Horace Wells

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Horace Wells (January 21, 1815 – January 24, 1848) was an American dentist who pioneered the use of anesthesia in medicine, specifically the use of nitrous oxide (or laughing gas). Although he was urged to patent his discovery, he never did, believing that freedom from pain should be "as free as the air we breathe."<ref>Template:Cite journal</ref>

Wells's groundbreaking discovery revolutionized pain management in both medical and dental procedures, marking a pivotal moment in the history of surgery and transforming it from a traumatic, painful ordeal to a more humane and tolerable practice.<ref name="Muacevic 2024">Template:Cite journalTemplate:Creative Commons text attribution notice</ref>

Early life

Wells was the first of three children of Horace and Betsy Heath Wells, born on January 21, 1815, in Hartford, Vermont.<ref name="Martin">Template:Cite journal</ref> His family had notable connections to American history: his grandfather, Captain Hezekiah Wells, served in the American Revolution, and his grandmother, Sarah Trumbull, was associated with Jonathan Trumbull, who served as Governor of Connecticut during the American Revolution. His parents were well-educated and affluent landowners who possessed extensive land near the Connecticut River, which allowed him to attend private schools in New Hampshire and Amherst, Massachusetts, including a private boys' school with Mr. Ballard in Hopkinton, New Hampshire. During his formative years, Wells showed demonstrative and inventive abilities, which led to him becoming an inventor in adult life.<ref name="Muacevic 2024"/>

After completing his early education, Wells was offered positions teaching writing at several schools. At one point, he considered the ministry as his career due to the intense effect of his father's death on his life, but this idea was short-lived. He later decided to pursue dentistry, possibly influenced by traveling dentists who stayed at his father's house, which served as a hotel for passersby of the Connecticut Valley.<ref name="Muacevic 2024"/>

At the age of 19 in 1834, Wells began studying dentistry under a two-year apprenticeship in Boston.<ref name="Jacobsohn">Template:Cite journal</ref> Due to his family's privileges, it is assumed that he completed his apprenticeship under Dr. N. C. Keep, who received recognition for his expertise in mechanical dental art and later became Dean of the Harvard Dental School in 1868. The first dental school did not open until 1840 in Baltimore.<ref name="Muacevic 2024"/><ref name=":2">Template:Cite journal</ref>

At age 23, Wells published a booklet An Essay on Teeth in which he advocated for his ideas in preventive dentistry, particularly for the use of a toothbrush. In his booklet, he also described tooth development and oral diseases, where he mentioned diet, infection, and oral hygiene as important factors.<ref name="Jacobsohn"/><ref>Template:Cite book</ref> In this work, he was a strong advocate of preventive practices, dedicating an entire chapter to the subject. He recommended the use of a brush for teeth cleaning and wrote: "Those teeth which are frequently cleansed with a brush seldom or never decay."<ref name="Muacevic 2024"/> He understood the harmful effects of sugar, stating, "There is nothing more destructive to teeth than a compound sold at nearly every corner of the street, under the name of candy."<ref name="Muacevic 2024"/> Wells was also a pioneer in identifying the need to preserve primary dentition, advocating that "primary teeth be allowed to remain until they are ready to fall out of themselves unless they become too troublesome to be endured."<ref name="Muacevic 2024"/>

Career

After he completed dental training in Boston, Wells opened his own office in Hartford, Connecticut on April 4, 1836. He successfully established his dental practice by advertising in the Connecticut Courant, where he promoted his services as a trained dentist specializing in the conservation of natural teeth using gold restorations. Wells invented his own instruments, which he used in his practice, making him a popular dentist among both the general population and the elite of the city. At a local exhibition, he won an award from the Massachusetts Mechanical Association for an instrument case he designed and built himself. His practice was highly profitable, earning him $5 to $20 per day in 1836, and by 1838, he reported profits of up to $100 per week.<ref name="Muacevic 2024"/>

