The early 19th century was marked by intense suffering in medicine, especially in surgical and dental practices. Before effective pain control, operations were spectacles of speed and agony, and dental extractions relied on the patient’s endurance or the dulling effects of alcohol or opium. This discomfort created an imperative to find a reliable method of rendering patients insensitive to pain. The introduction of nitrous oxide, colloquially known as “laughing gas,” represented a revolution, offering the first successful path to effective anesthesia and fundamentally changing the patient experience.
Early Understanding of Nitrous Oxide
The history of nitrous oxide began decades before its medical application when English chemist Joseph Priestley first synthesized it in 1772. Later, Sir Humphry Davy investigated the gas’s properties at the Pneumatic Institute in Bristol. Davy documented the physiological effects, noting the euphoria it produced, which led him to coin the name “laughing gas.”
Davy also recorded a temporary loss of physical pain sensation during his experiments, suggesting its possible use in minor surgery. Despite this observation, the gas did not immediately become a clinical tool. For nearly fifty years, nitrous oxide was used as a recreational novelty.
The public attended “laughing gas parties” or demonstrations to experience its intoxicating and euphoric effects. These exhibitions were common entertainment in the first half of the 1800s, where participants often exhibited strange behavior and temporary insensitivity to injury. This widespread, non-medical context ensured the gas’s peculiar effects were known, setting the stage for its eventual recognition as a pain-blocking agent.
The Pioneering Dental Application
The individual who translated the recreational use of nitrous oxide into a medical breakthrough was Horace Wells, a dentist in Hartford, Connecticut. Wells attended a demonstration by showman Gardner Quincy Colton on December 10, 1844. During the exhibition, Wells observed a participant inhale the gas, stumble, and severely bruise his leg. The key observation was that the man reported feeling no pain from the injury until the gas effects wore off.
Wells immediately recognized the analgesic implications for dentistry, a profession constantly grappling with patient pain. The next day, December 11, 1844, Wells arranged a private experiment. He enlisted Colton to administer the nitrous oxide while his colleague, Dr. John Mankey Riggs, prepared to extract one of Wells’ own teeth.
Wells inhaled the gas until he lost consciousness, and Dr. Riggs successfully extracted a wisdom tooth without Wells feeling any pain. Wells famously exclaimed, “A new era in tooth-pulling!” upon waking. This self-experiment marked the first recorded instance of a dental procedure using inhalation anesthesia. Wells subsequently administered nitrous oxide to his patients, reportedly completing 12 to 15 extractions with only two failures.
Establishing Anesthesia in Dentistry
Following his personal success, Wells attempted to introduce his discovery to the broader medical community with a public demonstration in Boston. In January 1845, Wells used the gas during a tooth extraction at Massachusetts General Hospital. However, the patient cried out during the procedure, leading the audience to declare the demonstration a failure. It is now believed the patient did not receive a sufficient quantity of the gas, but the public perception of failure damaged Wells’ cause.
This initial setback, combined with Wells’ reluctance to publish his findings, stalled the acceptance of nitrous oxide. Meanwhile, Wells’ former partner, William T.G. Morton, and chemist Charles T. Jackson began experimenting with diethyl ether, a more potent anesthetic. Morton successfully demonstrated the use of ether for a major surgical procedure in 1846. Ether was immediately embraced by the medical establishment and subsequently overshadowed Wells’s earlier work.
The controversy over credit for the discovery of general anesthesia was intense. Ether became the standard for surgical anesthesia due to its greater potency, despite its volatility and risks. It was not until the 1860s, years after Wells’s death, that Gardner Quincy Colton began successfully using nitrous oxide again in his dental clinics, leading to its widespread acceptance in dentistry. Wells was ultimately recognized posthumously by both the American Dental Association and the American Medical Association as the true discoverer of surgical anesthesia.