The Black History of Anesthesiology
William Thomas Green Morton (1819-1968) is often considered the first to discover general anesthesia and to pioneer its applications in surgery.
However, four and a half years before Morton’s breakthrough, a young man from the Southern states, Crawford Williamson Long (1815-1878), became the first physician to operate with no pain, performing minor surgical and obstetric procedures under anesthesia using diethyl (sulfuric) ether.
Long's legacy is a testament to the silent, but significant role that Black Americans occupied in the history of medicine.
The “Father of Anesthesiology” Crawford W. Long
The boy had a disease of a toe, which rendered its amputation necessary, and the operation was performed without the boy evincing the least sign of pain.
In another version of the account, revealed to us through the research of Brazilian anesthesiologist Almiro dos Reis Júnior, the boy had suffered a burn serious enough to warrant the amputation of two toes on one foot.
Here is a description of the event:
The boy agreed in being submitted to anesthesia. Long put him to sleep and amputated one toe with no patient reaction.
Long actually described this in a later report as being his third operation, his second one being the removal of an additional tumor from his first patient the previous month.
Long also claimed that a letter from the boy's master, a Mrs. Hemphill of Jackson county, Georgia, was 'sufficient' to prove that he did not recall experiencing any pain from the procedure.
His fourth operation was conducted on September 9, 1843, 'in the extirpation of a tumor from the head of Mary Vincent of Jackson county, Ga.'
A fifth operation was carried out on January 8, 1845, 'in the amputation of the finger of a Negro boy belonging to Ralph Bailey of Jackson county, Ga.'
Here is the sworn testimony of a witness to that operation:
I, Milton Bailey, certify that I was present in the early part of the year 1845 and witnessed Dr. C. W. Long cut off two fingers of a Negro boy, Isom, the property of my father, Ralph Bailey, Sr.
Long, however, noted:
The boy was etherized during one amputation, and not during the other; he suffered from one operation, and was insensible during the other.
Long had achieved his goal.
He was now completely convinced of ether's efficacy.
...he suffered from the latter operation and was insensible during the other.
Though he faced much criticism, Dr. Long continued his experiments.
He administered ether to his wife during childbirths and, in so doing, Long became a pioneer of obstetric analgesia.
(Source: P. I. Nixon Medical Historical Library via the Brazilian Journal of Anesthesiology)
This rare photo was found 30 years ago at a book fair in Austin, Texas, and was acquired by Dr. Scott Smith, resident in Anesthesiology of the Medical Center Hospital, who donated it to P. I. Nixon Medical Historical Library at the University of Texas Health Science Center in San Antonio, in honor of Dr. Maurice S. Albin, professor of Anesthesiology of the Health Science Center and director of neuroanesthesiology of the Medical Center Hospital and of the VA Medical Center.
Dated to 1855, the picture simulates a surgical procedure under the effect of ether.
This picture was discovered by an antiques tradesman in Gainesville, Georgia, who bought it from a descendant of Long's and sold it to a rare books dealer in Athens, Georgia.
Dr. Júnior, a specialist who works in the anesthesia department at Oswaldo Cruz German Hospital, in São Paulo, Brazil continues with more details:
It is an important document for the history of Medicine because it seems to be the only picture of Long; his other images are all oil paintings [there is also the black and white engraving].
The graphic scene - the intensity of Long's stare, the decisiveness in his grip, and the way Robert smothers the face of the lifeless man - is suggestive of an ulterior prejudice against his model patient.
It calls us to question: in this time of overt racism, what did this aspiring doctor think of his Black patients?
Long served in the Confederate army's sanitation service during the American Civil War. In his college days, he had become close friends with the future vice-president of the rebel nation, Alexander Hamilton Stephens, and they were college roommates. Stephens was known to be a staunch defender of 'African slavery' and White Supremacy, though he walked back much of his statements while in prison for high treason.
Pharmacist Joseph Jacobs, in his Personal Recollections of Dr. Crawford W. Long (1919) wrote the following on Long's relations with Black people:
As to the "Slavery Question” Dr. Long was a “Whig,” and followed the teachings of Henry Clay.
The Significance of the Ether Discovery
Long before the days of Horace Wells and of Morton and Jackson, we were on the eve of the discovery of anaesthesia.
