从麻沸散到乙醚：麻醉史上的四次突破

English

Before the mid‑nineteenth century, surgery was a desperate measure. Patients were held down, given alcohol or opium, knocked unconscious, or simply told to endure. The pain was not a side effect; it was the central horror. The development of reliable surgical anesthesia — the ability to render a patient insensible to pain while keeping them alive — is one of the most consequential achievements in the history of medicine. Four breakthroughs, spanning more than seventeen centuries, mark the path from ancient experimentation to modern practice.

中文

在十九世纪中叶之前，外科手术是一种绝望的补救措施。病人被按住、灌以酒精或鸦片、打昏，或者只是被告知忍受。疼痛不是副作用；它是整个手术中最令人恐惧的部分。可靠的麻醉——在保持病人存活的同时使其失去痛觉的能力——是医学史上最重要的成就之一。四次突破，跨越超过十七个世纪，标记了从古代尝试到现代实践的路径。

1. Hua Tuo’s Mafeisan (c. 2nd-3rd century CE) — The First Recorded General Anesthetic

一、华佗与麻沸散（公元2-3世纪）——最早记载的全身麻醉剂

English
The Chinese physician Hua Tuo (c. 145-208 CE) is traditionally credited with developing mafeisan (麻沸散), a powdered compound that, when mixed with wine, induced a state of unconsciousness on which major surgical procedures could be performed. The Records of the Three Kingdoms (Sanguozhi) notes that Hua Tuo used it for abdominal surgeries, including the removal of diseased organs. The exact formula has been lost, but historical accounts suggest it contained ingredients with narcotic properties, possibly including cannabis, datura, aconite, and other herbal anesthetics. If the accounts are reliable — and there is no reason to dismiss them outright — then Hua Tuo’s mafeisan represents the first documented use of a general anesthetic in human history, predating similar developments in the West by more than 1,600 years.

中文
中国传统医学中的华佗（约145-208年）被公认为发明了麻沸散——一种粉末状复方药剂，与酒混合后可诱导昏迷状态，使大型外科手术得以进行。《三国志》记载，华佗用它进行腹部手术，包括切除病变器官。其确切配方已失传，但历史记载表明其中含有麻醉性成分，可能包括大麻、曼陀罗、乌头以及其他草药麻醉剂。如果这些记载可靠——我们没有理由完全否定——那么华佗的麻沸散代表着人类历史上首次有文献记载的全身麻醉使用，比西方类似发展早了超过1600年。

2. Humphry Davy — Laughing Gas (1799)

二、汉弗莱·戴维与笑气（1799年）

English
Humphry Davy, a young British chemist, inhaled nitrous oxide (N₂O) in 1799 and immediately noted its remarkable effects: it relieved the pain of his inflamed gums and induced a state of euphoria he called “laughing gas.” In his book Researches, Chemical and Philosophical (1800), he wrote: “As nitrous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations.” The observation was exact, but forty‑four years passed before anyone acted on it. The delay is a classic example of how a discovery requires not only the right insight but also the right institutional, technological, and social conditions to become a practice.

中文
1799年，年轻的英国化学家汉弗莱·戴维吸入了一氧化二氮（N₂O），并立即注意到其显著效果：它缓解了他发炎的牙龈疼痛，并诱导了一种欣快状态，他称之为“笑气”。在1800年出版的《化学与哲学研究》一书中，他写道：“鉴于一氧化二氮在其广泛作用中似乎能够消除身体疼痛，它在外科手术中可能可以有利地使用。”这一观察是准确的，但过了四十四年才有人真正采取行动。这种延迟是一个经典案例，说明了发现不仅需要正确的洞察力，还需要正确的制度、技术和社会条件才能成为实践。

3. Crawford Long — First Use of Ether (1842)

三、克劳福德·朗与乙醚的首次使用（1842年）

English
Crawford Long, a physician in rural Georgia, observed that participants at “ether frolics” (recreational inhalation parties) often suffered injuries without feeling pain. On March 30, 1842, he used diethyl ether to remove a tumor from the neck of a patient named James Venable — the first documented surgical operation using inhaled ether as a general anesthetic. Long performed several more such operations over the following years, but he did not publish his results until 1849. As a result, his priority went largely unrecognized for decades. Today, he is honored as one of anesthesia’s pioneers, though his name remains less known than Morton’s.

中文
克劳福德·朗是佐治亚州乡村的一位医生。他注意到参加“乙醚狂欢”（娱乐性吸入聚会）的人经常受伤却不感到疼痛。1842年3月30日，他使用乙醚为一位名叫詹姆斯·维纳布尔的病人切除了颈部的肿瘤——这是有文献记载的第一次使用吸入乙醚作为全身麻醉的手术。此后几年，他又进行了多次类似手术，但直到1849年才发表结果。因此，他的优先权多年来未被广泛认可。今天，他被尊为麻醉学的先驱之一，尽管他的名字仍不如莫顿知名。

4. William Morton — The Public Demonstration (1846)

四、威廉·莫顿——公开演示（1846年）

English
On October 16, 1846, at the Massachusetts General Hospital in Boston, dentist William T. G. Morton administered diethyl ether to a patient named Gilbert Abbott while surgeon John Collins Warren removed a vascular tumor from Abbott’s jaw. Abbott felt no pain. The event, witnessed by a gallery of physicians, was front‑page news within days. Oliver Wendell Holmes Sr. coined the term anesthesia (from Greek an‑, “without,” and aisthēsis, “sensation”) to describe the state Morton had induced. The demonstration electrified the medical world; within months, ether was being used in hospitals across Europe and the Americas. It is not that Morton was the first — Long had preceded him by four years and Davy by four decades — but he was the one who made anesthesia visible, credible, and reproducible. He turned a curiosity into a standard of care.

中文
1846年10月16日，在波士顿的麻省总医院，牙医威廉·莫顿将乙醚给予一位名叫吉尔伯特·阿伯特的病人，同时外科医生约翰·柯林斯·沃伦切除了阿伯特下颌的一个血管瘤。阿伯特没有任何疼痛感。这一事件被一群医生见证，几天之内就登上了报纸头版。奥利弗·温德尔·霍姆斯老创造了anesthesia（麻醉）一词来描述莫顿所诱导的状态。这次演示震惊了医学界；几个月内，乙醚就被用于欧洲和美洲的医院。并非莫顿是第一个——朗比他早四年，戴维早四十年——但他是那个让麻醉变得可见、可信、可重复的人。他将一种好奇变成了标准治疗。

The Shape of Progress

进步的形态

English
The history of anesthesia is not a straight line. Hua Tuo’s formula was lost; Chinese surgery did not develop an unbroken tradition of general anesthesia. Davy’s insight lay dormant for two generations. Long’s results remained unpublished for seven years. It was Morton’s demonstration that changed everything — not because he was the first, but because he gave the world a technique that could be taught, repeated, and trusted. The four breakthroughs remind us that medical progress depends not only on discovery but on transmission, not only on genius but on the institutional readiness to receive it.

中文
麻醉史不是一条直线。华佗的配方失传了；中国外科未能发展出连续的全身麻醉传统。戴维的洞见沉睡了两代人。朗的结果七年未发表。是莫顿的演示改变了一切——不是因为他是第一个，而是因为他给了世界一种可以教学、重复和信赖的技术。四次突破提醒我们：医学进步不仅依赖于发现，还依赖于传播；不仅依赖于天才，还依赖于机构接受它的准备程度。

From Mafeisan to Ether – Four Breakthroughs in the History of Anesthesia 从麻沸散到乙醚：麻醉史上的四次突破