There is a blue plaque on a house in Gower Street, near University College, London, commemorating not the birth, life or death of a notable occupant but instead the completion of a minor dental procedure – the extraction of the tooth of one Miss Lonsdale on 19 December 1846. The text of the plaque mentions neither the lady nor her dentist, but rather the simple fact that this was the first time an anaesthetic had been administered in England. The development of ether and chloroform as medical treatments, inhaled by patients prior to operations to render them temporarily insensible, transformed modern surgery and also marks a watershed in the history of pain. It was a defining moment in modernity. As Joanna Bourke notes in her vivid and varied catalogue of two and a half centuries of Anglo-American suffering, she, like most of us, would not contemplate undergoing even a modest medical procedure, let alone major surgery, without effective pain relief. Before 1846, patients entertained no such comfortable expectations. They could take their chances with willow bark, opium, bleeding, hypnosis or, perhaps most realistically, large amounts of alcohol. Others hoped they could rely on strength of character alone to endure amputations. Some succeeded; others died trying.

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