What did people do before anesthesia? - Sally Frampton

翻译人员: Sophia Ye 校对人员: Jacky He

With medical students restraining the patient and onlookers eagerly awaiting,

医学学生控制住病人、 旁观者焦灼等待着，

Scottish surgeon Robert Liston poised himself to begin.

苏格兰外科医生罗伯特·利斯顿 (Robert Liston) 准备开始手术。

In quick succession, he cut his patient’s flesh,

接二连三地，他切开了病人的肌肉，

sawed through their tibia and fibula and, within just a few minutes,

锯断了胫骨和腓骨，仅仅几分钟内，

the amputation was complete.

便完成了截肢手术。

It was the 1830s and Liston was renowned for his surgical speed.

那是 19 世纪 30 年代， 利斯顿以手术速度而闻名。

This was important because, before anesthesia was widely used,

这很重要，因为在麻醉药广泛使用之前，

patients had to consciously endure every moment of surgery.

患者必须有意识地忍受手术的每一刻。

The quest for anesthetics that could induce unconsciousness

早在利斯顿之前，人们就开始寻求能够使 人失去知觉并实现更精确手术的麻醉剂。

and enable more meticulous surgeries launched long before Liston.

Around 200 CE, Chinese physician Hua Tuo described mixing alcohol

大约在公元 200 年，中国医生 华陀描述了将酒精与

with a powder of various ingredients to anesthetize patients.

多种成分的粉末混合 以使患者麻醉的方法。

And 13th century Arab surgeon Ibn al-Quff described patients taking anesthetics,

13 世纪的阿拉伯外科医生伊本·库夫 描述了患者接受麻醉的情况，

likely inhaling drugs like cannabis, opium, and mandrake,

很可能是吸入大麻、 鸦片和曼德拉草等药物，

from saturated sponges.

浸润在海绵里。

By the end of the 1700s, many scientists were pondering

到 18 世纪末，许多科学家 开始思考化学在医学上的应用。

chemistry’s medical applications.

This led to a profusion of anesthetic advancements involving three main players:

这导致了一系列麻醉方面的改进， 主要涉及三个化合物：

nitrous oxide, ether, and chloroform.

笑气、醚和氯仿。

In 1799, English chemist Humphry Davy began experimenting with nitrous oxide,

1799 年，英国化学家 汉弗莱·戴维开始用笑气进行实验，

or laughing gas— inhaling it himself and observing its effects on friends.

他自己吸入后观察朋友的反应。

Davy noted that its pain-relieving abilities might make it useful

戴维注意到笑气具有缓解疼痛的能力，

for surgical operations—

可能对手术有用，

but it would be decades before that happened.

但在几十年后才真正应用于手术中。

This was, at least in part, because some surgeons and patients

至少部分原因是因为 一些外科医生和患者

were skeptical of the effectiveness and safety of anesthetic drugs.

对麻醉药物的效果和 安全性持怀疑态度。

In 1804, Japanese surgeon Seishū Hanaoka successfully removed a breast tumor

1804 年，日本外科医生花岗 清秀成功地为一名患者切除了乳腺肿瘤，

from a patient anesthetized with a mix of medicinal herbs.

并采用一种混合草药的麻醉剂。

But the news stayed in Japan indefinitely.

但这一消息没有传出日本。

Eventually, ether started garnering medical attention.

最终，醚开始引起医学界的注意。

It was first formulated centuries before then came to be used recreationally.

它在几个世纪前首次被制成， 然后被用于娱乐。

During the so-called “ether frolics” of the early 1800s,

在 19 世纪初的所谓的 “醚派对”期间，

an American physician noted that the fall he suffered

一位美国医生注意到自己在使用 醚后摔倒，不感到疼痛。

while using ether was painless.

In 1842, he etherized a patient and successfully removed

1842 年，他为一名患者 使用醚进行麻醉，

a tumor from his neck.

并成功地切除了他的颈部肿瘤。

In the meantime, dentists finally began recognizing nitrous oxide’s promise.

