Tuesday, March 7, 2017

X - James Esdaile Performs Painless Surgeries in 19th Century India

James Esdaile was a surgeon assigned to work in the mid 19th century in colonial India. He spent almost twenty years there. Like many surgeons of the era, he was at large disadvantage compared to colleagues in Europe and especially those working after the appearance of chloroform and ether anesthesia. Opium and alcohol were for practical purposes the only painkillers available. Biting the bullet was often the only remedy hand for patients about to undergo major operations and even amputations.

Furthermore, he worked under very difficult conditions in a distant land, under tropical climate, and questionable sanitation. There were no blood transfusions and IVs, and not much more than beds, shelter and operating rooms with simple sharp knives, crude saws and rudimentary clamps. 

Working with Indian convicts in a prison hospital near Calcutta, Esdaile was struck by the idea of trying magnetism – mesmerism – on his patients in hopes of relieving the pain and discomfort of major operations to be done at his hand. [The following extract comes from his book Mesmerism in India published in England in 1851.]

Note: There is unfortunately no portrait of Esdaile (1808-1859) to be found on the Internet. 

An English surgeon ready with the knife circa 1840

First Experiment.
Madhab Kaura, a hog-dealer, condemned to seven years' imprisonment, with labour on the roads, in irons, for wounding a man so as to endanger his life, has got a double Hydrocele [fluid filling the scrotal sac common at the time in India, sometimes to enormous size and weight].

He was ordered to be taken from the jail to the charity hospital, to be operated upon.

April 4th.— The water was drawn off one side of the scrotum, and two drachms of the usual cor. sub. [corrosive sublimate - mercuric chloride] injection were thrown in. On feeling the pain from the injection, he threw his head over the back of the chair, and pressed his hands along the course of the spermatic cords, closing his eye lids firmly, and making the grimaces of a man in pain.

Seeing him suffering in this way, I turned to the native sub-assistant surgeon, an eleve [student] of the medical college, and asked him if he had ever seen Mesmerism? He said, that he had seen it tried at the medical college, but without effect. Upon which I remarked, "I have a great mind to try it on this man, but as I never saw it practised, and know it only from reading, I shall probably not succeed." —

The man continuing in the position described, I placed his knees between mine, and began to pass my hands slowly over his face, at the distance of an inch, and carried them down to the pit of his stomach. This was continued for half an hour before he was spoken to, and when questioned at the end of this time his answers were quite sensible and coherent.

He was ordered to remain quiet, and the passes were continued for a quarter of an hour longer — still no sensible effect. Being now tired (thermometer 85°), I gave it up in despair, and declared it to be a failure. While I rested myself, the man remained quiet, and made fewer grimaces, and when ordered to open his eyes, he said there was a smoke in the room. This roused my attention, and tempted me to persevere. I now breathed on his head, and carried my hands from the back of his head over his face and down to the Epigastrium, where I pressed them united. The first time this was done, he took his hands off his groins and pressed them both firmly down upon mine; drew a long breath, and said, "I was his father and mother, and had given him life again." The same process was persevered in, and in about an hour he began to gape, said he must sleep, that his senses were gone; and his replies became incoherent. He opened his eyes, when ordered, but said he only saw smoke, and could distinguish no one: his eyes were quite lustreless, and the lids were opened heavily. All appearance of pain now disappeared; his hands were crossed on his breast, instead of being pressed on the groins, and his countenance showed the most perfect repose. He now took no notice of our questions, and I called loudly on him by name without attracting any notice.

I now pinched him, without disturbing him, and then asking for a pin in English, I desired my assistant to watch him narrowly, and drove it into the small of his back; it produced no effect whatever; and my assistant repeated it at intervals in different places as uselessly. His back had continued to arch more backwards latterly, and he now was in a state of "opisthotonos;" the nape of his neck resting on the sharp back of the chair, and his breech on the edge of it. Being now satisfied that we had got something extraordinary, I went over to the Kutcherry, and begged Mr. Russell, the judge, and Mr. Money, the collector, to come and see what had been done, as I wanted the presence of intelligent witnesses in what remained to do. We found him in the position I had left him in, and no hallooing in his ears could attract his attention. Fire was then applied to his knee, without his shrinking in the least; and liquor ammonia?, that brought tears into our eyes in a moment, was inhaled for some minutes without causing an eyelid to quiver.

This seemed to have revived him a little, as he moved his head shortly afterwards, and I asked him if he wanted to drink; he only gaped in reply, and I took the opportunity to give, slowly, a mixture of ammonia so strong that I could not bear to taste it; this he drank like milk, and gaped for more. As the "experimentum crucis," I lifted his head, and placed his face, which was directed to the ceiling all this time, in front of a full light; opened his eyes, one after the other, but without producing any effect upon the iris; his eyes were exactly an amaurotic person's, and all noticed their lacklustre appearance. We were all now convinced that total insensibility of all the senses existed, and I ordered him to be placed on a mattress on the floor, and not to be disturbed till I returned.

It was now one o'clock, the process having commenced at 11 a. m. I returned at three o'clock, and was vexed to find that he had awoke, and been carried back to the jail hospital. The native doctor of the jail had come in; and on hearing that the Sahibs could not awake the patient, he set about doing so, and succeeded by throwing water on his face, &c. I again went to Messrs. Russell and Money, and requested them to accompany me to the jail, to be present when he was interrogated regarding his reminiscences; and we put down a series of questions to be put to him, at once, and without explanation. We found him looking well, with a lively expression of face, and the following questions were put to him ; his answers being taken down at the same time:—

"How do you feel?"

"Very well.”

