*Flagg JF. The inhalation of an ethereal vapor to prevent

sensibility to pain during surgical operations. Boston Med

Surg J 35:356-359, 1846

To the Editor of the Boston Medical and Surgical Journal

Sir,--That which has always been a desideratum in surgery, seems,

at length, to have been discovered. And if the effects of the agent

or agents be such as has been reported, of which there is little

room to doubt since the appearance of an article in a late No. of

your journal, by Dr. Bigelow, Jr., every one who has any sympathy

for human suffering must rejoice in the discovery; and all who are

called upon professionally to perform painful operations must feel

desirous to avail themselves of the means of diminishing or destroying

that state of consciousness which recognizes all violence done to

the sensitive tissues of the body, while such operations are in process.

But it appears, from numerous statements, and through your

correspondent, Dr. B., who speaks with much authority on the subject,

that the article used is a secret, or patented affair.

Now the enlightened and regular medical faculty of Massachusetts

(as well as of other parts of the country), are associated and have arrayed

themselves against all secret remedies, or patent medicines, and this for

the just and laudable purpose of protecting the community, as far as might

be, from imposition, and of preserving the integrity and standing of the

profession; they cannot, therefore, feel themselves at liberty, as I judge,

to seek aid for their patients through the adoption of such articles and

means.

If I wish to furnish those by whom I am called upon to operate in

painful cases with the relief which this new discovery may afford, I am

told I must obtain it and use it as a secret, or purchase the patented

article and employ it as such. But I ask why? It is said to be, by those

who really do, who assume to know what it is, the vapor of sulphuric

ether only. This was judged to be the agent by several who witnessed

some of its earliest public exhibitions under the hands of Mr. W.T.G.

Morton. Dr. E.R. Smilie, of this city, with all due candor and liberality,

has given, in your Journal for Oct. 28th, an account of his experience

with sulphuric ether and opium, the effects of which he says are similar

to those produced by the "_new gas."

The free use of the article has been ceded to the surgeons of the

Massachusetts General Hospital, and these gentlemen would receive it or

adopt its use, on no other condition, of course, than that of knowing

what it was, and having the full and free control of it for that institution.

Hence, I ask, why, if I wish to avail myself of any of the possible effects

of an article of our materia medica--an article which I have administered

to patients hundreds of times, which I have often swallowed, and have

inhaled till I was all but lost in sleep--why must I now purchase the

right to use it, and use it as a patent medicine.

But we are still told that _it is patented._ What is patented?

A power? A principle? A natural effect? The operation of a well-known

medicinal agent? I doubt the validity of such letters patent. It would

seem to me like _patent sun-light_ or _patent moon-shine_.

To my mind it seems unfortunate, to say the least, that the discovery

has not been brought to public notice in a different manner and under

different circumstances. And I am sorry that Dr. Bigelow, in his article

above mentioned, has attempted to apologize for the arrangements which

he says have been made by Dr. C.T. Jackson as one of the parties, to

secure by patent the control of a medicinal agent like the one in

question. The doctor seems to feel very fully his position in relation

to this point, when he says,

"For various reasons, discoveries in high science have been usually

rewarded, indirectly by fame, honor, position, and occasionally, in other

countries, by funds appropriated for the purpose. Discoveries in medical

science, whose domain approaches so nearly that of philanthropy, have

been generally ranked with them; and many will assent with reluctance to

the propriety of restricting by letters patent the use of an agent capable

of mitigating human suffering."

Of the three reasons which he offers worthy of consideration in

this behalf, two are, to my mind, entirely without force sufficient to

be any excuse for such a measure; and the total incorrectness of the main

part of the third, must be apparent to all who are at all acquainted with

the subjects on which it is made bear.

"1st. It is capable of abuse, and can readily be applied to nefarious

ends."

If, however, the right to be sold, and every opportunity is to be

improved to _make money_ of it, and all may buy who please, I do not see

how the abuses to which it may possibly be put by evil-minded persons are

to be restricted by a patent. And any one vile enough to use such an agent

for nefarious purposes, would not stop to ask about his _right_ to do so.

"2d. Its action is not yet thoroughly understood, and its use should

be restricted to responsible persons."

Who are the responsible persons to be trusted with this agent? All

will assent, no doubt, that they are such as are most likely to be

acquainted with the properties of the article, with the nature of those

unpleasant symptoms which _may_ occur from the use of it, and have

occurred in certain constitutions, and with such antidotes or remedies as

should be used if required; or, in three words, regular physicians,

surgeons and dentists. And I am at a loss to see why the use of the discovery

would not be as safe in such hands as in those of "_the propietor_" so

called.

"3d. One of its greatest fields is the mechanical art of dentistry,

many of whose processes are by convention, secret, or protected by patent

rights."

Who is there who bestows a thought on the subject, who will not see

at once, that this narcotizing process of inhaling the ether has nothing

to do with the _mechanical_ operations of dentistry, but only with those

which are strictly surgical, those which Dr. B., in speaking of the

importance of this process, couples with _amputations_.

As to that part of this third apology, which charges dentistry or its

professors with holding secrets, by convention, or by the security of

patent, I must view the writer as being entirely in error; for if there is

truth in the charge, I cannot find it. I do not know anything which is

practised in dentistry, in our own country, even relating to the

mechanical department, which is kept secret by or from the duly educated

dentists. [How this is with the host of ignorant pretenders, and

advertising imposters, I know not.] And with regard to a patent for any

process in the art, or even for an instrument, I do not know that such a

thing exists, nor am I willing to believe, without greater evidence than

the doctor's assertion, that a patent can be found that has any especial

bearing on the subject of dentistry.

I have been asked, by a member of the Massachusetts Medical Society

---a respectable and excellent dentist of this city, what I intended to do

about using the "new gas," stating that he had used it and knew what it

was, and when questioned by me directly, did not hesitate to say, "it is

simply sulphuric ether"; but added, "the discovery is patented." My reply

to him was, "I shall not obtain and use it as a _secret medicine_--I shall

not purchase and use it as a _patent medicine_. If it is simple sulphuric

ether, and it will produce the desired effect, I shall use it, and so will

others who wish to do so." If it is a compound, as still advertised to be

by Mr. Morton, it is said to be ceded to the surgeons of the Massachusetts

General Hospital. These gentlemen, it is to be presumed, will not consent

to hold it as a secret or patent medicine; and if known to the medical

students who are privileged to attend that institution for the purpose

of acquiring information and obtaining instruction in all that is done

there pertaining to their profession, no one, as I judge, can rightfully

restrict them from using what is there used for relief of suffering

humanity; and it will become, as it ought to be, free to all who should be

trusted to do good with it, or who can receive relief from suffering by it.

To patent it would be, what it would have been for the immortal

philanthropist Jenner to have patented vaccination.

These, Mr. Editor, are some of my thoughts on the subject; and if I

am in error for holding them, or for thus giving them to the public, you

are able, no doubt, and will be ready to set me right. J.F.FLAGG

No. 31 Winter street, Boston, Nov. 23d, 1846

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