与此同时，牙医们终于开始认识到 笑气的潜力。

But, in 1845, when an American dentist attempted a public tooth extraction

但是，在 1845 年，当一位 美国牙医试图给一位

on someone anesthetized with nitrous oxide,

被笑气麻醉的患者拔牙时，

he apparently encountered a setback when his patient screamed.

他似乎遇到了问题，患者尖叫起来。

It was probably just an insufficient dose—

这可能只是剂量不足，

but it was a bad publicity moment for the drug.

但对这种药物来说 是负面的公众态度。

Meanwhile, dentists refined ether for tooth extractions.

与此同时，牙医们 改进了用于拔牙的醚。

And, in October 1846, an American dentist administered ether to a patient,

在 1846 年 10 月， 一位美国牙医给一位患者施用了醚，

and a surgeon removed the man’s neck tumor.

一位外科医生切除了 这个人的颈部肿瘤。

Two months later, Liston himself performed an upper leg amputation

两个月后，利斯顿本人为一位麻醉 的病人进行了上肢截肢手术，

on an etherized patient,

据报道，病人在几分钟后恢复了意识， 并询问手术何时开始。

who reportedly regained consciousness minutes after

and asked when the procedure would begin.

Further ether-enabled successes followed from India, Russia, and beyond.

印度、俄罗斯等地的医生 也取得了醚麻醉的成功。

But ether had issues, including unpleasant side effects.

但是醚也存在问题，包括不愉快的副作用。

Scottish obstetrician James Simpson heard about an alternative anesthetic

苏格兰产科医生詹姆斯·辛普森听说了 一种名为氯仿的替代麻醉剂。

called chloroform.

And, in 1847, he and two colleagues decided to try some themselves

1847年，他和两位同事决定自己 尝试一些氯仿，

and promptly passed out.

并很快昏倒了。

Soon after, Simpson administered chloroform

之后不久，辛普森给他的一位 分娩中的患者施用了氯仿。

to one of his patients during childbirth.

It quickly gained popularity because it was fast-acting

它很快流行起来，因为它起效快，

and thought to be side-effect-free—

被认为没有副作用，

though we now know it’s harmful and probably carcinogenic.

尽管现在我们知道它是有害的， 很可能是致癌的。

Because anesthetics weren’t yet fully understood,

由于麻醉剂尚未完全被理解，

they sometimes had lethal consequences.

它们有时会导致致命后果。

And some doctors held sexist and racist beliefs that dictated

一些医生持有性别歧视 和种族歧视的态度，

the amount of anesthesia they’d provide, if any at all.

并在麻醉的情况下 主观决定麻醉剂剂量。

American obstetrician Charles Meigs argued that the pain of childbirth

美国妇产科医生查尔斯·米格斯认为

was a form of divine suffering

分娩的疼痛是一种神圣的受苦方式，

and was skeptical that doctors should interfere with it.

并质疑医生对其的干预。

Throughout the 1840s, American physician James Marion Sims

在 19 世纪 40 年代，美国医生 詹姆斯·马里昂·辛姆斯

conducted experimental gynecological surgeries without pain relief,

在未给黑人奴隶妇女 减缓疼痛的情况下

primarily upon enslaved Black women.

进行了实验性的妇科手术。

By the late 19th century, those who could access anesthetics

到了 19 世纪末， 那些可以使用麻醉剂的人

were undergoing increasingly complex operations,

进行越来越复杂的手术，

including some that were previously impossible.

包括一些原本不可能的手术。

Chloroform came to be understood as a riskier, more toxic option,

氯仿被认为是一种 风险更大、更有毒的物质，

and fell out of favor by the early 1900s.

并在 20 世纪初逐渐冷门。

Alongside newer drugs, ether and nitrous oxide are still used today—

在新药物的推动下， 醚和笑气仍然在今天使用，

but in modified formulations that are safer and produce fewer side effects,

但是更安全、 副作用更少的改良配方，

while doctors closely monitor the patient’s state.

而医生密切监测患者的状态。

Thanks to these advances,

源于这些进展，

speed is not always of the essence and, instead of acute agony,

速度不再是最重要的； 与其是剧痛，

surgery can feel like just a dream.

手术更像是做了一场梦。