He used himself as a test subject and invented spinal anesthesia

Using his own body to conduct anesthesia experiments, physically stimulating each other with his assistants to verify the effect, and because of the sequelae left by the anesthesia experiments (headaches occur when reading for a long time)...

All of the above behaviors come from August Beer, the pioneer of spinal anesthesia.

Image source: Wikipedia August Beer

Bill's anesthesia surgery

August Bier was a famous German surgeon.

In 1886, doctors used lumbar puncture to extract cerebrospinal fluid from humans for the first time. Based on this innovation, Bill boldly speculated that it might be possible to inject sedatives into the spinal cord, so that the nerves and muscles that control the area below the injection point would be blocked.

In 1898, a patient with a foot injury who needed surgery came to Bill's hospital.

Before the operation, the patient had undergone multiple general anesthesia and experienced various anesthesia side effects. Considering the patient's safety, Bill proposed a new alternative - spinal anesthesia, which is to inject anesthetics into the lumbar spine for anesthesia.

After obtaining the patient's consent, the first surgery in human medical history using spinal anesthesia was performed.

Image source: pexels

On the day of the operation, Bill injected a certain amount of cocaine into the patient's spine. About 20 minutes later, the patient's lower body lost consciousness. During the operation, the patient remained conscious.

After the anesthetic effect wore off, the patient experienced adverse reactions such as nausea, vomiting, and severe headache. The vomiting symptoms disappeared quickly, but the headache continued until the next day.

In the following days, Bill performed similar anesthesia on different patients, and each patient's reaction was different.

In order to find out the situation, Bill asked his assistant Hildebrandt to pierce the protective membrane of his spinal cord with a hollow needle and insert the needle into the fluid-filled cavity.

Unexpectedly, during the injection process, the assistant accidentally connected the needle to a syringe of an incompatible size, causing the spinal fluid in Bill's spinal cord to drip onto the ground and most of the cocaine solution to be washed out.

Due to the loss of spinal fluid, Bill had to postpone the experiment, but his assistant volunteered to take over as the next "guinea pig." Bill then injected cocaine into his assistant.

After the anesthetic took effect, Bill subjected the assistant to various physical stimulations, including muscle pulling, pulling out body hair, and even burning the assistant's skin with cigarette butts. When these actions occurred on the upper body, the assistant would feel obvious pain, but when Bill stimulated the lower body, the assistant had no reaction.

Image source: pexels

After the anesthesia wore off, Bill and his assistant drank some wine to celebrate their victory. The next day, Bill and his assistant both felt unwell, with symptoms such as headache and nausea.

Fortunately, the experiment was successful, and the reason why the two had such serious side effects was largely because they did not get proper rest after the anesthesia. Bill published a paper on spinal anesthesia the following year, and this method of anesthesia gradually became popular, and the anesthetics used were also updated.

Who first proposed spinal anesthesia?

However, just after Bill's paper was published, the academic community began to discuss "who was the first to successfully perform spinal anesthesia", and some people believed that this honor should belong to Leonard Corning.

Image source: Wikipedia Leonard Corning

Strictly speaking, Corning's experiment did precede Bill's.

In 1885, Corning conducted an experiment on spinal anesthesia in dogs. Moreover, Corning's injection was not in the cerebrospinal fluid, but in the epidural space, and the dosage was slightly higher. Epidural anesthesia started from Corning's experiment and gradually developed into maturity.

Epidural anesthesia takes longer to take effect, about half an hour. This method will not cause cerebrospinal fluid leakage, and an indwelling needle can be used to supplement anesthetics, making it suitable for long-term surgery.

Bill's method of anesthesia, which later became subarachnoid anesthesia, requires a small amount of anesthetic and takes effect quickly, making it suitable for short-term surgery. However, after the anesthesia wears off, it will be accompanied by postoperative complications such as decreased intracranial pressure, headache, nausea, etc.

Image source: pexels

There is currently no consensus on who performed the first spinal anesthesia (epidural anesthesia, subarachnoid anesthesia, combined spinal-epidural anesthesia, collectively referred to as spinal anesthesia), but the innovations of both men in the field of medical technology have brought more possibilities for saving lives.

Risks of anesthesia

Although anesthesia can help patients relieve pain, it must be acknowledged that anesthesia has risks.

When the anesthesiologist injects anesthetics, he needs to use a needle to pierce multiple layers of structures such as the superficial fascia, deep fascia, supraspinous ligament, etc. in order to reach the intervertebral space. This operation is blind and is entirely based on the anesthesiologist's personal experience.

Image source: Wikipedia

Some people believe that local anesthesia does no harm to the body because it allows the brain to remain awake.

In fact, local anesthetics are toxic. Depending on the tolerance of patients, they can cause various excitements or inhibitions in the central nervous system and cardiovascular system. In mild cases, they may cause dizziness, tinnitus, and tongue numbness. In severe cases, they may cause convulsions, seizures, and even respiratory and cardiac arrest.

With the development of medical technology, more and more diseases are being conquered. Perhaps one day, we will be able to use safer and more reliable anesthetics.

END

Audit experts:

Wang Linjue, associate chief physician of the Department of Orthopedics, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.

Tadpole Musical Notation original article, please indicate the source when reprinting

Editor/Xiao Xitushuo