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In 1846 there were no anaesthetics. An operation meant searing pain, hardly dulled by rum or opium, enduring only through strong men holding the patient on the table. Surgeons like Robert Liston learned to operate swiftly, to be merciful… Liston could amputate a leg in 50-odd seconds. Suddenly, the knot of agony was loosened, with —Laughing gas— and ether come to Europe from New England. Like other obvious benefits to humanity, the anaesthetics brought antagonism, chicanery, and violent death to their originators. Richard Gordon—s depiction of medicine and medical men in London, Boston and Edinburgh during the 1840—s is a brilliant new departure for this most versatile and entertaining of English novelists.