed to pass out, the “laughing gas” spread throughout the room, and the experimental patient woke up from a sharp pain at the time of tooth extraction. The audience laughed under the influence of the gas, the patient screamed in pain ... The overall picture of what was happening was depressing. The experiment failed. The doctors present booed Wells, after which he gradually began to lose patients who did not trust the "charlatan" and, unable to bear the shame, committed suicide by inhaling chloroform and opening his femoral vein. But few people know that Wells' student, Thomas Morton, who was later recognized as the discoverer of ether anesthesia, quietly and imperceptibly left the failed experiment.

T. Morton's contribution to the development of pain relief

At that time, Thomas Morton, a doctor, an orthopedic dentist, was experiencing difficulties regarding the lack of patients. People, for obvious reasons, were afraid to treat their teeth, especially to remove them, preferring to endure rather than undergo a painful dental procedure.

Morton "finished" the development of diethyl alcohol as a strong pain reliever through multiple experiments on animals and his fellow dentists. Using this method, he removed their teeth. When he built the most primitive anesthesia machine by modern standards, the decision to carry out the public use of anesthesia became final. Morton invited an experienced surgeon as his assistant, taking on the role of an anesthesiologist.

On October 16, 1846, Thomas Morton successfully performed a public operation to remove a tumor on the jaw and tooth under anesthesia. The experiment took place in complete silence, the patient slept peacefully and did not feel anything.

The news of this instantly spread throughout the world, diethyl ether was patented, as a result of which it is officially considered that it was Thomas Morton who was the discoverer of anesthesia.

Less than six months later, in March 1847, the first operations under anesthesia were already performed in Russia.

N. I. Pirogov, his contribution to the development of anesthesiology

The contribution of the great Russian doctor, surgeon to medicine is difficult to describe, it is so great. He also made a significant contribution to the development of anesthesiology.

In 1847, he combined his developments on general anesthesia with data already previously obtained as a result of experiments conducted by other doctors. Pirogov described not only positive sides anesthesia, but the first one pointed out its disadvantages: the likelihood of severe complications, the need for accurate knowledge in the field of anesthesiology.

It was in the works of Pirogov that the first data appeared on intravenous, rectal, endotracheal and spinal anesthesia, which is also used in modern anesthesiology.

By the way, F.I. Inozemtsev was the first Russian surgeon to perform an operation under anesthesia, and not Pirogov, as is commonly believed. It happened in Riga on February 7, 1847. The operation with the use of ether anesthesia was successful. But between Pirogov and Inozemtsev there was a complex strained relationship, somewhat reminiscent of the rivalry between two specialists. Pirogov, after a successful operation performed by Inozemtsev, very quickly began to operate using the same method of applying anesthesia. As a result, the number of operations carried out by him significantly overlapped the operations carried out by Inozemtsev, and thus, Pirogov took the lead in number. On this basis, in many sources, it was Pirogov who was named the first doctor to use anesthesia in Russia.

Development of anesthesiology

With the invention of anesthesia, there was a need for specialists in this field. During the operation, a doctor was needed who was responsible for the dose of anesthesia and controlling the patient's condition. The first anesthesiologist is officially recognized by the Englishman John Snow, who began his career in this field in 1847.

Over time, communities of anesthesiologists began to appear (the first in 1893). Science has developed rapidly, and purified oxygen has already begun to be used in anesthesiology.

1904 - the first intravenous anesthesia with hedonal was carried out, which became the first step in the development of non-inhalation anesthesia. There was an opportunity to do complex abdominal operations.

The development of drugs did not stand still: many painkillers were created, many of which are still being improved.

In the second half of the 19th century, Claude Bernard and Greene discovered that it was possible to improve and intensify anesthesia by preliminary administration of morphine to calm the patient and atropine to reduce salivation and prevent heart failure. A little later, antiallergic drugs began to be used in anesthesia before the start of the operation. This is how premedication began to develop as a medical preparation for general anesthesia.

Constantly used for anesthesia, one drug (ether) no longer satisfied the needs of surgeons, so S. P. Fedorov and N. P. Kravkov proposed mixed (combined) anesthesia. The use of hedonal turned off the patient's consciousness, chloroform quickly eliminated the phase of the patient's excited state.

Now in anesthesiology, too, a single drug cannot independently make anesthesia safe for the patient's life. Therefore, modern anesthesia is multicomponent, where each drug performs its necessary function.

Oddly enough, but local anesthesia began to develop much later than the discovery of general anesthesia. In 1880, the idea of ​​local anesthesia was put forward (V.K. Anrep), and in 1881 the first eye surgery was performed: the ophthalmologist Keller came up with local anesthesia using the administration of cocaine.

The development of local anesthesia began to gain momentum quite quickly:

• 1889: infiltration anesthesia;
• 1892: conduction anesthesia (invented by A. I. Lukashevich together with M. Oberst);
• 1897: spinal anesthesia.

Of great importance was the now popular method of tight infiltration, the so-called case anesthesia, which was invented by AI Vishnevsky. Then this method was often used in military conditions and in emergency situations.

The development of anesthesiology as a whole does not stand still: new drugs are constantly being developed (for example, fentanyl, anexat, naloxone, etc.) that ensure safety for the patient and a minimum of side effects.