Students of eighteenth-century history are familiar with the two great prime ministers of England, William Pitt the Elder and William Pitt the Younger. Medical historians, however, may be more interested in the two Boston physicians, Jacob and Henry Bigelow, also father and son, who in a way eclipsed one another by attaining a great reputation within almost the same generation.¹

Jacob Bigelow (1787–1879)

The elder Bigelow, Jacob, son of a Congregational minister, was born in 1787 in Sudbury, Massachusetts. He was a polymath and classical scholar, writing poetry as a boy and continuing to do so well into old age. After graduating from Harvard College in 1806, he obtained a medical degree from there in 1810, and in the following year, established one of the most successful medical practices in Boston. In 1815 he became Professor of Materia Medica and Botany at Harvard Medical School, a post he held for forty years. In 1820 he became the associate editor of the United States Pharmacopeia; in 1830 he published “Elements of Technology,” a treatise on the application of the science, mechanics, and engineering to the fine arts; and in 1832 was commissioned by the City of Boston to visit New York to observe and report on the Asiatic cholera epidemic that was raging there.

Jacob Bigelow contributed greatly to the development of medical institutions in America by advocating rigorous scientific education as well as practical training. In his 1835 lecture titled “Self- limited Diseases” and in later influential addresses, he advocated expectant treatment for several diseases in preference to aggressive treatments such as bleeding, purging, and other heroic measures popular at the time.^1,2

He served as a founding member of several scientific and educational institutions, of the Massachusetts General Hospital and of the Boston Society of Natural History. As a prominent botanist and horticulturist, he published Florula Bostoniensis in 1814 and American Medical Botany in 1817–1820, cataloguing the flora of North America and providing valuable insights into the medicinal uses of plants. At age thirty-eight, he founded the Mount Auburn Cemetery in Cambridge, Massachusetts, which served as a botanical garden and arboretum, a model for future cemetery designs.

At the age of eighty-three Jacob Bigelow was well enough to go with his wife and some friends on a pleasure trip to California. He subsequently continued to amuse himself by writing poetry and translating some into Greek and Latin, and his mind remained undimmed until the very end.¹

Henry Bigelow (1818–1890)

Jacob’s fifth son, Henry Jacob Bigelow, was born in Boston in 1818 and educated there. Following in the footsteps of his father, he entered Harvard College in 1833 and graduated in 1837. Handsome, thin, athletically gifted, and charismatic, he studied in Paris and London, then received a medical degree from Harvard in 1841. He began practicing in Boston in 1844, and in 1846 was appointed visiting surgeon at the Massachusetts General Hospital. It was there that at the age of twenty-eight, on the historic “Ether Day” of October 16, 1846, he witnessed the dentist William Morton perform the famous first public demonstration of ether anesthesia that led the surgeon, John Warren, to famously declare “This is no humbug.”

On November 9, Henry Bigelow reported the event at a meeting of the Boston Society of Medical Improvement, and on November 18 he published it the Boston Medical and Surgical Journal which later became the New England Journal of Medicine.³

Early on in the history of anesthesia, Humphry Davy had declared that nitrous oxide inhalation might be useful to dull the pain in some surgical operations. In the early 1840s Dr. Crawford Long in Georgia used ether but did not publicize his work until later. The dentist William Clarke in New York also used ether in 1842. Another dentist, Horace Wells, used nitrous oxide in his practice in 1844, but an attempted demonstration in January 1845 was a failure.

Henry Bigelow’s article announcing the success of “ether day” remains one of the most influential articles ever published in medicine. He recognized the importance of anesthesia as the greatest discovery of his time, promoted its use, was always in a state of great excitement when he spoke about it, and said that within a fortnight of his publication the news of this wonderful discovery will be all over the world. By November 21,1846, in a letter to Morton, Dr. Oliver Wendell Holmes, Sr., suggested the word “anesthesia” to describe the mental state produced by the inhalation of the ether vapor.³

Bigelow remained Professor of Surgery at the Harvard Medical School for more than thirty years, from 1849 to 1882. He wrote some forty articles, lectures, or manuals on anesthesia, orthopedics, fractures, hernias, clinical cases, medical education, and ethics. He described in detail the anatomy of the hip joint, and in his many papers such as the 1878 “Lithotripsy by a Single Operation” he advocated for “the crushing and removal of a stone from the bladder at one sitting,” rather than crushing the stone first and then remove the remaining fragments later at the cost of much discomfort and complications. In a remarkable article with neurological implications, he wrote in 1850 about the famous case of Phineas Gage, the man who had a crowbar driven through the side of his face and come out at the top of his skull, destroying much of his frontal lobe and leaving him with a changed personality.

In 1869 Bigelow was involved in a controversy and debate with Sir James Simpson, the Edinburgh obstetrician, who in his opinion had taken too much credit for himself as the discoverer of the anesthetic properties of chloroform and gave inadequate credit to the city of Boston for first using ether.⁴ To some extent posterity proved him right; eventually chloroform proved toxic and stopped being used, whereas ether remained the mainstay of anesthesia until the advent of fluothane almost a century later.

References

1. Editorial. Jacob Bigelow. The British Medical Journal, Apr 4, 1902;1(2153):850-1.
2. Jacob Bigelow. Proceedings of the American Academy of Arts and Sciences, May 1878 – May 1879;14:333-42.
3. Elizabeth Makris, Kevin Makhoul, Terence Lee, Jr, and Manisha Desai. Henry Jacob Bigelow (1818–1890): A Champion for Anesthesia and Catalyst for the Advancement of Surgery. Ann Surg Open. Jan 20, 2022;3(1):e118.
4. Walter Friedland. The Bigelow-Simpson controversy: Still another early argument over the discovery of anesthesia. Bull. Hist. Med., 1992;66:613-62.