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A406
October 13, 2007
2:00 PM - 4:00 PM
Room Hall D, Area N,
Religious and Cultural Controversies Surrounding the Advent of Anesthesia. Some Myths Debunked
Michael C. Lewis, M.D., Aharon Avramovich, M.D., Jayanthie Ranasinghe, M.D., Donald H. Penning, M.D.
Anesthesiology, Miller School of Medicine, University of Miami, Miami, Florida
Ether anesthesia was first introduced in 1842. Labor analgesia was a major contribution to medical science. This abstract examines how medicine and religion joined forces to initially oppose this innovation.

The controversy was rooted within the biblical 'Curse of Eve'. “"I will greatly multiply your pain in childbearing; in pain shall you bring forth children." [1]. Labor pain was regarded as God's curse on Eve and her descendents.

In 1591 an Edinburgh woman, named Euphanie Macalyane, being unable to bear the pain of childbirth asked her midwife to give her a pain relieving remedy. King James VI was furious and ordered the mother to be burned alive, as a warning to those who dare to evade the curse of Eve.

The scientific pioneer of obstetric anesthesia was the Scottish Obstetrician, James Simpson who discovered that chloroform could reduce labor pain. He was convinced that nobody ought to suffer the pain of labor. On November 10 1847, in an address to the Edinburgh Medico-Chirurgical Society, Simpson reported that he had tested the analgesic successfully thirty times.

The reaction of the Scottish Calvinist Church was quick and furious; they called his discovery “Satanic invention”. In churches, some preachers warned pregnant women that if they allow this devilish treatment, that their children would be denied the sacrament of baptism.

History books have told the story of James Simpson's defense of woman's right to labor pain relief. However, the question arises as to where the opposition actually came from? Simpson's arguments for anesthesia are based on religion, and thus historians have traditionally accused the Church of impeding progress.

It seems that Simpson was expecting public outcry based on religious objections. He was well versed with the bible. Therefore, in December of 1847, Simpson published the “Answer to the Religious Objections Advanced Against the Employment of Anesthetic Agents in Midwifery and Surgery.” He argued that the meaning of the word sorrow could also be interpreted as “toil”, referring to a woman's muscular effort against the anatomical forces of her pelvis in expelling the child. Simpson used another verse of the Bible to defend the use of anesthesia, “and the Lord caused a deep sleep to fall upon Adam; and he slept; and he took one of his ribs, and closed up the flesh instead thereof.” [2] If God had had mercy on Adam when removing his rib, he contended then so was it appropriate for a physician to relieve pain with an anesthetic. The church reply was that Adam's "operation" was done before the curse on Eve was pronounced. So the curse stays!

Simpson ignored the controversy and continued to employ chloroform in his practice. In 1853, Queen Victoria consented to use chloroform during one of her deliveries and anesthesia subsequently gained wider acceptance.

However, the most vigorous disagreement to the use of anesthesia even within obstetrics were from those who believed that childbirth was a “natural” process in which there should be little intervention. An obstetrician William Smith claimed 'women were now free to choose between pain and poison'. The popular story of the religious controversy and the emergence of anesthesia exemplify a case of unbalanced history. Although there was opposition from the church it was matched by opposition of the medical community.

References:

[1] Genesis 3:16

[2] Genesis 2:21.

Anesthesiology 2007; 107: A406