Inhalation of ether.

[CASE XI: ether surgery of parotid tumor].

Warren, Jonathan Mason, 1811-1867.

Boston : David Clapp, Proprietor and Publisher, 1847.

Journal : Boston Medical and Surgical Journal ; vol. 36, no. 8 (March 24).

Description : p. 155-156.

Photograph : daguerreotype of the patient and his surgical team, led by Dr. Jonathan Mason Warren.

Photographer : Josiah Johnson Hawes (18081901) of Southworth & Hawes.

Subject : Parotid gland — Tumors ; ether surgery.

Notes :

EDD No. 1

Ether Dome daguerreotype No. 1 (1847). Owned by the Massachusetts General Hospital, Boston, and currently archived at the Fogg Museum (Object no. 3.1979). Number tags added for the following attributions: 1.) George Parkman 2.) Solomon David Townsend 3.) William Augustus Briggs—unverified 4.) Augustus Addison Gould 5.) William T. G. Morton 6.) Patient 7.) Samuel Parkman 8.) Jonathon Mason Warren 9.) Henry Jacob Bigelow 10.) Daniel Denison Slade 11.) Ward attendent.

A considerable amount of guesswork obscures the origin and meaning of Ether Dome Daguerreotype No. 1. The identities of the surgeons and the clinical subject represented by this historic image may never be fully known. Of the three possible scenarios, the least probable one is that the dag represents a "re-enactment" of the historic Abbott surgery prosecuted by Dr. John Collins Warren on October 16, 1846. The event marked the first use of ether within a hospital setting, officially entering anesthesia into the surgical armamentarium. The legend behind the re-enactment scenario holds that Josiah Hawes of the photographic firm, Southworth & Hawes, was on hand to capture the Abbott surgery, but because he was sickened by the sight of blood and incapable of completing his commission, a second photo session was later staged to commemorate the historic event.

There are too many inconsistencies in the composition of EDD No. 1 to support a re-enactment scenario. To my eye that is not John Collins Warren in the photo, but rather his son, Jonathan Mason Warren, who later testified that he was not present for the Abbott surgery (Morton, 1853; p. 387: »»). The House-physician Charles Bertody, who was one of the principals for the Abbott operation, is missing. Bertody can be identified in EDD No. 5 with his hand positioned on the patient's nape. Furthermore, the unmistakable identity of a medical student, Daniel Denison Slade, is seen standing behind Dr. Gould in the dag and is incongruous for a staged re-enactment scenario. Slade's first Ether Dome experience came as a witness to the amputation of the leg of Alice Mohan, conducted by Dr. Hayward on November 7, 1846. And finally, the figure in the dag who I identify as Dr. Samuel Parkman is questionable for a re-enactment scenario. Parkman was never deposed as a witness for the Morton patent trials, which casts doubt he was one of the principals for the Abbott operation.

A second scenario, that Morton himself arranged the photo session with his friends and champions gathered around, also lacks credibility. Morton was an avid self-promoter and spent a considerable personal fortune to maintain his historical relevance, but there is no evidence he distributed or advertised copies of the dag, or even owned a copy.

The third scenario, one in which the dag represents an actual surgical event, is the most promising. This would have to be a case prior to April, 1846, by which time the sponge had replaced Morton's apparatus at the hospital and his superintendence was no longer needed. According to Henry Jacob Bigelow's tables, there were twenty-six ether surgeries conducted at Mass. General Hospital from the date of the Abbott surgery to the end of March: ten were female and sixteen were male subjects (Bigelow, 1847; C.–2. »»). Only two cases of the male cohort match the age and physical description of the patient in the dag — late twenties to late thirties — and the type of surgery represented. Berthody supervised the etherisation of the first of these two cases, Parkman's reduction of dislocated shoulder, with ether delivered "by an apparatus furnished by Mr. Morton to the Hospital." The patient was discharged the following morning. Not only was there insufficient time to arrange for a photo session of an urgent care walk-in, but Morton was not present. This leaves the second case adduced from Bigelow's tables, Warren's parotid surgery, as the likely scenario represented by the dag:

  1. Parkman's reduction of dislocated humerus on Dec. 9, 1846: "A stout healthy carpenter" (Parkman, 1846; p. 409: »»).
  2. Jonathan Mason Warren's March 13, 1847 operation for parotid tumor (Case XI): "A large, powerful, full-blooded man" (Warren, 1847; p. 155: »»).

Morton was the etheriser for Warren's parotid tumor patient as stated in the report: "Ether was given him by Dr. Morton, who was desirous of seeing its effects on so powerful a patient." The other principals of the surgical team who were named included: "Drs. J.C. Warren, George Parkman, S. Parkman, Briggs and Mr. Slade." Although Warren failed to provide a date of the surgery, this is learned through a follow-up report in his epitome, Surgical observations, with cases and operations, published posthumously (Warren, 1867; p. 497: »»).

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