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In 1843, John Elliotson (1791-1868), Professor of Medicine at University College, London, and the first physician in Britain to adopt the stethoscope for medical examinations, reported on Numerous Cases of Surgical Operations Without Pain in the Mesmeric State (Elliotson, 1843/1977). Mesmer’s doctrine of animal magnetism had been discredited more than half a century earlier by a French royal commission appointed to investigate his practices. But this same commission had expressly declined to discredit Mesmer’s cures, attributing them to "imagination" rather than to Mesmer’s hypothesized physical force (an interesting observation about hysteria and psychosomatics, but one for which 18th-century science was simply unprepared). Partly for this reason, mesmerism continued to be practiced, both as a popular entertainment and as a medical technique. In 1829, a case of mastectomy under "mesmeric coma" was reported to the French Academy of Medicine by Jules Cloquet, professor of surgery at the University of Paris, who was in turn dismissed as a dupe and his patient as an imposter by the former surgeon-in-chief of the Grande Armee. Other, less-well-documented cases go back as far as 1797 (Gravitz, 1988). Click on the image to see an enlarged version of the painting by Richard Bergh (1887).
Elliotson himself had witnessed a demonstration of mesmerism by a visiting French colleague, and detailed a number of instances in which the state dramatically altered somatosensory function. Nevertheless, the Royal Medical and Chirurgical Society of London dismissed his and others’ cases as fraudulent and banned the technique, leading Elliotson to resign from the Society and found his own journal, The Zoist, to publish reports of mesmeric phenomena. That same year, another English physician, James Braid (1795-1860), attempted to rescue what was worthwhile in mesmerism for both science and practice by changing its name to neurhypnology (soon shortened to hypnosis) and offering a new theory couched strictly in physiological terms (Gravitz & Gerton, 1984; Kihlstrom, 1992b; Kravis, 1988).
Elliotson’s protégé, the Scottish physician James Esdaile (1808-1859), had more freedom to practice as a medical officer in the British East India Company, especially if he was operating on Indians rather than Englishmen. In 1846, Elliotson published his observations in a book entitled Mesmerism in India, and its Practical Application in Surgery and Medicine (Esdaile, 1846/1977). Included among his many successful cases were one amputation each of an arm and a breast, two amputations of penises, three cataracts removed, five cases of removing enlarged toenails by their roots, seven operations for fluid buildup in various body cavities, and the removal of fourteen scrotal tumors, ranging from 8 to 80 pounds in weight. At a time when surgical mortality was about 40%, Esdaile reported a rate of about 5% -- a reduction that he attributed to successful relief of pain with mesmerism.
It is worth remembering that, up until this time, medical and dental surgery was performed without anesthetic, for the simple reason that no anesthetics were available. Like Elliotson, Esdaile hoped that mesmerism would become widely available for the benefit of the public, but he feared it would never happen: "that not many of this generation will live to benefit by Mesmerism, if they wait till it is admitted into the Pharmacopoeia" (1847/1977, p. 9).
Esdaile’s words were prophetic, but for different reasons. On October 18, 1846, less than six months after Esdaile’s book went to press, the dentist William T.G. Morton applied an ether-soaked sponge to the patient Gilbert Abbot, and the surgeon John Collins Warren, who himself had experimented unsuccessfully with mesmeric anesthesia earlier in his career, removed a tumor from Abbott’s neck without the patient showing any signs of pain. Within two years, ether, nitrous oxide, chloroform, and other chemical anesthetics were widely used in dentistry, and surgery; and mesmerism was consigned to the dustbin of history -- at least as an approved medical technique.
In fact mesmerism and hypnosis continued to thrive as a source of popular entertainment. In England, Charles Dickens, who was a close friend of Elliotson, mesmerized his family and friends for entertainment, although he would never let himself be hypnotized. In 1847, Jane Carlyle entered into a "battle of wills" with a mesmerist who claimed his powers reflected his moral and intellectual superiority, but who (as she wryly noted) did not pronounce his hs (Winter, 1998). Later in the century, in France, observation of hypnotized subjects’ insensibility to pain and other stimuli led Jean-Martin Charcot and his protégé Pierre Janet to draw parallels between hypnotic and hysterical anesthesia. On the other hand, Milne Bramwell and Albert Moll, two followers of Charcot’s rival Ambroise Liebeault, debated the effectiveness of hypnosis in the relief of pain. Janet and his rival, Sigmund Freud, both used hypnosis in the treatment of hysteria, but few people gave much thought to the use of hypnosis in the treatment of real diseases, or real pain (for an excellent treatment of this early history, see Gauld, 1992).
In this era, one medical application of hypnosis does stand out. In 1862, Mary Baker Eddy, suffering from an aching back, consulted Phineas Parkhurst Quimby, a hypnotist in Portland, Maine. His treatment worked. Quimby, as it happens, had also coined the term "Christian Science". In 1875, nine years after Quimby’s death, Eddy published the first edition of Science and health with Key to the Scriptures, and a new religion was founded.
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Clinical Studies of Hypnotic Analgesia
Mechanisms of Hypnotic Analgesia
Efficacy of Hypnotic Analgesia
John F. Kihlstrom, PhD
Plenary address presented at the annual meeting of the American Pain Society, Atlanta, Georgia, November 3, 2000. The point of view represented in this paper is based on research supported by Grant #MH-35856 from the National Institute of Mental Health. I thank Lucy Canter Kihlstrom for her comments. Painting by Richard Bergh (1887).
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