bai zhi (Chinese:白芷,Angelica dahurica),
cao wu (Chinese:草烏, Aconitum kusnezoffii, Aconitum kusnezoffii, Kusnezoff's monkshood, or wolfsbane root),
chuān xiōng (Chinese:川芎,Ligusticum wallichii, or Szechuan lovage),
dong quai (Chinese:当归, Angelica sinensis, or "female ginseng"),
wu tou (烏頭, Aconitum carmichaelii, rhizome of Aconitum, or "Chinese monkshood"),
yang jin hua (洋金花, Flos Daturae metelis, or Datura stramonium, jimson weed, devil's trumpet, thorn apple, locoweed, moonflower),
ya pu lu (押不芦,Mandragora officinarum)
杜鹃花,和
茉莉根。
其他人认为该药水可能还含有大麻,[26] bhang,[27] shang-luh,[22]或鸦片。[31] Victor H. Mair写道,mafei“似乎是与”吗啡“相关的一些印欧词汇的转录。”[32]一些作者认为华佗可能已经通过针灸发现了手术镇痛,并且mafeisan要么没有做或只是他的麻醉策略的辅助。[33]许多医生试图根据历史记录重新制作相同的配方,但没有一个达到与华佗相同的临床疗效。无论如何,华佗的公式似乎对主要业务没有效果。[32] [34]
炼金术士Ramon Llull在1275年发现了二乙醚。 [43] Aureolus Theophrastus Bombastus von Hohenheim(1493-1541),更为人所知的是Paracelsus,在1525年左右发现了二乙醚的镇痛特性。[44]它最初是由Valerius Cordus在1540年合成的,他注意到了它的一些药用特性。他称之为发烟硫酸矾,这个名字反映了它是通过蒸馏乙醇和硫酸的混合物合成的事实​​(已知)那时作为硫酸油)。奥古斯特·西蒙德·弗罗贝尼乌斯于1730年将这个名字命名为SpiritusViniÆthereus。[45] [46]
18世纪
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James Gillray的讽刺漫画展示了皇家机构的讲座,Humphry Davy拿着风箱和Count Rumford看着极右翼。
Joseph Priestley(1733-1804)是一名英国博学家,他发现了一氧化二氮,一氧化氮,氨,氯化氢和(以及Carl Wilhelm Scheele和Antoine Lavoisier)的氧气。从1775年开始,Priestley发表了他的研究“不同种类空气的实验和观察”,这是一部六卷的著作。[47]最近关于这些和其他气体的发现引起了欧洲科学界的极大兴趣。 Thomas Beddoes(1760-1808)是一位英国哲学家,医生和医学教师,和他年长的同事Priestley一样,也是伯明翰月球协会的成员。为了进一步推动这项新科学的发展以及为以前认为无法治愈的疾病(如哮喘和肺结核)提供治疗,Beddoes于1798年在布里斯托尔克利夫顿的道里广场成立了吸气治疗气动研究所。 [48] Beddoes聘请化学家和物理学家Humphry Davy(1778-1829)担任研究所主管,工程师James Watt(17​​36-1819)帮助制造气体。其他成员如Erasmus Darwin和Josiah Wedgwood也积极参与该研究所。
William T. G. Morton,19世纪的美国牙医
FriedrichSertürner(1783-1841)于1804年首次从鸦片中分离吗啡; [61]他将其命名为希腊梦之神Morpheus之后的吗啡。[62] [63]
Henry Hill Hickman(1800-1830)在19世纪20年代尝试使用二氧化碳作为麻醉剂。他会使动物感觉不敏感,有效地通过几乎窒息二氧化碳,然后通过切断其中一个肢体来确定气体的影响。 1824年,希克曼在一篇题为“关于假死的信件”的简短论文中向英国皇家学会提交了他的研究成果:旨在确定其在人类受试者外科手术中的可能效用。回应是1826年在“柳叶刀”上发表的题为“外科欺骗”的文章,该文章无情地批评了他的作品。希克曼四年后去世,享年30岁。尽管他在去世时并未受到重视,但他的工作得到了积极的重新评价,现在他被认为是麻醉之父。
到19世纪30年代后期,汉弗莱戴维的实验已在美国东北部的学术界广泛宣传。流浪的讲师将举行公众集会,称为“以太嬉戏”,鼓励观众吸入二乙醚或氧化亚氮,以展示这些代理人改变思维的特性,同时为旁观者提供更多娱乐。[64]四位著名的人参加了这些活动,目睹了以这种方式使用以太。他们是William Edward Clarke(1819-1898),Crawford W. Long(1815-1878),Horace Wells(1815-1848)和William T. G. Morton(1819-1868)。
