March 26, 2022

3 Natural, Ancient Anesthetics No One Talks About: Opium, Alcohol, Marijuana

Many plants were used in ancient times to achieve surgical anesthesia. Ethanol (alcohol), cannabis, and poppy seeds were used across the world for hundreds of years. But did they actually work to provide adequate anesthesia?

Plants can be powerful medicine, but can you have anesthesia from all natural sources? How did they do surgery in ancient times? Could you achieve anesthesia from plants?

I love plants as medicine, so let’s explore the three original anesthesia agents: alcohol, marijuana, and poppy. They were often mixed together because any individual one would be too poisonous.

Alcohol (Ethanol): Unconscious for Surgery?

Wormwood was added to alcohol to make it stronger for use as anesthesia in ancient times. Unfortunately, wormwood can also be toxic, and this wasn't a particularly effective technique.
Wormwood was added to alcohol to give it more psychotropic effects

Beer making first started around 6-8,000 years ago in the middle east. We didn’t figure out how to concentrate it until about 1,000 years ago using distillation technology, because alcohol has a lower boiling point than water. Sometimes it was mixed with wormwood for more psychotropic properties (but that could be toxic!).

Mild intoxication kicks in around 0.03-0.05% blood concentration. You hit a coma at around 0.4%.

So at high enough doses, you can induce general anesthesia (because it's like the anesthesia medical coma). The problem is that in old times there was no IV ethanol, so they had to drink over half a liter of pure alcohol. Not only is that tough to down, but it’s also dangerous because you can vomit while unconscious and aspirate. That alone can be lethal, as can the toxic effects of that much alcohol in your body!

On top of that, alcohol is dangerous during surgery and hurts recovery. It can increase bleeding, infections, delirium, and heart problems. It can also slow wound healing, which can prolong pain. By the way, that’s why you should hold off on drinking alcohol for at least 1-2 weeks before surgery!

Cannabis: Natural Anesthesia?

China recorded using cannabis indica for anesthesia almost 1,000 years ago. They called it mafeisan. Ayurvedic medicine in India recorded cannabis indica over 1,500 years ago. It was used in ancient Egypt, but they didn’t know the best way to deliver it to the body, so they tried orally, rectally, vaginally, on the skin, and inhaling.

One strategy in India was to use wine to get drunk, then smoke cannabis in preparation for surgery. This was really hard to standardize and reproduce though! This isn’t ideal for surgery. Imagine your anesthesiologist telling you “this should work, we’ll see if you stay awake for your surgery.”

Nowadays we have so many hybrid species that you might think it’s possible to achieve anesthesia with marijuana. There’s even a hybridstrain called “anesthesia” with THC content in the 30% range.

But marijuana has a modest pain relieving effect at best, especially in ancient times before we had these highly manipulated hybrids. And anesthesia is not a narcotic, so comparing this potent strain to anesthesia and narcotics is for marketing. The good news is that marijuana at modest doses doesn’t cause respiratory depression like opioids do. But it’s also not potent enough to undergo surgery with, especially alone. There's also a risk of cannabis use disorder and marijuana can cause complications during surgery.

Hua Tuo reported the effects of mafeisan, or cannabis indica, was used in ancient China for its anesthetic properties. Unfortunately, it simply isn't powerful enough to achieve adequate depth of anesthesia for surgery.
Hua Tuo in ancient China discovered the anesthetic properties of cannabis indica (called Mafeisan)

Poppy seeds: Natural Pain Relievers?

Even though poppy grows in the middle east, it was used for food and not opium in ancient times. There’s no drug activity in the poppy leaves, fruit, or roots. Raw opium comes from unripe seed capsules, and it doesn’t look like this was known in ancient times.

Ancient Egyptians may have discovered that some lotus plant species also had narcotic like properties that are released with alcohol. That may have been why they added lotus to wine for pain relief.

The Romans and ancient Persians described the opium extraction process well and its pain-relieving properties. They also used this with Mandrake, mulberry, and other herbs for procedural sedation.

The most advanced technique was soaking these in a sponge and having the patient inhale them to knock them out. Unfortunately, the patient still had to be strapped down before cutting…

The same hold today. Opioids, including synthetic ones like fentanyl, aren’t strong enough to be an anesthetic agent. In the old days it was even more dangerous because these substances turn off your breathing reflexes. And that would have been lethal before the invention of ventilators to support your breathing.

Unfortunately, our society is well aware of the risks of opioid addiction, too.

The poppy seed is the source of the ancient pain reliever opium. However, this wasn't discovered in ancient times, possibly because the flower and other parts of the plant don't have any pain relieving properties.
Unripe poppy seeds are the source of opium, but this wasn't discovered in ancient times.

Conclusion: did Natural Anesthesia Work?

So why didn’t these concoctions of different plants work? People died because they weren’t standardized. They tried mixing these with fats and oils so they could be absorbed through the skin or rectum. Theoretically that could avoid having to eat them and cause gastrointestinal poisoning, but that theory simply didn’t work.

By the 19th century, many forms of herbal anesthesia were outlawed because of these dangers. Elective surgery simply didn't exist! This was around the time that clinical hypnosis began taking off. This was also around the time that ether's anesthetic properties were discovered. Clinical hypnosis fell by the wayside (until today) and modern anesthesia began.

So thank you modern medicine for helping develop safe and comfortable surgery!

 

And here's a great reference!

Holzman, Robert S. "The history of sedation." Pediatric Sedation Outside of the Operating Room. Springer, New York, NY, 2012. 3-10.

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