Anesthesia is considered an American invention, although innovations of such significance can hardly have arisen spontaneously. The individual‘s well-being was not genuinely considered until the need for surgical treatment of disease arose; attempts at relieving pain were previously sporadic. True, operations had been performed over the centuries but always for the superficial malady—a fracture, amputation, cataract extraction, trephination of the skull, or removal of bladder calculus. To these ends, the anesthetic properties of hypnosis and trance, pressure over peripheral nerves and blood vessels, application of cold, alcohol intoxication, or ingestion of herbal concoctions were used. A more influential approach to illness had been the galenic concept of disease, in which an imbalance among four cardinal body humors—blood, phlegm, and yellow and black bile—was said to exist; this concept survived well into the present century.
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