The Southern Origins of Anesthesia

Some call it eureka, that moment of inspiration when an imaginative brain makes a connection no one else made. Dr. Crawford W. Long of Georgia possessed this gift when he discovered that ether could be used as an anesthetic in surgery—a long sought remedy after hundreds of years of suffering. What led to Dr. Long’s discovery? First, let’s meet the man.

Crawford Williamson Long was born on November 1, 1815, in Danielsville, Georgia. He was the son of a wealthy planter. He was a quiet, studious boy who loved horses, dogs, swimming, fishing, and outdoor activities. He was a student of the Bible from a young age and was said to be governed by its precepts his entire life.

At the age of fourteen, he attended Franklin College (now the University of Georgia) in Athens and graduated in 1835 at the age of nineteen with a Master of Arts degree. While in college, his roommate happened to be Alexander H. Stephens who would one day become Vice President of the Confederacy. Long and Stephens remained lifelong friends.

After graduating, he taught at the Danielsville Academy and then began studying medicine under the apprenticeship of Dr. Grant of Jefferson, Georgia.  After that, he took a one-year medical course at Transylvania College in Lexington, Kentucky. He participated in several surgeries where he observed the excruciating pain patients suffered, since there was no effective way to avoid it. Doctors tried various substances, such as alcohol, or hypnotism (then called “mesmerism”), which often helped to calm patients down but did little to stop the pain of the knife. Indeed, the name of the game was speed. Amputations could be performed in about one minute by skilled surgeons. Surgeries that took a long time were frequently avoided because of the pain. Imagine how many needless deaths occurred in order to avoid the intolerable pain of long surgeries.

In 1837, Long entered Jefferson College (now the University of Pennsylvania) to obtain his medical degree. His father was determined that Crawford have the best possible medical education. Indeed, the college’s Medical Department was considered the best in the country with a world-renowned faculty and state-ofthe-art techniques.

After his graduation in 1839 (receiving his M.D.) at the age of 23, Long spent 18 months as an intern in New York “walking the hospitals” to further perfect his surgical skills. He gained a reputation as a skilled surgeon.

Now it was time to practice his trade. The big cities certainly appealed to young Crawford. In those busy places, he could participate in numerous surgeries and work alongside what was considered some of the best medical minds in the country. But Crawford had promised his father he would return to Georgia, so he returned to Jefferson in 1841 and purchased the practice of his former mentor, Dr. Grant. In 1842, he married Mary Caroline Swain. Together they would have 12 children, 7 of whom would live into adulthood.

Chance favors the prepared mind

In the early 1800’s, there were “wandering lecturers” in chemistry. Some people in the audience would be invited onstage to inhale nitrous oxide (laughing gas) or sulfuric ether so the spectators could be amused by its “exhilarating” and “mirth provoking” (gaiety manifested in laughter) antics. Hence, human nature being what it is, the gases began being used for recreation.

Crawford Long was a witness to these demonstrations and even tried the gases himself. One thing fascinated him about ether. Many under its influence acquired bumps, bruises, and sprains from falling down or bumping into things but had no memory whatsoever of feeling pain. The pain only came when the effects of ether wore off.

Long would later ask himself:  If people could acquire bumps and bruises without pain while on ether, couldn’t ether eliminate pain during surgery?

Louis Pasteur is credited with the quote, “Chance favors the prepared mind.” Long’s mind was certainly prepared for his chance discovery. He had always been troubled watching patients cry out in excruciating pain during surgery. Surely his prepared mind helped him make the connection no one else did, including the fine doctors he worked with in Philadelphia and New York.

