Brit. vet. J.

(1963), 119, 477

THE EVOLUTION OF VETERINARY

ANAESTHESIA
By D. E. STEVENSON
"Shell" R esearch Limited, Tunstall Laboratory, Sittingbourne, Kent

The history of anaesthesia is interesting and often instructive. There are many
references, especially in the oriental countries, to the use of narcotic drugs
many centuries before anaesthesia was introduced into surgical practice. There
was in fact considerable opposition at first amongst practitioners, both medical
and veterinary, to the use of anaesthetic agents. The analgesic properties of
certain compounds was known long before the successful use of ether by Long
and by Morton in America. In 1800, Sir Humphrey Davy discussed the use of
nitrous oxide as a remedy for operative pain in his pamphlet "Researches
chemical and philosophical chiefly concerning nitrous oxide and its respira-
tion" .
Davy was probably the first to anaesthetize a laboratory animal. He wrote
"into a mixture of one oxygene, and three nitrous oxide, a small guinea pig was
introduced. He immediately began to struggle, and in two minutes reposed on
his side, breathing very deeply. He made afterwards no violent muscular
motion; but lived quietly for near fourteen minutes: at the end of which time,
his legs were much convulsed. He was taken out and recovered".
Ether had long been known for the feeling of exhilaration which accompanied
inhalation of the vapour. This had led to the use of ether in "frolics". It was at
such an occasion that Crawford Long noticed that injuries could occur without
the feeling of pain. As a result he realized that ether could be used to relieve
operative pain.
In this country Henry Hickman experimented on small animals between
1820 and 1824 and was able to relieve pain by an inhalation technique. It is
generally thought that this was carbon dioxide narcosis. Although Hickman
read a paper in London in 1824 and in Paris in 1828, the importance of his
findings passed unrealized until many years later.
The production of narcosis by intravenous methods was also known for a
very considerable time before such methods were clinically employed. Boyle in
1665 injected opium into the hind leg of a dog "whereof the success was that
the opium, being soon circulated to the brain, did within a short time stupify
though not kill the dog". The syringe was probably of the pattern designed by
Sir Christopher Wren from a bladder and a quill. Wren injected opium solutions
into animals and man. His first injection into man unintentionally produced
unconsciousness (about 1657). In 1842, Glover reported in the Edinburgh
Medical and Surgical Journal some experiments in which the intravenous injection
of chloroform and bromoform produced, among other things, stupefaction.
 BRITISH VETERINARY JOURNAL, 119, 10

Shortly after the introduction of ether as an anaesthetic agent in America a

demonstration was given in London (December 21St, 1846). Within a year
ether had been tried on most domestic animals and the Veterinarian published an
article describing the use of ether on six dogs and two cats. The method of
administration is interesting-"I placed the sulphuric ether in a Florence
flask, to the neck of which a large bladder was secured. The head of the animal
was then introduced into the bladder and a spirit lamp applied to the flask".
Few workers would have the courage to repeat such a procedure today. The
results of this experiment were "not calculated to inspire any very sanguine
hopes. We cannot tell whether the cries emitted are evidence of pain or not;
but they are suggestive of agony to the listener, and, wi.thout testimony to the
contrary, must be regarded as indicative of suffering. The process, therefore, is
not calculated to attain the object for which in veterinary practice it would
most generally be employed, namely, to relieve the owner from the impression
that his animal was subjected to torture". Consideration for the patient appears
to have developed somewhat later in the history of anaesthesia.
Further trials were reported on dogs, horses, asses and sheep, with more
promising results. It was soon recognized that asphyxia might also result from
the methods employed for the administration of ether. Olden published details
of a mask to overcome this. The modern chloroform mask appears to have no
advantage over this early model.
An interesting comment is made in the editorial of the Veterinarian on May
1st, 1847. A professor was criticized for saying to a meeting of the Royal Agri-
cultural Society that nothing beyond "a common soap-dish filled with aether
and held to the animal's nose" was required, and that the odour was
"so delightful that the vapour is readily inhaled. When sufficiently affected the
animal lies quietly down, and submits, resistlessly to whatever is requisite to be
done". The editorial made the comment, "The artist in his studio could hardly
from his imagination have painted a picture more pleasing to the mind than this;
and we shrewdly suspect our agreeable professor was seated in that pleasant
backroom of his, which looks out into the garden when he drew up for the Royal
Agricultural Society his enchanting description of the effects of aether".
It was perhaps unfortunate that ether had been in use for only a few months
before the advent of chloroform. This agent, used in Edinburgh by Simpson,
had many advantages over ether and as a result ether was neglected for many
years. Some of the advantages of chloroform were described as follows: "1st.
A much less quantity will produce the same effect. 2nd. A more rapid, complete
and generally more persistent action, with less preliminary excitement and
tendancy to exhilaration and talking. 3rd. The inhalation is far more agreeable
and pleasant than that of ether. 4th. As a smaller quantity is used, the applica-
tion is less expensive, which becomes an important consideration if brought
into general use. 5th. The perfume is not unpleasant, but the reverse, and more
evanescent. 6th. No particular instrument or inhaler is necessary".
The first reported veterinary use of chloroform concerned a carriage horse
from the Royal Mews. Chloroform was given by means of two pieces of sponge
in a "common leathern mask". The groom "impressed the muzzle upwards
 VETERINARY ANAESTHESIA 479