Between 1841 and 1845, Wells became a reputable dentist in Hartford, where he had many patients and attracted apprentices. Among his patients were respected members of society such as William W. Ellsworth, the governor of Connecticut. His three apprentices were John Mankey Riggs, C. A. Kingsbury, and William T. G. Morton. In 1843, Wells and Morton started a practice in Boston and Wells continued to instruct Morton.<ref name=":2" /><ref name="Gordon">Template:Cite journal</ref> John Riggs later became his partner.<ref>Template:Cite web</ref> Wells also received a certificate from the renowned chemist and geologist Dr. Charles Jackson for his invention of gold solder.<ref name="Muacevic 2024"/>

A significant part of Wells's dental practice involved tooth extractions, as evidenced by the large number of forceps in his inventory and his daybook records. He was deeply distressed about the pain and discomfort his patients experienced during extractions and actively searched for methods to minimize their suffering. In 1840, during a discussion with Linus P. Brockett, a physician of Hartford, Wells expressed that he was "deeply impressed with the idea that some discovery would yet be made by which dental and other operations might be performed without pain."<ref name="Muacevic 2024"/> This concern for patient comfort would prove to be the driving force behind his groundbreaking discovery.

Use of nitrous oxide

Wells first witnessed the effects of nitrous oxide on December 10, 1844, when he and his wife Elizabeth attended a demonstration by Gardner Quincy Colton billed in the Hartford Courant as "A Grand Exhibition of the Effects Produced by Inhaling Nitrous Oxide, Exhilarating, or Laughing Gas." The demonstration took place at Union Hall, Hartford, and was organized for public entertainment. During the demonstration, a local apothecary shop clerk Samuel A. Cooley became intoxicated by nitrous oxide.<ref name="Muacevic 2024"/> While under the influence, Cooley did not react when he struck his legs against a wooden bench while jumping around. After the demonstration, Cooley was unable to recall his actions while under the influence, but found abrasions and bruises on his knees. Importantly, when asked about his pain perception, he denied having experienced any pain while under the influence of nitrous oxide. From this demonstration, Wells realized the potential for the analgesic properties of nitrous oxide, and met with Colton about conducting trials.<ref name="Finder">Template:Cite journal</ref><ref name="Haridas">Template:Cite journal</ref>

The following day, December 11, 1844, Wells conducted a trial on himself by inhaling nitrous oxide from a paper bag brought by Colton and having John Riggs extract his wisdom tooth.<ref name="Haridas" /> Wells showed no discomfort during the entire procedure, and when asked about his pain perception afterward, he famously responded, "It is the greatest discovery ever made! I didn't feel it so much as the prick of a pin!"<ref name="Muacevic 2024"/> Upon this successful trial where he did not feel any pain, Wells went on to use nitrous oxide on at least 12 other patients in his office, with Riggs performing one procedure in which six teeth were extracted in a single sitting.<ref name="Finder"/><ref name=":1">Wells, Horace, 1815-1848., "Letter of Horace Wells to the editor of the Hartford Daily Courant," OnView, accessed May 27, 2024, https://collections.countway.harvard.edu/onview/items/show/18187.</ref> At Wells's request, Colton taught him how to prepare the nitrous oxide gas, and during the following weeks, Wells and Riggs continued using the gas during tooth extractions as an anesthetic.<ref name="Muacevic 2024"/>

Boston demonstration

In 1844, Hartford did not have a hospital, so Wells sought to demonstrate his new findings in either Boston or New York. In January 1845, he chose to go to Boston where he had previously studied dentistry, and his former student and associate William Morton resided. Wells and Morton's practice had been dissolved in October 1844, but they remained in contact. Morton was enrolled in Harvard Medical School at the time and agreed to help Wells introduce his ideas, and provide him with dental instruments, although Morton was skeptical about the use of nitrous oxide.<ref name="Haridas"/><ref>Template:Cite book</ref><ref name=":4">Template:Cite book</ref>

