Remembering the forgotten ophthalmologist who discovered local anesthesia
Imagine going to the dentist and needing a filling, but there’s nothing to numb you up. There’s no novocaine. Just drilling.
Thankfully, we have local anesthesia for dental work and eye surgery. For that, we can thank a man who died 74 years ago today.
University of Michigan medical historian and PBS contributor Dr. Howard Markel joined Stateside to talk about Karl Koller, the ophthalmologist who figured out the magic of local anesthesia and caught beef with Dr. Sigmund Freud at the same time.
Listen to the full conversation above, or read highlights below.
On Karl Koller
According to Markel, he was one of Freud’s colleagues. They were both resident physicians at the Vienna General Hospital, which was known as the world’s best in the 1880s. Around this time, cocaine was considered a “wonder drug” that could cure all.
“Freud was interested in the drug for different purposes, and just as a throwaway he said ‘it does numb the gums and the nose when you touch the solution to those parts of the body,” Markel said.
While ether anesthesia was invented in the 1840s, it wasn’t conducive to eye surgery because it creates too much pressure behind the eyes and inside the chest.
“You look for things that help you in your work,” Markel said. “He [Koller] found that he could perfectly numb the eyeballs and do his work.”
On announcing his discovery to the world
Because Koller didn’t have enough money to travel from Vienna to Heidelberg, where a congress on ophthalmology was held in September of 1884, he sent a senior colleague to read his research paper on his behalf.
The colleague proved the numbing effects of cocaine anesthesia on a dog’s eyes before the live crowd of established ophthalmologists — something Markel notes would not be an acceptable demonstration today. He actually operated on the dog’s eyes, and it didn’t whimper or flinch.
“It became world news,” Markel said. “Not just in ophthalmology circles, but it made front-page headlines around the world that you had this solution that could numb the body to pain.”
The medical world made use of the drug almost instantly.
On his feud with Freud
Freud was furious when gossip spread of Koller’s discovery.
“He was scooped on this great finding,” Markel said. “He had the ticket. He was right, but he didn’t figure that out.”
Why? Markel speculates Freud, a psychoanalyst, was looking for different treatments, preoccupied with treating addiction and depression.
“Or it might be that he was so high he just didn’t notice it, which is difficult to prove, but it may have been that,” Markel said.