History of nitrous oxide—with special reference to its early use in Germany

The history of nitrous oxide (N2O) begins with its isolation by Joseph Priestly in 1772. Some years later Humphry Davy incidentally noted its analgesic action but this fact was not recognized by surgeons. The gas was used for public entertainment and during one of these demonstrations, Horace Wells realized the therapeutic applicability of the gas. His first public demonstration at the Massachusetts General Hospital was a failure, a story that is too well-known to need re-telling. In the early 1860s the itinerant lecturer Gardner Quincy Colton and the dentist Thomas Evans were among the most fervent advocates of the use of N2O in dentistry. Due to their close contacts with Jean Babtiste Rottenstein – a German dentist living in Paris at the same time, they also popularized its use in Germany. Publications from the Russian surgeon Stanislaw Klikovich stimulated obstetricians to use the anaesthetic in combination with air or oxygen for pain relief during childbirth in the early 1880s. Maximilian Neu was the first to use rotameters for a more accurate dosage of inhaled N2O–oxygen mixtures in 1910. Some years later Wilhelm Knipping suggested the use of an oxygen monitoring device in order to ensure that no hypoxemic N2O gas mixture was administered. The development of his device had been initiated by Helmut Schmidt and Paul Sudeck who, in the meantime, had popularized the use of N2O with air or oxygen among German surgeons. The anaesthetic was administered with a new anaesthetic apparatus, which had a circle system and was equipped with a carbon dioxide absorber. The device became available in the mid-1920s and was produced by the Draeger Company, Luebeck. Thus, this manufacturer became a protagonist of N2O anaesthesia apparatus in the German speaking countries.