Snow Anesthesia 1812 – Relieving Pain

The ancient Latin saying “Divinum est opus sedare dolorem” (Relieving pain is a divine task) symbolizes surgeons' quest to control pain during operations.

From 2500 BCE onward, the ancient Egyptians sometimes used hypothermia (low temperature) to treat injuries and reduce inflammation. The Greek physician Hippocrates (460-370 BCE) suggested that “swelling, pain and sprains in a joint are generally relieved by abundant infusions of cold water, because moderate numbness reduces pain”. The renowned Islamic physician Ibn Sina (980-1037) used ice-cold water to numb teeth and gums before surgery.

One of the best-known figures to use snow and ice for pain control was the French surgeon Dominique Larrey (1766-1842), who established a horse-drawn ambulance system and a system of patient prioritization in which wounded soldiers were treated according to the severity of their injuries. In 1807, at the Battle of Eylau in Prussia, Larrey observed that amputation pain was greatly reduced when limbs were cooled. During the Battle of Borodino against Russia in 1812, Larrey is said to have performed 200 amputations in 24 hours and another 300 procedures later at the Battle of Berezina. Whenever possible, he used snow and ice to relieve pain.

An ardent supporter of cold anesthesia, the British surgeon James Arnott (1797-1883) was concerned that some early experiments with ether and chloroform, which marked the birth of modern anesthesia, had caused deaths. Arnott's approach involved a mixture of crushed ice and salt applied to the skin around the operation site. Arnott wrote: “In all superficial operations, applying cold is certainly better than chloroform for producing anesthesia (and preventing inflammation), considering such factors as safety, ease of application, and savings in time and trouble.” Arnott placed great importance on the effect of applying cold for pain control and especially on its safety advantages.

About the Article Image: Antoine-Jean Gros (1771–1835) painted the Battle of Eylau in Prussia (February 7–8, 1807)

Historical Figures Mentioned in the Article: Hippocrates of Cos (460 B.C.–377 B.C.), Abu ‘Ali al-Husayn ibn ‘Abd-Allah Ibn Sina (Avicenna) (980–1037), Dominique Jean Larrey (1766–1842), James Arnott (1797–1883)

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