Frederick Sertürner, First of the Alkaloid Chemists, Synthesizing Morphine
Artist: Robert Thom
(Source: The Hanneman Archive)
For Sims, the question was settled. After learning the facts just a year prior from a Dr. Philip A. Wilhite, who assisted Long in his surgery on his friend James M. Venable in Jefferson, Georgia, Sims was convinced that the title belonged to Long.
The claims of Long have never been fairly stated in connection with those who came after him. I am ashamed to say I was wholly ignorant of them until a very recent day, and I believe that the great mass of the profession are in the same category with me.
Wilhite stated that 'the boys and girls in his neighborhood near Athens, Georgia, were in the constant habit' of inhaling ether for a quick high and that 'there was hardly ever a gathering of young people that did not wind up with an ether frolic.'
Some would laugh, some cry, some fight, and some dance, just as when nitrous oxide gas is inhaled.
Mr. Venable, past 21 at the time of his operation, confirmed the local hysteria about the "exhilarating powers" of ether among the youth of 'Jefferson and the adjoining county,' claiming to have been an ether enthusiast himself.
I...was very fond of its use.
Wilhite recalled one of the "quiltings" where these "frolics" took place. Unbeknownst to the young Wilhite, he would be the first to attest to the sedating effects of ether and the first person to experience this phenomenon would be an unsuspecting Black teenager.
It was in the Fall of 1839. Wilhite was a romping boy of seventeen. All the boys and all the girls had inhaled the ether, some of them more than once.
Historic Wilhite House Marker
Photo by Brian Scott
(Source: The Historical Marker Database)
What was seemingly an innocent prank had actually turned into one of the most groundbreaking discoveries of all time.
For a long time, surgeons ordered strong liquor, opiates (like morphine), hemp, mandrake, and even straightjackets to minimize errors caused by their writhing patients. Mesmerism was the standard in Europe and in America.
Now, all they needed was a sponge or towel and a bottle of ether.
At the close of the century, New Jersey minister Amory H. Bradford declared 'the discovery of anaesthetics...one of the greatest blessings which ever came to the human race.'
Sims went as far as to say it was the second greatest.
Vaccination is perhaps the greatest boon ever conferred by science on humanity. Anesthesia is the next. England gave us the one. America the other.
...he presumed that he (Dr. Wilhite) was the first person who had ever profoundly etherized any one — and it was under these circumstances.
However, ether for medical purposes was unheard of.
At the age of 20, ten whole years before graduating medical school, Wilhite's research with Dr. Long cemented his place in the history of medicine.
After quite a few "frolics" of their own, Long and his team (all between 19 to 21 years of age) made the decision to experiment with the "wonder drug" in other ways. What might appear to our modern sensibilities as juvenile judgement, was not simply an ecstatic epiphany. (Although they were probably on ether at the time.) It was not by chance or by happenstance that Long proceeded with human trials. Rather, Sims tells us:
Wilhite encouraged him by relating the case of the Negro boy he had playfully and unintentionally put under the influence of ether for an hour or more in the Fall of 1839.
In his first article on the subject, Long wrote that his inspiration to induce ether anesthesia for surgical purposes came from the fact he and his friends never felt the pain of bruises they received while under the influence of ether.
For some reason or another, Long had conveniently left out Wilhite's story of the Negro boy.
Because neither Long, nor Wilhite, published their findings, other men such as Morton, Wells, John Charles Warren, and E. E. Marcy (who suggested Wells try ether in place of nitrous oxide), were often credited for the discovery of ether's anesthetic properties.
But the record is clear. Sims highlights the facts:
Long's anaesthesia with sulphuric ether was on the 30th March, 1842.
It was not until seven years after his discovery that Long published "An account of the first use of Sulphuric Ether by Inhalation as an Anaesthetic in Surgical Operations" in the Southern Medical and Surgical Journal.
While the scientific community remained largely unfamiliar with the details of Long and Wilhite's accomplishments, a handful of professional bodies caught on over time.
In 1852, the Medical Society of the State of Georgia (now the Medical Association of Georgia) officially considered Long the first to use sulfuric ether for surgical anesthesia and referred the discussion about this claim to the American Medical Association (AMA).
Years later, at an AMA meeting, Wilhite was acknowledged to be the official discoverer of the anesthesia ether. It was also determined that his services should be recognized by the government, but this was never done.
