Today, pain is something to be eliminated but 150 years ago pain was accepted as part of life. There were no readily available analgesics. Surgical procedures were carried out without any pain relief. ‘Historical perspective’ looks at the different types of relief that have been used such as alcohol, opium, nightshades, nitrous oxide, chloroform, and barbiturates. The development of anaesthesia was paralleled by advances in other areas of medicine, such as germ theory and aseptic technique. Advances in surgical practices have been vast but, however sophisticated today's anaesthetic practices are, the fundamental approach to problems has barely changed.