Hypnosis As An Adjunct To Chemical Anesthesia

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THE most learned man in the history of medical hypnosis was Doctor Henry Munro, who lived and practiced in Omaha, Nebraska, at the turn of the century. In 1900 there was practically no preoperative medication. There was very little to alleviate surgical shock. Even today the average person faces surgery with apprehension, but in 1900, the situation was much worse. One in four hundred people died on the operating room table as a result of the anesthesia— not the surgery.

The fears of patients were much greater than they are today. One man knew something about those fears and tried to alleviate them. Doctor Murno had a good method for alleviating fears. He would get his patients into the hypnotic state, discuss their fears with them, and tell them that when they went into the operating room knowing they were going to recover, they would have a quick recovery and would feel a lot better. He was the first to give preoperative talks in hypnosis.

One man came in for surgery who was filled with apprehension. The surgery had to be done, so Doctor Munro hypnotized him, removed his fears and said, "Well, you'll never be in better condition for the surgery than right now, so let's go ahead." Ether was the anesthesia agent then most commonly used. With about ten percent of the usual amount of ether, Doctor Munro was amazed to find that he had perfect surgical anesthesia, and he went ahead and performed the surgery. He thought this was luck and would probably not happen again. But a month later, a woman came in for surgery. She was very nervous. Doctor Munro hynotized her and, with about twenty-five percent of the usual amount of ether, again he was able to get perfect surgical anesthesia —banishing the excitement stage of ether entirely. One of his observations was that such patients recovered easily and quickly; the postoperative recovery was almost miraculous. He drew the conclusion that he might be able to get the same excellent results with every patient through hypnosis. He had about a hundred surgical cases in succession in which he was able to do surgery with from ten to twenty-five percent of the usual amount of chemical anesthesia. He had made a great discovery, but other doctors ridiculed him.

He arranged a group of lecture dates, one of which took him to Rochester, Minnesota. Before the lecture that night, he had dinner with two of the doctors who were working at St. Mary's Hospital—the Mayo brothers. It was before the days of their clinic.

Doctor Munro was telling the Mayo brothers about his discovery. The Mayo brothers decided his discovery was worth testing. If the patient didn't get the necessary anesthesia, all they had to do would be to use more ether. If it worked they'd have a valuable medical aid.

When they got back to St. Mary's Hospital, the Mayo brothers started Case Number One of Seventeen Thousand deep abdominal surgical procedures, without a single death or injury directly traceable to the anesthetic. The eyes of the world focused on the Mayo brothers, and success was theirs. This was the only place in the world where a patient didn't have to take a chance on dying from anesthesia. Anyone who needed surgery could be confident of living through the operation.

Alice Magaw, the anesthetist of the Mayo brothers, was very proud of her work. She wrote an article for the Obstetrical Journal of May, 1906. That Journal was not widely circulated. Many doctors did not get it in 1906, and the story remained obscure. I know about it because Doctor Munro occasionally visited my father (we lived in Fargo, North Dakota, which is not far from Rochester) and I heard the two men discussing it. But, strangely, the Mayo brothers never said that they used hypnosis.

Here is a technique similar to that which Doctor Munro showed the Mayo brothers; you will see it is very simple to use. You're in the operating room. Say to the patient, "We're going to start the anesthesia in just a minute, and to make this procedure very easy for you, I want you to do just as I tell you. Open your eyes wide. I'm going to pull them shut, like this. Now pretend you can't open your eyes. That's all you have to do. Pretend you can't open your eyes. We're going to start the anesthesia, and in a little while you'll wake up in your room upstairs. The operation will be over and you'll be on the road to recovery. Just keep on pretending you can't open your eyes and we'll go ahead and start the anesthesia." That is all that is necessary. This is a bypass of the critical faculty and it implants selective thinking. Try it, and you will be amazed at what you are able to do with it.

The fourth edition of Doctor Henry Munro's book "Suggestive Therapeutics" contains a careful documentation of every fact I have told you. I make this documentation available to all my students, but some doctors are still hesitant to use the Mayo technique.

A doctor who was president of the Anesthetists of New Jersey was one of my students. At the third class session, he arrived early and told me this story: "All this week I have used the technique you described and have been working with from twenty-five to thirty-five percent of the usual amount of pentothal that I would normally use in surgery. I will not turn a patient over to a surgeon if that patient does not have complete surgical anesthesia. Henry Munro was absolutely right. You get perfect surgical anesthesia with twenty-five to thirty-five percent of what is usually used. This is just as important today as it was in 1900. Today we have only an occasional death, but we also have an occasional injury of some kind, traceable to anesthesia. If I can stay seventy-five percent away from the saturation point, I never have to worry about an injury from anesthesia. As an anesthetist, I can tell you this is very important."

As more and more doctor-students began using the technique which had been ignored all these years, anesthetists would get up in class and tell of their experience with the Mayo technique. Surgeons and anesthetists tell me they have never varied this technique—that they use it for every surgical procedure.

I could give you case history after case history of surgeons and anesthetists who have used this technique. I have been told by quite a few doctors in OB-Gyn that it works beautifully, when you're first learning hypnosis, and still using chemical anesthesia, to carry a patient through a complete delivery without her feeling a solitary thing.