On June 18, 1879, the National Eclectic Medical Association passed a resolution acknowledging Long's primacy.
The American Society of Anesthesiologists recognizes anesthesia as 'possibly America's greatest contribution to medicine' and Long's work as 'the world's first administration of anesthesia for surgery.'
Medical experts and professional researchers still get it wrong from time to time. A March 2015 article on "Ethics and the Practice of Anesthesia," published in the AMA's Journal of Ethics begins as follows:
Anesthesia began in 1846, when an American dentist administered diethyl ether to a patient undergoing neck surgery.
This is evidently a reference to Morton's public demonstration of his ether brand "Letheon" in an attempt to patent the drug for personal profits.
However, it is prudent on us, not only as researchers, but as representatives of our community, to shine a light upon the contributions of our people, no matter how dim that light may often seem.
Early Operation Using Ether For Anesthesia
(Also the first photographic record of an actual live medical operation, featuring Dr. Warren)
late spring 1847
Photographers: Albert Sands Southworth and Josiah Johnson Hawes
(Source: The J. Paul Getty Museum)
Read more about this photograph here.
In this case, the work of Dr. Long and Dr. Wilhite amplifies that light.
Dr. Morton was Dr. Wells' student. Morton introduced Wells to Dr. Warren and Dr. Jackson.
It was Jackson who recommended Morton use ether in his dental surgeries. With success, Morton applied the gas during a September 1846 tooth extraction.
Then it was the operations performed on patients "etherized" by Morton at Massachussetts General Hospital the following month, which, Sims says, 'introduced and popularized the practice throughout the world.'
If anything, Morton could lay claim to the invention of an apparatus for a more precise and effective delivery of ether.
But when Jackson visited Dr. Long in 1854, he affirmed that the various oral and material evidences of Long's discovery had predated all others.
So who got the credit?
Sims wrote that each of these men had, in one way or another, suffered from a lack of recognition for their work.
Wells, disappointed in carrying off the honor of the great discovery of anaesthesia, became insane and committed suicide in New York in 1848.
Having returned to New York in July 1868, a mentally exhausted Morton fled treatment at one hospital only to die from his physical exertions in another.
Jackson has been for some time in an insane asylum, hopelessly incurable.
Long lost his all during our great civil war, and in his old age he is now being worked to death for the daily bread necessary to support himself and family.
Meanwhile, a monument to the discoverer of Anesthesia stood in Boston, with 'no man...designated thereon by name.'
Still, Sims was optimistic.
The State of Georgia will, at no distant day, erect at its Capitol or its University, a statue of Long, who was unquestionably the first discoverer of anaesthesia.
Halothane and newer fluorinated ether inhalants have since replaced sulfuric ether, but Long and his patients will be forever remembered for their part in the development of modern anesthesiology and ether anesthesia continues to be a safe and inexpensive option for health care systems in developing countries.
The Cost of Our Ignorance
At this point in the study of our history, we must accept the fact that ingenuity is not uncommonly devoid of certain ethical considerations. It must be understood that at some level or another, scientists such as Sims and Long built their successes upon the exploitation of others.
Bereft of Black bodies, Long would not be known to us now as the "father of anesthesiology. Likewise, Sims would not be nearly so esteemed as the "father of anesthesiology."
If it weren't for the positions of privilege they occupied in American society, long established along racial lines, they would not have had access to those honorary titles by which we know them today.
The acknowledgement of Black men, Black women, and Black children as a principle factor in the careers of these and other scholars is not to nullify the merits of their knowledge, neither should it serve to subtract from the satisfactions of healing, which we enjoy today.
The greater threat, however, comes from within.
The image of Long posing with his assistants before a Black patient has appeared countless times on our social media pages and websites with a caption about "drapetomania" diagnoses during the time of slavery and the practice of doctors amputating the legs of runaways as a "cure" for their insanity (read thoughts of freedom).
Certain interpretations on the experience of American slavery, while they carry the best of intentions, can become problematic when removed from their rightful context.
Is Long's work in the 1840s interchangeable with that of Dr. Samuel Cartright, who first wrote on drapetomania in 1851? It is worth noting that the removal of fingers and toes triggers a different response in the body from the removal of external tumors. Did he amputate the appendages of slaves to relieve their suffering or to cause them pain? Were these vessels merely for practice, like Sims used his patients, to perfect his technique for a more affluent and delicate (White) clientele?
