A neglected pioneer of anaesthesia

During a short holiday in south Shropshire this summer my wife and I visited Tenbury Wells, where we popped into the town museum. Like many local museums it turned out to be much more engaging than the out-of-town visitor might expect. In particular, I found myself absorbed by displays relating to Henry Hill Hickman (1800–30), a local physician and a neglected pioneer of surgical anaesthesia.

We are all aware of anaesthesia induced by inhaled substances such as ether, nitrous oxide and chloroform. These three compounds were all first used in surgery in the 1840s. Ether led the way, used by American physician Crawford W Long when excising a couple of skin tumours in 1842 (although he did not announce his discovery until 1849). Nitrous oxide was first employed by an American dentist, Horace Wells, two years later. And the first use of chloroform was by the Scottish obstetrician James Young Simpson in 1847.

The anaesthetic action of all three gases had been discovered many years earlier, but they were used only recreationally before the 1840s. That is why Henry Hill Hickman is important, because in the 1820s he had the foresight to carry out research with the specific aim of finding a practical inhaled anaesthetic.

Reports of the effects of ether, nitrous oxide and chloroform may not have reached rural Shropshire, because the newly qualified Dr Hickman chose instead to use carbon dioxide. Experimenting on dogs, cats and mice, he found that when the gas was administered until it induced unconsciousness he could quickly carry out amputations with the subject apparently feeling no pain and exhibiting no after-effects (other than those related to the loss of body parts, of course).

In 1824, convinced that his findings could be applied to human surgery, Hickman prepared a pamphlet describing his experiments in detail. A sample paragraph reads as follows: “Exp. 7th. I filled a glass globe with the Gas exhaled from my own lungs; into it I put a Kitten. In 20 seconds I took off its Ears and tail; there was very little hemorrhage, and no appearance of pain to the animal.”

Hickman sent the pamphlet to the president of the Royal Society, Sir Humphry Davy. We do not know whether Davy ever saw it, but the scientific establishment certainly became aware of Hickman’s experiments. Sadly, the London luminaries showed no interest — perhaps because they saw country doctors such as Hickman as hicks.

After a Lancet article in 1826 had savaged his work, Hickman turned instead to France. In 1828 he travelled to Paris and presented a paper to the Bourbon king, Charles X. The proposal was forwarded to the Academie Royale de Medicine, which set up a committee of inquiry. Despite support from the famous surgeon Baron Dominique-Jean Larrey, the investigation fizzled out inconclusively.

A disillusioned Hickman returned to Shropshire, where he died from tuberculosis two years later at the age of 30 — two decades before the first human operations were carried out using the inhaled anaesthesia technique he had pioneered. 

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Citation
The Pharmaceutical Journal, PJ, 18 October 2014, Vol 293, No 7832;293(7832):DOI:10.1211/PJ.2014.20066550