What about the man in dentistry or the doctor giving local anesthesia? He says to himself, "This applies to gen eral anesthesia but doesn't apply to local." Yes, it does. Take your ampule of xylocaine, and instead of giving the patient the full ampule, cut it down and give ninety percent. You'll get just as good a result as you did with one-hundred percent. With your next patient, cut it down to eighty percent, then seventy, sixty, fifty, forty percent—and you'll find that because of the selective thinking you've implanted you'll soon get to the point where you will be working with a drop or less of xylocaine or novocain or whatever it is you are using, and get just as good an anesthesia as with an entire ampule.

I feel very proud of the fact that I, as a layman, brought the attention of physicians to Doctor Munro's great discovery. Doctors have too long ignored his findings. Here is the documentation that can be found in the fourth edition of Doctor Henry Munro's wonderful book, "Suggestive Therapeutics."

"Let us now look into the facts bearing evidence of the value of the employment of suggestion as an adjunct in the administration of anesthetics and the safety of the method to the patient.

"Alice Magaw, Dr. W. J. Mayo's anesthetist at Rochester, Minnesota, who has, with possibly one exception, anesthetized more patients than any other person in the world, has an unbroken record of approximately seventeen thousand surgical anesthesias without a single death directly from the anesthetic.

"No other surgical clinic in the world has been so constantly witnessed by surgeons during the last several years, and no other clinic presents a greater number of difficult cases to be operated upon, or those that are more unfit for favorable results from the administration of anesthetics.

"At St. Mary's Hospital, in the personalities of Alice Magaw and Miss Henderson, the anesthetists of W. J. and C. H. Mayo, at Rochester, Minnesota, we see the results from the outcome of surgical work done with a minimum amount of the drug employed for anesthesia and the free and intelligent use of suggestion as an adjunct to its administration.

"It was with no small degree of pleasure that, upon a visit to Rochester during the month of November, 1907, I found these women actually putting into practice one particular phase of psychotherapy that I had so strongly urged upon surgeons during the eight years previous.

"Both Alice Magaw and Miss Henderson were highly appreciative of that particular part of my lecture to the Physicians' Club of Rochester wherein I urged the importance of the employment of suggestion as an adjunct in the administration of anesthetics, and cited their everyday work as an illustration of complete surgical anesthesia with the use of but little ether, and the employment of suggestion to meet the requirements of the individual patient as an adjunct. Moreover, these women were free to say that they knew from everyday experience that what I had to say in reference to the use of suggestion as an adjunct in the administration of anesthetics was true.

"In the Journal of Surgery, Gynecology and Obstetrics of December, 1906, Alice Magaw says: 'Suggestion is a great aid in producing a comfortable narcosis. The anesthetist must be able to inspire confidence in the patient, and a great deal depends on the manner of approach . . . The secondary or subconscious self is particularly susceptible to suggestive influence; therefore, during the administration, the anesthetist should make those suggestions that will be most pleasing to this particular subject. Patients should be prepared for each stage of the anesthesia with an explanation of how the anesthetic is expected to affect him—"talk him to sleep" with the addition of as little ether as possible.'

"By the employment of suggestion scientifically and earnestly, very little ether is required to produce surgical anesthesia, and even less chloroform, to keep the patient surgically anesthetized.

"I do not exaggerate in the least when I assert that it is quite the common occurrence for an anesthetist who does not understand the use of suggestion to use from ten to twenty times the amount of ether in anesthetizing a patient than is used by Alice Magaw and Miss Henderson, who make use of suggestion in every possible way in a given operation.

"Nor is the anesthesia where such enormous quantities of ether are employed one iota more satisfactory from the surgeon's point of view than is secured by the Mayos. On the contrary, there is no period of excitement, no struggling of the patient that demands restraint, comparatively little stertorous breathing, no feeling of the pulse, and no hypodermics administered in the course of the operation, and, more yet, an unbroken record of approximately seventeen thousand cases without a single death from the anesthetic.

"But the significance of the employment of suggestion as an adjunct to the administration of anesthetics goes far beyond the danger to the patient directly and immediately during the course of the operation. The surgeon who does not have his patient's reserved energies so weakened and exhausted, and the patient's brain and nerve centers presiding over all physiological processes so seriously and permanently injured, as is the case with the Mayos, on account of the employment of suggestion to obviate the necessity of such enormous quantities of the anesthetic, simply has more recuperative power left in the cells of the organism upon which the hope for a favorable outcome from a major operation is based, and surgical operations upon patients with the minimum amount of poison from the anesthetic to combat are unquestionably attended with better results than where larger quantities of the drug are used.

"Inherent within the protoplasmic mechanism of the human organism is an untapped reservoir of available energy, which is either utilized by the judicious employment of suggestion for the welfare of the patient, or it is exhausted, perverted, or wasted by the indiscreet use of the anesthetic."

You will find that this technique works with every type of chemical anesthesia. In a class at Forest Hills, Long Island, one of the doctors read an open letter to me from Doctor Fein, head of the Queens County General Hospital. The letter invited me to speak to a special staff meeting. The doctor who read the letter explained the reason for the invitation: "I have my Boards in anesthesia, and I specialize in nitrous oxide particularly. When you told us about this technique, I wondered how well it would work with nitrous oxide. Let me tell you why that's important. You showed us a technique whereby we could cut down the amount of nitrous oxide, and with the first fifty cases I tried it on, I have never had to go above thirty-five percent nitrous oxide and sixty-five percent oxygen, and I can start my patient at that point and decrease from there. When I took the statistics on the fifty cases to Doctor Fein, he said, 'That's the finest set of statistics on nitrous oxide that I've ever seen.' I told him where I'd learned the technique, and he wants you to talk to the staff."

I talked to the staff, and afterwards gave the same talk before the Queens County Medical Society.

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