and so forced the sponge against the nostrils, a compression which caused the
liquid to drop out from below". As a result the horse became wild and unmanage-
able, falling over backwards. The groom managed to pull the cavesson,
bridle and muzzle off the head. The horse recovered.
This account was followed by another where chloroform was "poured on
a piece of flannel cloth, below which was a sponge, the whole being placed
in a tin case, which was tied over the horse's nose and surrounded with a
flannel bag. In three and a half minutes the animal fell over, and in five minutes
it was perfectly insensible". In this case the trial was more orderly and con-
vmcmg.
As a result of the struggling involved in the administration of chloroform,
the editorial comment of the Veterinarian of September 1st, 1848, was "Abandon-
ing the use of this potent chemical agent as an anaesthetic, at least for all
practical purposes, let us turn our attention to it as an internal remedy".
In spite of this comment some practitioners continued to experiment, but
neither ether nor chloroform was used extensively for some years.
In man chloroform was responsible for many deaths, usually due to cardiac
failure. Snow ( r858) published a series of such cases, many of which were of
healthy subjects. Because of this hazard, ether was considered to be the safer
agent as respiratory failure occurred before cardiac failure. The side effects of
ether and the difficulty of obtaining a sufficient concentration prevented its
universal use and the controversy as to the relative merits of the two agents went
on for many decades.
An interesting note in the Veterinarian of r848 describes how Professor
Thiernesse in Belgium noticed that arterial blood from dogs anaesthetized by
chloroform or ether inhalation was darker in colour. If chloroform was given
intravenously, then the arterial blood "exhibited a florid red hue". There was a
considerable body of opinion for many years that anaesthetic agents produced
their effect by asphyxia. In many cases this was true, but asphyxia was caused
by the technique and not by the anaesthetic agent.
By r865 morphine was sometimes used to prolong chloroform anaesthesia.
Administration was by subcutaneous injection, apparently after the induction
of anaesthesia. The use of morphine as a pre-anaesthetic agent appears to have
been developed at a later date.
The difficulties of administration of anaesthetics by inhalation led to the
search for easier methods of producing anaesthesia. By r866 local anaesthesia
produced by an ether spray had been used. In r869 Spencer Wells published an
account of the use of chloral hydrate, an agent which had been introduced by
Liebreich in Berlin. Administration appears to have been by subcutaneous
injection in small doses. It was claimed that no local irritation took place. Wells
found that by this method it was possible to produce narcosis in rabbits and
other animals.
Ore, in France, after making preparatory tests in dogs (r 872-3), produced
anaesthesia in man by the intravenous injection of chloral hydrate. There were
several fatalities however, and by 1877 the method had been discarded in man.
Wright (r952) states that Humbert is credited with the trial of this agent in the
 BRITISH VETERINARY JOURNAL, 119, 10

horse. Nocard (1886) stated that "for years he had used no other general
anaesthetic agent but chloral hydrate, in a solution of 1 to 3 of water, as an
intravenous injection". This had been used in the horse, ox and dog. In the
horse and ox administration was by puncturing the jugular vein, and in the
dog the external femoral vein was laid bare and punctured with a trocar, or
hollow needle. In 500 to 600 injections he had had no anaesthetic death.
However, a statement of numbers such as these must always be open to suspicion
unless accurate records have been kept.
At about the same time cocaine was introduced as a local anaesthetic.
Penhale (1890) reported anaesthesia of mucous membranes with this agent. A
4 per cent solution applied to the cornea "had been found useful in removing
foreign substances from the eye, especially in cattle". In one operation on a dog
he injected the solution near the corner of the eye, dropped some on the cornea
and waited 3-4 minutes before removing the membrana nictitans. Incidentally,
this author noted that less chloroform was required to anaesthetize a pregnant
animal.
Wright (1952) credits Hobday with popularizing the use of cocaine in
veterinary sugery. Cocaine was employed in both local and regional anaesthesia.
Cocaine had undesirable central effects after absorption, and the introduction of
procaine in 1905 enabled considerable advances to be made in this type of
anaesthesia.
The status of veterinary anaesthesia at the turn of the century was well
described by Hobday. He wrote "In my student days, I had been taught that
the administration of chloroform to the dog, the cat and other small animals
was exceedingly dangerous. Deaths were of such frequent occurrence that the
anaesthetic was used in the severest of cases, and then with extraordinary
trepidation. Even in those days it was recognised that it was safer to chloroform
a horse than a dog or cat, one indisputable reason being that the larger animal
was perforce hobbled and secured in such a position that its lungs could expand
and the chest was not pressed upon by human hands."
As a result of his reasoning Hobday developed a table for the restraint of
dogs and cats while they were being chloroformed. He also popularized the
use of apparatus to give a steady flow of chloroform in a controlled concentra-
tion. Hobday published a series of 900 cases of chloroform anaesthesia in which
"only five deaths occurred altogether, and in all except one, the post-mortem
examination satisfactorily explained the cause of death. In this instance, owing
to a misunderstanding, a post-mortem was not made." (Hobday, I902).
In I9I5, Hobday published the first English textbook completely devoted to
veterinary anaesthesia. Most of this book was devoted to methods of inhalation
anaesthesia, although local, regional and spinal anaesthesia were also mentioned.
One point of interest mentioned was the use of premedicant drugs prior to
chloroform anaesthesia in Bucharest by Professor Iliesco. Scopolamine was
used either as an intravenous or a subcutaneous injection for this purpose,
sometimes being combined with morphine. The advantages of premedication
were summarized as follows: "I. The period of initial excitement produced by
chloroform when administered alone, which may be long, violent and often
 VETERINARY ANAESTHESIA