With Morton's help, Wells organized a demonstration session in the presence of Dr. John Collins Warren, the Chief of Surgery at Massachusetts General Hospital.<ref name="Muacevic 2024"/> He gave a demonstration to medical students in Boston at the end of January 1845.<ref name="Haridas" /> However, the gas was improperly administered—Wells removed the bag before the gas had taken full effect—and the patient cried out in pain during the tooth extraction. The patient later admitted that although he cried out in pain, he remembered no pain and did not know when the tooth was extracted. It was later found that the gas is not as effective on both obese people and alcoholics—the patient was both. The demonstration was deemed "an imposition" and a "humbug affair," and Wells was labeled a "charlatan" and a "fake." After the embarrassment of his failed demonstration, Wells immediately returned home to Hartford the next day. From this point on, his mental health declined, and his dental practice became sporadic.<ref name="Martin" />

Later years

Wells closed his office nine times and relocated six different times between 1836 and 1847. He closed his office due to ill health, although his physician could not find any physical cause for his non-specific complaints. He mentioned his recurring illness in a letter to his sister Mary Wells Cole in April 1837. He also became ill shortly after marrying Elizabeth Wales in 1838 and having his only son Charles Thomas Wells. During winter months, he would not write letters to any family or friends, except for his published letter in 1846 after Morton's ether demonstration.<ref name="Martin" />

On February 5, 1845, Wells advertised his home for rent.<ref>Template:Cite book</ref> On April 7, 1845, Wells advertised in the Hartford Courant that he was going to dissolve his dental practice, and referred all his patients to Riggs, the man who had extracted his tooth, stating that the "excitement of this adventure (Boston) brought on an illness from which I did not recover for many months, being thus obliged to relinquish entirely my professional business."<ref name=":3">Template:Cite book</ref>

In October 1846, Morton gave a successful demonstration of ether anesthesia in Boston, leading to the naming of the amphitheater as the "Ether Dome," which was published in the Boston Medical and Surgical Journal in November.<ref name="Muacevic 2024"/> Following Morton's demonstration, Wells published a letter recounting his successful trials in 1844 in an attempt to claim the discovery of anesthesia.<ref name=":1" /> Wells was initially pleased with his student's achievement but became dejected when Morton proclaimed himself to be the pioneer of anesthesia,<ref name="Muacevic 2024"/> leading to what his wife referred to as the "gas war." His efforts in establishing his claim were mostly unsuccessful.<ref name="Finder"/>

Despite his advertisement for dissolving his practice in April 1845, Wells sporadically continued his practice, with his last daybook entry being on November 5, 1845. Later, he continued using nitrous oxide sedation for dental procedures and even trained other dentists in its use. He also facilitated surgeons with anesthesia for certain surgeries such as amputations and tumor removals between 1846 and 1848. Additionally, he pursued other interests such as natural history, arranging an exhibition in Hartford in 1845.<ref name="Muacevic 2024"/><ref name="Martin"/>

Wells definitively ended his dental practice in late 1845 and began selling shower baths for which he received a patent on November 4, 1846.<ref name="Martin"/> He also planned to sail to Paris to purchase paintings to resell in the United States. He traveled to Paris in early 1847, where he petitioned the Academie Royale de Medicine and the Parisian Medical Society for recognition in the discovery of anesthesia.<ref name="Finder"/>

Wells moved to New York City in January 1848, leaving his wife and young son behind in Hartford. He lived alone at 120 Chambers St in Lower Manhattan and began self-experimenting with ether and chloroform, and he became addicted to chloroform.<ref name="Aljohani">Template:Cite journal</ref> The effects of sniffing chloroform and ether were unknown at the time. His self-experimentation with these substances led to mental disturbances.<ref name=":0">Smith, Ken. Raw Deal. Blast Books: New York, 1998. pp. 62–63.</ref>

Wells rushed into the street on January 21, 1848, his 33rd birthday, and threw sulfuric acid over the clothing of two prostitutes whom he addressed as "abandoned females." He was committed to New York's infamous Tombs Prison. As the influence of the drug waned, his mind started to clear and he realized what he had done. He asked the guards to escort him to his house to pick up his shaving kit.<ref name=":0" /> He committed suicide in his cell on January 24, slitting his left femoral artery with a razor after inhaling an analgesic dose of chloroform.<ref>Template:Cite news</ref><ref>Template:Cite journal</ref> He died at the age of 33. He is buried at Cedar Hill Cemetery in Hartford, Connecticut.<ref>Template:Cite web</ref>