Crawford W. Long是19世纪中叶在乔治亚州杰斐逊市执业的医生和药剂师。在19世纪30年代后期作为宾夕法尼亚大学医学院的学生期间,他观察并且可能参与了当时流行的以太嬉戏。在这些聚会上,Long观察到一些参与者经历了颠簸和瘀伤,但后来却没有回忆起发生的事情。他假定二乙醚产生类似于氧化亚氮的药理作用。 1842年3月30日,他吸入二乙醚给一名名叫James Venable的男子,以便从男人的脖子上清除肿瘤。[70]很久以后,再次在乙醚麻醉下从Venable移除了第二个肿瘤。他继续使用乙醚作为肢体截肢和分娩的全身麻醉剂。然而,很长一段时间没有公布他的经历直到1849年,从而否定了他应得的大部分功劳。[70]
随着现代医学的开始,为医生和外科医生设定了一个阶段,以建立麻醉变得有用的范例[71]。
1844年12月10日,Gardner Quincy Colton在康涅狄格州哈特福德市举行了一氧化二氮的公开示威活动。其中一名参赛者塞缪尔·库利(Samuel A. Cooley)在受到氧化亚氮影响的情况下腿部严重受伤而没有注意到受伤情况。当天在观众中出席的康涅狄格州牙医霍勒斯威尔斯立即抓住了这种明显的氧化亚氮镇痛作用的重要性。第二天,Wells在Colton施用的一氧化二氮的影响下进行了无痛的拔牙。 Wells随后开始给患者服用一氧化二氮,并在接下来的几周内成功进行了几次牙科拔牙。
威廉·T·莫顿(William T. G. Morton)是另一位新英格兰牙医,曾是威尔斯的学生和当时的商业伙伴。他也是William Edward Clarke的前熟人和同学(两人曾在纽约罗切斯特一起上过本科学校)。 Morton安排Wells在著名的外科医生John Collins Warren的陪同下,在麻省总医院的氧化亚氮全身麻醉下展示他的拔牙技术。这次演示于1845年1月20日举行,当病人在手术中途痛苦地哭泣时结束了。[72]
Hermann Emil Fischer,德国化学家
20世纪,气管切开术,内窥镜检查和非手术气管插管的实践从极少使用的手术转变为麻醉,重症监护医学,急诊医学,胃肠病学,肺病学和外科手术的基本组成部分。
1902年,Hermann Emil Fischer(1852-1919)和Joseph von Mering(1849-1908)发现二乙基巴比妥酸是一种有效的催眠药。[94]这种新药也被称为barbital或Veronal(拜耳制药公司指定的商品名),成为第一个商业销售的巴比妥酸盐;从1903年到20世纪50年代中期,它被用作治疗失眠症。
同样在1913年,Henry H. Janeway(1873-1921)公布了他最近使用喉镜实现的结果。[98] Janeway是一位在纽约市Bellevue医院执业的美国麻醉师,他认为直接气管内注入挥发性麻醉剂可以为耳鼻喉科手术提供更好的条件。考虑到这一点,他开发了一种专为气管插管而设计的喉镜。与Jackson的设备类似,Janeway的仪器包含远端光源。然而,独特的是在手柄内包含电池,刀片中的中央凹口用于在插管期间将气管导管保持在口咽中线,并且与刀片的远端尖端略微弯曲以帮助引导导管穿过声门。这种设计的成功导致其随后用于其他类型的手术。因此,Janeway在推广麻醉学实践中广泛使用直接喉镜和气管插管方面发挥了重要作用。[93]
1928年,亚瑟·欧内斯特·盖德尔(Arthur Ernest Guedel)介绍了带袖套的气管导管,这种麻醉可以完全抑制自发呼吸,同时通过麻醉师控制的正压通气输送气体和氧气[99]。麻醉机也是进口现代麻醉的开发。仅仅三年后,盖尔开发出了一种技术,麻醉师一次只能通气一肺[100]。允许胸外科手术的发展,这种手术以前一直被pendulluft [101]问题所困扰,在这个问题中,由于胸腔向大气开放而失去真空,导致患者呼气时肺部受到充气。最终到了20世纪80年代早期,双腔气管插管由透明塑料制成,使麻醉师能够选择性通气,同时使用柔性纤维支气管镜检查来阻断患病肺部并防止交叉污染[78]。一个早期的设备,铜壶,是由威斯康星大学的Lucien E. Morris博士开发的。[102] [103]
硫喷妥钠是第一种静脉麻醉药,于1934年由Ernest H. Volwiler(1893-1992)和Donalee L. Tabern(1900-1974)合成,为Abbott Laboratories工作。[104]它于1934年3月8日由Ralph M. Waters首次用于人类,研究其性质,即短期麻醉和令人惊讶的镇痛效果。三个月后,John Silas Lundy应雅培实验室的要求,在梅奥诊所开始了硫喷妥钠的临床试验。 Volwiler和Tabern于1939年因发现硫喷妥钠而获得美国专利2,153,729,并于1986年入选国家发明家名人堂。
另见
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The Zoist: A Journal of Cerebral Physiology & Mesmerism, and Their Applications to Human Welfare
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