dangerous, is almost suppressed by the employment of scopolamine. 2. The

quantity of chloroform employed in the mixed method of chloroform with
scopolamine is smaller than in the case of anaesthesia with simple chloroform.
3. The time occupied is shortened with mixed anaesthesia than with chloroform
alone, and the recovery of the animal more rapid".
Merillat, in his textbook on veterinary surgery (19 I 5), indicated that the
the use of anaesthesia was not universal at that time. His comments are interest-
ing and uncomplimentary to the profession: "In Veterinary Surgery, anaes-
thesia has no history. It is used in a kind of desultory fashion that reflects no
great credit to the present generation of veterinarians ... Many veterinarians
of rather wide experience have never in their whole lifetime administered a
general anaesthetic in performing their operations ... Anaesthesia in veterinary
surgery today is a means of restraint and not an expedient to relieve pain. So
long as an operation can be performed by forcible restraint without imminent
danger to the technique, the operator or the animal, the thought of anaesthesia
does not enter into the proposition".
The comments of Hobday and of Merillat provide a useful background for a
study of the Animals Anaesthetic Act, 1919. This Act made the use of general
anaesthesia compulsory for many types of operation. The impression given by
the veterinary literature of that time was that the Act became law as a result of
public opinion rather than as a result of representations from the veterinary
profession. It must be remembered that at the time there were a considerable
number of unqualified practitioners, but without doubt qualified practioners
were also to be blamed in this respect. Hobday wrote in his memoirs, "Who can
estimate the suffering relieved by these new methods backed by law? Thousands
of operations had been carried out with no anaesthetic-a memory as disturb-
ing as it is heartening to know one had some share in bringing about so great
an alleviation".
Although the 1919 Act ensured, as far as possible, the universal use of general
anaesthesia, it also delayed the introduction of new techniques into general
practice. The law must be regarded as being very unsatisfactory until the pass-
ing of the Veterinary Surgeon Act, 1948, which made unqualified practice
illegal except in scheduled cases, and the Protection of Animals (Anaesthetic)
Act, 1954, which allowed the veterinarian to choose the type of anaesthesia
employed, as long as there was "adequate anaesthesia".
In the decade before the Second World War there were two major advances
in veterinary anaesthesia. These were the introduction of the barbiturates and
the development of epidural anaesthesia. Kreutzer (193 I) first reported the use
of pentobarbitone in veterinary anaesthesia in the United States. Administra-
tion was by intraperitoneal injection. In this country, Wright (1933) published
a series of 100 cases in the dog and cat, of anaesthesia by intraperitoneal
injection of pentobarbitone. There was a considerable variability of response,
however, with an agent which could not easily be eliminated once administered.
Barbiturates had been administered by intravenous injection in man and
this method was now tried in animals by Auchterlonie (1934) and Wright (1934).
It was found that the onset of narcosis was more rapid by this route and it was
 BRITISH VETERINARY JOURNAL, 11 9, IO