Moment of Truth

On March 30, 1842, Mr. James M. Venable (21 years old) agreed to be Dr. Long’s first patient using ether for surgery. James wanted two lumps removed from his neck. This story is best told by Dr. Long himself:

The first patient to whom I administered ether in a surgical operation was Mr. James M. Venable, who then resided within two miles of Jefferson, and at present (1849) lives in Cobb County, Georgia. Mr. Venable consulted me on several occasions in regard to the propriety of removing two small tumors situated on the back of his neck, but would postpone, from time to time, having the operations performed, from dread of pain. At length, I mentioned to him the fact of my receiving bruises while under the influence of the vapour of ether, without suffering, and as I knew him to be fond of and accustomed to inhale ether, I suggested to him the probability that the operations might be performed without pain, and proposed operating on him while under its influence. He consented to have one tumor removed, and the operation was performed the same evening. The ether was given to Mr. Venable on a towel, and when fully under its influence, I extirpated the tumor. It was encysted and about one-half inch in diameter. The patient continued to inhale ether during the time of operation, and when informed it was over, seemed incredulous, until the tumor was shown him. He gave no evidence of suffering during the operation, and assured me after it was over that he did not experience the slightest degree of pain from its performance. This operation was performed on March 30, 1842.  

Years later, a family member asked, “Were you not afraid to make a man unconscious?” Dr. Long replied:

No! When giving it to Venable, with one hand I held the towel over his mouth and nose permitting him to breathe a little air as he inhaled the drug. I kept my other hand upon his pulse. When he became insensible to the prick of a pin I operated. As an inducement to Venable to allow himself to be the subject of such experiment, my charge for the operation was merely nominal, $2.00, ether, 25 cents.

Thanks to the courage of Dr. Long and especially Mr. Venable, Long continued his surgeries with ether. He had a special affection for women suffering during childbirth.

“First” use of ether for surgery at the Massachusetts General  Hospital in Boston announced with great fanfare! 

Imagine Dr. Long’s surprise when he one day read that a surgery was performed with ether as an anesthetic at the Massachusetts General Hospital in Boston on October 16, 1846. Many people witnessed the procedure, including doctors and medical students. It was hailed as the first use of ether as an anesthetic for surgery. News spread like wildfire.

But wait … this was more than four years after Dr. Long first used it!

The decades-long ether controversy begins

In 1846, at least three doctors clamored for recognition as the first to discover ether for surgery. These included a Boston dentist, William Morton, as well Drs. Horace Wells and Charles Jackson. The winner could receive a financial reward from the government, a patent for ether, and, of course, worldwide fame.

But there was a problem:  All the claims of ether’s use in surgery dated long after Dr. Long’s first use of it in 1842.

This gave Dr. Long the push to finally publish his results. Why did it take so long?  Well, for starters, the life of a country doctor was laborious, necessitating long journeys often through muddy roads. In addition, he wanted to test the use of ether for surgery numerous times before publishing.

When Dr. Long and his friends and associates learned of the experiment at Mass. General, they were eager to submit affidavits swearing to Dr. Long’s claim of being the first to use ether for surgery. These included the witnesses present at Mr. Venable’s surgery, as well as Long’s colleagues, friends, and patients. Indeed Dr. Long’s use of ether for surgery was well known in the community, and many patients after Venable benefited. Numerous others conducted investigations, including some famous European doctors, who were happy to provide statements. (Originals of the affidavits reside in the University of Georgia’s library today.)

It was easy to support Dr. Long. He was much loved and respected. He had a kind and gentle manner. He was humble and caring. He did not seek a patent or financial reward. He simply wanted recognition from his peers.

Long’s discovery, including copies of affidavits, was published in the Southern Medical and Surgical Journal in December 1849.

I imagine it came as a shock to the Boston doctors when they first learned that Dr. Long beat them to the discovery by more than four years. Their instinctive reaction surely was denial. A country doctor? In Georgia?

A whole book could be written about the long contentious battle for recognition for the first use of ether in surgery. It should have ended early on when numerous affidavits were submitted to medical societies, and when people who thoroughly investigated the matter provided their proof. In the end, it was hopeless for Dr. Morton and the others. The evidence was irrefutable.  Dr. Crawford W. Long of Georgia was the first to discover the use of ether as an anesthetic during surgery.