Legacy

Twelve days before his death, the Parisian Medical Society voted and honored him as the first to discover and perform surgical operations without pain, recognizing him as "the first person, who first discovered and performed surgical operations without pain…and to the last day of time must suffering humanity bless his name" and stating he was "due all the honor of having successfully discovered and applied the use of vapors or gases whereby surgical operations could be performed without pain."<ref name="Muacevic 2024"/> In addition, he was elected an honorary member and awarded an honorary MD degree.<ref name=":3" /> However, Wells died unaware of these decisions, as the recognition arrived in New York after his death.<ref name="Jacobsohn"/><ref name=":4" /> Every physician in Hartford, Connecticut testified that Wells was the primary discoverer of anesthesia by signing a document.<ref name="Muacevic 2024"/>

Wells first voiced his concern for minimizing his patients' pain during dental procedures in 1841. He was known for caring about his patients' comfort.<ref name="Martin"/> During his time as a dentist, Wells advocated for regular checkups for dental hygiene, and also began the practice of pediatric dentistry in order to start dental care early. He was particularly well-regarded for treating children and understood the importance of preserving primary dentition.<ref>Template:Cite web</ref>

The American Dental Association honored Wells posthumously in 1864 as the discoverer of modern anesthesia, stating "that to Horace Wells of Hartford, Connecticut belongs the credit and honor of the introduction of anesthesia in the USA,"<ref>Archer, 200</ref> and the American Medical Association recognized his achievement in 1870, agreeing "that the honor of the discovery of practical anesthesia is due to the late Horace Wells of Connecticut."<ref>Archer, 202</ref><ref>Template:Cite web</ref> The Baltimore College of Dental Surgery posthumously bestowed a Doctor of Dental Surgery degree in 1994.<ref name="Muacevic 2024"/>

Hartford, Connecticut, has a statue of Horace Wells in Bushnell Park.<ref>Template:Cite Americana</ref><ref>Archer, 174-176</ref> On the 50th anniversary of Wells's discovery in 1894, an organization of dentists and physicians was formed in Hartford, Connecticut, called "The Horace Wells Club." This organization provides scholarships to Connecticut dental students who show significant accomplishment in the field of sedation and annually awards individuals with significant accomplishments in the same field. They maintain the statue of Horace Wells in Hartford's Bushnell Park and arrange fundraisers in his honor, using the raised funds to maintain and restore Wells's tomb in Cedar Hill Cemetery and contribute to local suicide prevention organizations.<ref name="Muacevic 2024"/>

A monument to Horace Wells was raised in the Place des États-Unis, Paris.<ref>Archer, 184-185</ref>

The Baltimore College of Dental Surgery awarded him an honorary posthumous degree (Doctor of Dental Surgery, DDS.) on October 10, 1990.<ref name="Haridas" /><ref>Template:Cite journal</ref>

Wells's discovery laid the groundwork for the development of anesthesiology as a medical specialty, leading to further discoveries such as ether and chloroform.<ref name="Muacevic 2024"/> His work transformed surgical practices from procedures that were considered "virtual death sentences" due to unbearable pain into more tolerable medical interventions. Nitrous oxide continues to play a crucial role in modern dentistry, especially in pediatric care, serving as a cheaper alternative to general anesthesia for handling anxious children and intellectually disabled patients.<ref name="Muacevic 2024"/> Studies have shown high success rates for nitrous oxide conscious sedation, with one study of 688 pediatric patients showing a success rate of 86.3%.<ref>Template:Cite journal</ref>

See also

  • Horace Wells Plaque
    Horace Wells Plaque
  • Statue of Horace Wells in Hartford, Connecticut
    Statue of Horace Wells in Hartford, Connecticut
  • Horace Wells Burial Monument (1909), Cedar Hills Cemetery, Hartford, Connecticut (Louis Potter, sculptor).
    Horace Wells Burial Monument (1909), Cedar Hills Cemetery, Hartford, Connecticut (Louis Potter, sculptor).
  • Statue of Horace Wells in Paris
    Statue of Horace Wells in Paris
  • Death Mask of Horace Wells
    Death Mask of Horace Wells

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