therefore possible to inject the drug over a period of 3- 4- minutes while assessing
the degree of narcosis, until the required depth was obtained. As long as the
barbiturate was injected at a slow rate this method proved to be far in advance
of previous methods of anaesthesia. One of the greatest advantages, once the
technique of intravenous injection had been mastered, was the quiet period
of induction of anaesthesia.
For short periods of anaesthesia, thiopentone sodium was found to be satis-
factory (Wright, I937). Pentobarbitone and thiopentone have remained two
of the most widely used anaesthetic drugs in small animal practice, despite
some disadvantages. In medical practice the barbiturates and thiobarbiturates
have only been used extensively as hypnotic agents. It has long been realized
that the analgesic properties of these drugs were limited, and in order to stop
all response to pain it was necessary to give considerably more than was
necessary for hypnosis. In veterinary practice these agents have usually been
used as the sole anaesthetic agents; relatively large doses are given, which tends
to prolong the time taken for recovery.
The development of epidural anaesthesia owes a great deal to Brook ( I935 ).
Spinal anaesthesia was first used by Corning (I 885), who injected a solution of
cocaine into the region of one of the posterior thoracic interarcual spaces,
with resultant anaesthesia of the hind limbs, penis, urethra and inguinal region.
Brook ( I 935) quotes Cuille and Sendrall ( I 90 I ) as being the first to use the
method in the horse, ox and dog by means of lumbosacral puncture. This type
of anaesthesia did not become popular, for several technical reasons including
the danger of permanent nerve damage and the introduction of infection.
Epidural anaesthesia differs from spinal anaesthesia in that injection of
local anaesthetic is outside the spinal membranes. This eliminates several of the
disadvantages found in spinal iqjections. Retzgen, Pape and Pitzch (1925) are
quoted by Brook (I 936) as being the first to use epidural anaesthesia in veter-
inary surgery. These workers used the method in Berlin on the horse. In the
following year Benesch introduced the method into ca ttle practice. It is in
cattle obstetrics that epidural anaesthesia has proved of greatest value.
Farquharson (I 94-0) developed another type of regional anaesthesia which
proved of great value in cattle practice. By the injection of local anaesthetic
solution in the region of the spinal nerves as they left the intervertebral foramina
and passed under the lumbar transverse processes he was able to desensitize
the skin of the flank and to relax the underlying muscle. This is known as
paravertebral anaesthesia and has become widely used as the method of
anaesthesia for the performing of rumenotomy and laparotomy in the ruminant.
Since the Second World War there have been several advances in veterinary
anaesthesia, many of which have resulted from the application of medical
techniques to veterinary subjects. There has been a renewed interest in
inhalation anaesthetics and three new agents, cyclopropane, trichlorethylene
and fluothane, have proved to be of value. Endotracheal intubation, and closed
circuit techniques, first used in the dog a century ago by Snow, have been
used on all types of domestic animals. Intubation is now considered the best
available way of administering inhalation anaesthetics when narcosis has
 VETERINARY ANAESTHESIA

first been induced by intravenous injection. The knowledge gained in medical

anaesthesia concerning the design of apparatus is being applied, particularly as
regards the necessity for efficient elimination of carbon dioxide. These new
methods need not be much more expensive than the older methods and are
far more satisfactory.
The introduction of the "muscle-relaxants" into medical practice in this
country by Gray and Halton (1946) is generally considered to be a major
advance in anaesthesia. Certainly many operations have been made possible
or simplified by the use of these agents. However Beecher and Todd (1954)
reported that there were more anaesthetic deaths in curarized patients than
when other forms of anaesthesia were used, and the medical literature contains
many references to the dangers of these agents. Muscle relaxants have been
used in veterinary surgery (Hall, 1957), but it would seem doubtful that they
will find general use, at least for several years, except in veterinary hospitals
where there are specialist anaesthetists.
Methods for producing a dry surgical field have also been employed by
veterinary anaesthetists. Those which employ ganglionic blocking agents have
been used (Clark and Weiss, 1952), but it is doubtful whether such agents will
be widely used in general practice. It is perhaps to the advantage of the
veterinary patient that the human subject served as an experimental animal
for neuromuscular and ganglionic blocking agents and that the difficulties of
these new methods will be known by the time they are introduced into general
veterinary use. Nevertheless there is a definite use for these agents in certain
types of surgery.
The history of veterinary anaesthesia indicates that the knowledge necessary
for advance is often present long before the general recognition of a new
concept, for "It is the customary fate of new truths to begin as heresies and to
end as superstitions". What knowledge is now waiting to be applied to the general
benefit of man and animals?

REFEREN C ES

BROOK, G. B. (1935). Vet. Rec., 15, 549, 57 6, 597,63 1 & 659·

HALL, L. W. (1957). Advanc. vet. Sci. , 3, I.
HOBDAY, F. ( 1915). Anaesthesia and Narcosis of Animals and Birds. London: Bailliere,
Tindall & Cox.
MERILLAT, V. A. (1915). The Principles of Veterinary Surgery. Chicago: Alexander Eger.
Veterinarian, (Lond. ) ( 1828- 1902) . London: Longman, Reef, Orme, Brown & Green.
WRIGHT, J. G. (1952) . Veterinary Anaesthesia. London: Bailliere, Tindall & Cox.

(Received for publication, 30 May, 1963)