"Any pain in the throat, or elsewhere?"

"A little uneasiness in the throat, no pain anywhere else."

"What has happened to you to-day?"

"I went in the morning to the Imbarah Hospital, to get the water taken out of my scrotum."

"Was the water drawn off?"


"What do you remember after the operation?"

"I went to sleep soon after, and remember nothing else."

"Did you eat or drink after the operation?"

"I felt thirsty, but got nothing to drink till Kurreem AH, the native doctor, awoke me."

"Did any body prick, or burn you?"

"No, no."

"Did you smell anything disagreeable?"


"Were you happy when asleep?"


"Did you hear any thing when you were asleep?"

"I heard voices, but did not understand them."

"Did you see any gentleman in the hospital but me?"


"Did you feel any pain in the scrotum after going to sleep?"

"I felt none till I awoke."

"Any pain in that part now?"

"A very little."

"How many motions have you had to-day?" (he was suffering from chronic diarrhoea.)

"Four, before going to the hospital, none since; belly is much easier than it has been for some time."

Having answered all these questions readily and frankly, he began to cry, thinking it was some kind of judicial investigation, I suppose.

"The above is an exact relation of what took place in our presence, and we are thoroughly convinced that there was a complete suspension of sensibility to external impressions of the most painful kind.

(Signed) F. W. Russell, D.J.Money.

Esdaile went on to perform numerous surgeries on the likes of the patient pictured below. 

The following is a letter from Esdaile (further explaining his work) to James Braid, the claimed inventor of hypnotism who took mesmerism in another direction. It was published in 1850 towards the end of Esdaile’s surgical career in India.

I shall find much in the books to interest and instruct me, as I did in your first work on Hypnotism; but I shall not wait to read them before replying to your communication.
I have not seen any of the papers you allude to in the journals; but am glad to hear that the doctors are, at last, condescending to turn their attention to one of the most interesting and important subjects ever submitted to the consideration of the physiologist, the metaphysician, and natural philosopher.
Regarding the reality and cause of the mesmeric phenomena, if I venture to differ from you even, who are so much better prepared to investigate the subject [than certain individuals to whom the Doctor had referred], it is for reasons which I hope you will consider worthy your attention. I am fully aware that there are various modes of inducing the mesmeric symptoms, to a certain extent, without the probability, or even possibility, of any vital force proceeding from the operator being concerned in the matter. But I have never (except for experiment) produced the mesmeric state of the system by the exhaustion of any organ, such as the eye, or by acting strongly on the imagination, or by any means that could favour self-mesmerization, as you will perceive from the following resumé of my practice:—

During the last six years I have performed upwards of 300 capital operations of every description, and many of them of the most terrible nature, without inflicting pain on the patients; and, in every instance, the insensibility was produced in this fashion.

All knowledge of our intentions was, if possible, concealed from the patients; and if they had never heard of mesmerism and painless operations, so much the better. They were taken into a darkened room, and desired to lie down and shut their eyes. A young Hindoo or Mussulman then seated himself at the head of the bed, and made passes, without contact, from the head to the epigastrium, breathing on the head and eyes all the time, and occasionally resting his hands for a minute on the pit of the stomach. This often induced the coma deep enough for the severest surgical operation in a few minutes; but the routine was for me to examine the patient at the end of an hour, and if he was not ready, the process was repeated daily. Taking the average, the operation, of whatever description, was usually performed on the fourth or fifth day.

Probably as many more cases were subjected to the trance for medical
purposes, and were usually treated in the same way, for its convenience to both parties.

The enclosed remarkable case of clairvoyance, with transference of the
senses to the epigastrium, will show that the mesmeric control of the system may be obtained, when the patient is not only asleep, but in a state of intense natural coma.

I have also entranced a blind man, and made him so sensitive, that I could entrance him however employed, (eating his dinner, for instance) by merely making him the object of my attention for ten minutes. He would gradually cease to eat, remain stationary a few moments, and then plunge, head foremost, among his rice and curry.

Numbers of madmen have been entranced in the lunatic asylum of Calcutta; and I performed a mesmeric operation on one man who had cut his throat.

I frequently desired the visitors of my hospitals to pretend to take the
portraits of patients, and to engage their attention as much as possible, by conversing with them. I then retired to another room, and reduced them to statues, without the possibility of their suspecting my intentions.

How such phenomena can be accounted for, without presuming the
existence of a physical power transmitted from the operator to the subject, passes my comprehension. That the mesmeric virtue can be communicated to inanimate matter, is a physical fact, of which I am as well convinced as of my own existence. It was my common hospital practice to entrance patients for the purpose of having their sores burned with Nitric Acid, by giving them mesmerised water to drink.
Community of taste, and thought-reading, are among the most common of the higher mesmeric phenomena; and how they are to be explained, except by the transmission of the operator’s sensations, through his thought-stamped, nervous fluid, sent to the brain of the subject, I cannot conjecture.

"Important, if true", you will probably say. I can only say, that healthy senses, a natural power of seeing things as they really are, and an earnest desire to know the truth, whatever it may be, are perfectly useless for the acquisition of knowledge, if all I have related is not perfectly true.
Till such facts are known to medical men and natural philosophers, it is surely premature to dogmatise about the only source of the mesmeric phenomena.
[End of letter]

Esdaile performed his 300+ operations in truly extraordinary circumstances with no aseptic techniques, crude instruments, difficult climate and on criminals. His operations included major surgeries, amputations, extraction of tumors and hydroceles weighing up to 100 pounds and yet the mortality rate of his patients was around 5 percent. That number in itself, phenomenally low even in the best of modern conditions, should have produced global interest. But ...

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