The Independent Inventions of General Anesthesia in 19th century Japan and United States

Abstract

In October of 1804, surgeon Hanaoka Seishū performed the first documented surgery using general anesthesia. Hanaoka’s formulation, a mixture of plant extracts called tsūsensan, was commonly used in Japan, but it had minimal influence elsewhere. It was not until the 1840s that general anesthesia was used outside of Japan. In the eastern United States, four individuals, including dentist William Morton, were independently experimenting with the use of diethyl ether and nitrous oxide as general anesthetics. Unlike Hanaoka’s invention, Morton’s successful use of diethyl ether in a neck tumour removal surgery sparked the rapid development and proliferation of new anesthetic technologies and compounds throughout the world. This paper examines why Hanaoka’s work was not significantly influential outside of Japan, while the later American discoveries achieved global prominence despite being four decades later. Additionally, historical context behind both stories is included. Reasons for this disparity include Japan’s isolationist policy at the time (sakoku) and differences in 19th century Western and Japanese approaches to medical education and research.