Crawford Long’s last surgery

Dr. Long breathed his last breath just after delivering a baby. He was stricken with apoplexy (stroke) and suddenly fell over on the patient’s bed. He was carried to another room where he died the next day. Just before his death, he regained consciousness, and his first words were to inquire about his patient. “How is she?” he asked, and then, knowing people wanted to help him, said, “Care for the mother and the child first,” and gave instructions for their care. It was June 16, 1878. He was sixty-two years old.

Dr. Long was not given full recognition in his lifetime

Although there was no doubt Dr. Long was the first to use ether for surgery, many persisted in giving the Boston doctors credit. One wonders whether the War Between the States followed by the Reconstruction years had anything to do with it. On that note, it was interesting to come across this article from 1894 in The Galveston Daily News:

Discover of Ether

First Applied as an Anesthetic by

Dr. Crawford W. Long in 1842

Dr. Cerna Corrects Dr. Shrady and Want [sic] Justice Done to the Southern Surgeon

Dr. Cerna was furious because Dr. George F. Shrady of New York had recently published an article giving the discredited claimants (Morton, Jackson, and Wells) full credit for discovering ether as anesthesia! Surely the whole medical profession knew the truth by now. Was there another motive? Interestingly, Dr. Cerna, after pleading Dr. Shrady to tell the truth, added, “And it is time that the truth, and nothing but the truth, in the matter at issue should be told, regardless of national jealousies or sectional strife.”

Today Dr. Long gets credit—well, for the most part

To this day, although Long’s name does come up in Google searches giving him credit for being first, all too many credit Morton and the Massachusetts General Hospital. Shockingly, even on Mass. General’s website, they completely ignore Long and write, “William Morton, a dentist from Hartford, Connecticut, came up with the idea of administering ether to a patient … The success of this event marked the birth of anesthesiology … “ There is also a monument in Boston’s Public Garden with the inscription, “To commemorate the discovery that the inhaling of ether causes insensibility to pain. First proved to the world at the Mass. General Hospital in Boston October AD MDCCCXLVI.”

Rightful Recognition and Monuments

I guess these people never saw Long’s portrait hanging in numerous colleges and hospitals, the Anesthetists Hall of the Royal Society of Medicine in London, and the Capitol building in Georgia. Maybe they never saw the granite monument in the form of a shaft in Jefferson near the spot of Long’s first operation with ether.

Or the bronze medallion at the University of Pennsylvania with the inscription:

“To the memory of Crawford W. Long who first used ether as an anesthetic in Surgery March 30, 1842.”

Then there’s his statue in Statuary Hall in the United States Capitol building in Washington, D.C., and a wonderful museum, The Crawford W. Long Museum, in Jefferson, Georgia.

Doctors’ Day

And do the folks at Mass. General even know why March 30^th was chosen as Doctors’ Day, the National day honoring physicians? Doctors’ Day was conceived by Mrs. Eudora Brown Almond, wife of Dr. Charles B. Almond, of Georgia, in 1933, and the date chosen was the anniversary of the first use of anesthesia in surgery, March 30, by Dr. Crawford W. Long—one of the greatest benefactors to human suffering.

References

• Crawford W. Long and the Discovery of Ether Anesthesia. Frances Long Taylor, 1928.
• Crawford Williamson Long and Ether. E. M. Magruder, M.D., Atlanta J. Rec. Med., Nov. 1917, 64(8), P. 236 (3) Galveston Daily News, May 6, 1894.
• General Hospital: https://www.massgeneral.org/anesthesia/news/ether–175#:~:text=On%20October%2016%2C%201846%2C%20the,Building%20at %20Massachusetts%20General%20Hospital.

• Crawford W. Long Museum in Jefferson, Georgia.
• University of Georgia Special Collections Library.

Lorene Leiter

Lorene Leiter spent most of her working years in scientific research in the fields of nutrition, cancer, and neuroscience. Most recently, she taught Anatomy and Physiology at Midlands Technical College in Columbia, South Carolina. She has a B.A. in Anthropology from the University of Massachusetts and a Ph.D. in Nutrition from Rutgers University. She is the author of many scientific papers.

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