What cannot be ignored must be endured, but you can rely on religion to make a virtue of it. Poverty, hardship, hunger, solitude and even pain all have redeeming value, seen through the eyes of a believer. Man is born unto trouble as the sparks fly upward, says the Book of Job; so grit your teeth and make the best of it. To suffer, even where suffering can be relieved or actually avoided, is to experience the chance of redemption.

Only by such a perverse set of values is it possible to understand the reaction of so many Victorians - doctors, theologians, and even surgeons - to the discovery of anaesthesia. The abolition of pain was greeted by pursed lips and knotted brows.

According to Charles Meigs, Professor of Obstetrics at Jefferson Medical College, its use in surgery was “a questionable attempt to abrogate one of the general conditions of man”. The Lancet responded to the death of several patients under anaesthesia by suggesting that the avoidance of pain scarcely justified the risks - even for amputations of the leg.

Stephanie Snow's admirable account of the slow triumph of anaesthesia constantly astonishes by its revelation of the inhumanity of so many doctors. Happily, some of the the 19th century's greatest men - among them Darwin, Dickens, and John Snow, the founder of epidemiology - reinforce one's good opinion of them by having been solidly in favour of anaesthesia from the start. Darwin, a sensitive man, insisted that his wife Emma should have their seventh child in 1850 with the aid of newly discovered chloroform, which he administered himself. “It is the grandest and most blessed of discoveries,” he wrote.

But many surgeons had it in their heads that pain was a necessary prologue to recovery, the way in which the body marshalled its forces to overcome the shock of an operation. There was no real evidence for this, and indeed it is far more likely that the sheer terror of operations actually cost lives. Some patients were simply frightened to death, and no wonder. It is hard to read Fanny Burney's account of her mastectomy in 1811 without feeling faint.

As a result, operations were a last resort, At leading London hospitals, only a handful were carried out each month. Routine operations such as appendectomies were unknown. In the mid-19th century, a grumbling appendix was normally diagnosed as “gastric seizure” or “cramp of the bowel” and the patient nursed in the hope it would resolve itself. King Edward VII had his appendix removed in 1902, under a mixture of chloroform and ether, and his coronation took place after a short postponement. Had Queen Victoria suffered the same crisis in 1837, she would probably have died.

In 1850, Sir Robert Peel did die after a riding accident in Hyde Park in which he broke his collarbone, several ribs and his leg. The pain was so intense that he could not bear to have the bones properly set. Chloroform was known, and might have saved him, but his doctors lacked Darwin's courage and did not use it. After three days of excruciating pain and growing weakness, Peel died.

Ether, chloroform and nitrous oxide transformed surgery, enabling surgeons to carry out operations that were unimaginable before. Yet many resisted, citing the unpredictable deaths that sometimes occurred under chloroform, the best of the three anaesthetics - as if surgery without anaesthesia did not already kill a large proportion of its patients. British Army surgeons, too, opposed offering the benefits of pain relief to the injured and the dying during the Crimean War, although the French and Russian surgeons were far more enlightened.

With changing attitudes came a revolution in the way we think of pain, and here Stephanie Snow turns what is already an entertaining account of a medical innovation into something more profound. “We had always understood that pain was given us as a blessing,” one surgeon wrote, in a treatise about, of all subjects, the rectum. To interpret a pain in the arse as a blessing takes a very peculiar cast of mind, yet even today pain relief is often doled out - and even to the dying - as if it were on the ration. Old attitudes die hard.

Blessed Days of Anaesthesia: How Anaesthetics Changed the World by Stephanie J. Snow
OUP, £16.99 Buy the book

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