Of course, the nature of Sims' and Long's experiments were not identical. Both involved the use of slaves. But to conflate them may lead us down a slippery slope.
We might consider, for example, that the work of Long would have helped Sims' patients through his procedures had Sims held off on his own experiments. But even then, does that justify Sims' choice of subjects? If ether had not been as effective, would Long's work prove to be just as callous?
It seems that although Sims never used anesthesia, an interest in its applications was present in his later years.
One thing is for certain: to consistently pair research with physical and mental abuse is a sure way to encourage ignorance. It seems that all too often, scientific research has been associated with the darker parts of our story. Naturally, one might be lead to question...
Is science the White man's witchcraft?
Were Black people their sacrificial lamb of human experimentation?
Is the purpose of science itself to eradicate the Black race?
Is the study of medicine just a tool to kill us all?
"Drapeto-mania" may be a vestige of quack science, but left unchecked and taken to the extremes, our fears can drive us to the edge.
Given the history of medical experimentation on Black Americans from colonial times to the present, Black people have reason to be concerned.
Harriet A. Washington, author of the critically acclaimed Medical Apartheid, writes in her book:
Historically, African Americans have been subjected to exploitative, abusive involuntary experimentation at a rate far higher than other ethnic groups.
But 'the fear of medicine,' says Washington, 'helps perpetuate our nation’s racial health gulf.'
Physicians, patients, and ethicists must also understand that acknowledging abuse and encouraging African Americans to participate in research are compatible goals.
The key question for us now in the 21st century is this: How much have we changed as a society when it comes to our approach to medical research?
Some of us only see the evidence of these historical injustices as yet another opportunity to challenge the qualifications of "White academia."
Some evoke the nightmare of American history only to use these stories as further pretext for demonizing campaigns calling for a prioritization of our health through proven channels.
But we must never lose sight of our own fundamental need for medical research and our share (and well-deserved at that) in the resulting benefits of these studies - whether that research is in a lab or in a clinical setting.
History and today's deplorable African American health profile tell us clearly that Black Americans need both more research and more vigilance.
Sure, we must be vigilant, but it is not for us to lose sleep over these affairs.
After all, our health is just as important as our history.
To stem the prospect of another medical apartheid - studies like Long's and Sims' - will take a prevailing awareness about these sensitive chapters of history among our own people. For those of us who have the knowledge, it is time for us to engage in studies of our own. We can do this by organizing our own researchers, men and women from our communities who we can trust, under the oversight of conscientious leaders.
We don't need to fear for the future. We need to learn from the past.
We need not substitute ignorance for information.
Where we are lacking in knowledge, let us seek the truth.
You will find the truth, not by guesswork, but by the power of research.
With history as your guide, make science your pride.
The science that deforms is the same science that restores.
The science that disturbs is the same science that preserves.
The science that ills is the same science that thrills.
The bottom line is this:
While you're busy being "woke" to your history,
don't sleep on the science.
This article was originally posted on our Tumblr blog on July 16, 2017.
It was re-posted here and augmented on March 5, 2020. View the original post here.
Scientific Researcher, Independent Historian, and Co-Founder of Black Research Central
New Georgia Encyclopedia - Crawford Long (1815-1878)
Revista Brasileira de Anestesiologia [Brazilian Journal of Anesthesiology] (May/June 2006) - Volume 56, No. 3
The Wood Library-Museum of Anesthesiology - The History of Anesthesiology, Reprint Series: Part One (1992)
The Silver Canvas: Daguerreotype Masterpieces from the J. Paul Getty Museum (2000) by Bates Lowry, Isabel Lowry
The Historical Marker Database - Historic Wilhite House
Social History of Medicine - Medical Apartheid (December 2007); Volume 20, Issue 3, pages 620-621
Spirit and Life: Thoughts for Today (1888) by Amory H. Bradford
BMC Anesthesiology - Ether in the developing world: rethinking an abandoned agent (2015); Volume 15, Issue 149
PBS NewsHour - The Painful Story Behind Modern Anesthesia
Black Research Central
In-Depth Info on History and Science from another perspective.