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2005
Introduction Hidden behind Jacob Bigelow's imposing mausoleum at Mt. Auburn cemetery stands a small tablet engraved "William SB (1850-1926)." The humble marker covers the ashes of William Sturgis Bigelow, the only child of Henry J. Bigelow, and the last of the line (figure 1). William Bigelow gave up medicine after two years of surgery and only made minor contributions to anesthesia: his biography of his father pointed out the latter's decisive role in the adoption of ether in surgery, and as Harvard trustee he saw to it that ether anesthesia was used in all surgical operations and animal experiments. But his colorful life and his contributions to the arts deserve to be remembered. Early Years (1850-1871) William S. Bigelow, the only son of Henry J. and Susan Bigelow, was born on April 4, 1850, at 5 Chauncey Place, in the heart of old Boston. His mother was the eldest daughter of William Sturgis, a Salem captain who had amassed an enormous fortune in whaling and in the China trade. Susan Bigelow committed suicide when William was three, and doting aunts and grandmothers, all Mayflower descendants, raised him in the best upper class, or "Boston Brahmin" traditions. Like his father, William attended the Dixwell's Latin School. Two of his schoolmates were Henry Cabot Lodge, the future senator, and Frederick Cheever Shattuck, later Harvard physician and medical librarian. Both became lifelong friends. Bigelow ranked in the middle of his class 2 2 2 2 BULLETIN OF ANESTHESIA HISTORY BULLETIN OF ANESTHESIA HISTORY BULLETIN OF ANESTHESIA HISTORY BULLETIN OF ANESTHESIA HISTORY
Anesthesia & Analgesia, 2018
I n America, the task of giving the patient a "whiff" of ether or chloroform during surgical procedures was often left to junior house officers, nurses, medical students, orderlies, or individuals with no medical training. Harvard medical students Harvey Cushing (1869-1939) and Ernest Amory Codman (1869-1940) were required to do their share of "anesthesia duty" in the mid-1890s. Death under anesthesia was not uncommon, and in some instances, the surgical procedure would be continued despite the patient's death to maximize the learning opportunity. 1 During one fateful operation, Cushing's patient died during anesthesia, an event that greatly affected him and even led him to question his career choice. 2,3 However, instead of succumbing to despair, he and fellow medical student Codman began keeping accurate records during anesthesia. Their motivation for this action is not known, although Cushing writes that he was instructed to do so by the chief of surgery. In the process, these 2 medical students made a lasting contribution to a medical specialty that had not yet been born. They kept anesthesia records for more than 100 surgical procedures, which are now the property of Massachusetts General Hospital (MGH) and are preserved at the Francis A. Countway Library. 4 Every anesthesia record in this collection was examined for this study, and never before have they been subjected to the detailed analysis we offer: their notes, comments, drugs administered, and vital signs recorded. There is no indication that other students or house officers continued to maintain anesthesia records after Cushing and Codman. Later in their distinguished careers, these physicians continued to make major contributions to the safety and improved outcomes of surgical procedures.
The anesthesiology profession may one day serve as a cautionary tale of how power, politics and privilege can perturb science and progress. Previous anesthesia practitioners possessed a superior understanding of physiology and pharmacology, but overenthusiastic CO2 supplementation with inadequate monitors and machines caused asphyxiation disasters that were improperly attributed to CO2 toxicity. Dr. Ralph Waters founded the anesthesiology profession on the basis of a practical new anesthetic tech- nique that introduced elective intubation and hyperventilation to eliminate CO2 toxicity, but mechanical hyperventilation dangerously depletes CO2 tissue reserves and exag- gerates morbidity and mortality. The bene ts of CO2 supplementation were forgotten, and consequent CO2 confusion has derailed research, discouraged opioid treatment, damaged patient safety, and disrupted professional progress. Anesthesiologists can no longer claim to provide superior service, and hospital administrators are replacing them with nurses. Professional membership is in decline, and professional survival is in ques- tion. Modern machines have eliminated asphyxiation, and modern monitoring enables safe and bene cial hypercarbia that complements opioid treatment and minimizes sur- gical morbidity and mortality. CO2 reform promises revolutionary advance but faces formidable opposition.
Journal of Oral and Maxillofacial Surgery, 2011
In this report, we explore the little known role of Dr Nathan Cooley Keep in the dissemination of ether anesthesia in Boston. Keep was a prominent Boston dentist who, for a short time, taught and employed both William Morton and Horace Wells. He used ether anesthesia for a variety of dental and other surgical procedures requiring pain control. Keep administered ether to anesthetize Henry Wadsworth Longfellow's wife during the delivery of their daughter. This was the first use of ether for obstetric anesthesia. Dr Keep was also the first Dean of the Harvard Dental School and convinced the Massachusetts General Hospital to appoint a dentist to the staff of the hospital for the first time.
Bulletin of Anesthesia History, 2013
The absence of a recognized formal curriculum in anesthesia history means that many of us have known and unknown gaps in our knowledge. These gaps limit our ability to understand how things came to be, how things may become and how we can affect the future. I have asked Dr. Manisha Desai and Dr. Sukumar Desai to provide a primer on the history of medicine and anesthesia history. The goals of this primer are to educate and to help individuals target future study. Below is the second article in a continuing series.
Anesthesiology, 2014
W E are delighted that AnEsthEsiology is publishing this special Edition, highlighting research at the harvard-affiliated departments. harvard Medical school (hMs) is unusual, perhaps unique, in that it has approximately 10,000 faculty appointees, including many physicians with additional appointments at multiple affiliated and financially independent academic hospitals that provide clinical training to hMs students, residents, and fellows, and also accommodate academic researchers. There are currently four academic hospitals with anesthesia departments that are affiliated with hMs: Boston Children's hospital, Brigham and Women's hospital, Beth israel Deaconess Medical Center, and Massachusetts general hospital (Mgh). here, we briefly review the history of the Department of Anesthesia (traditionally Anaesthesia) at hMs, essentially that of its affiliated hospital departments, and some of their collaborative initiatives that have influenced patient care, trainee education, and research. The hMs Department of Anesthesia officially came into existence with the unanimous approval of the faculty on october 16, 1969, the date chosen to coincide with Ether Day. 1 Before this, the hMs-affiliated hospitals had established autonomous anesthesia service groups, some functioning as academic departments. in 1936, Professor henry Knowles Beecher, M.D. (1904-1976) became the first anesthetist-in-chief at Mgh (established in 1811). subsequent chairs of the Mgh department have been Professor Richard
Tennessee medicine : journal of the Tennessee Medical Association, 2005
++Title Slide++# 1 I administered my very first human anesthesia in 1956, and I continuously practiced anesthesiology forty five years, beginning July 1, l958. I have been asked dozen of times why I chose anesthesiology, and why I stayed in the specialty. The answer to the first question is easy-"to avoid destroyer duty." You see I was in the Navy. The Navy needed either destroyer doctors or anesthesiology residents and of course, the choice was easy. ++Slide of young Smith and Navy destroyer ship++#2 However, I eventually made my way onto several destroyers on special duty…but that's a story for another day! I have often avoided answering the second question. As a wise man once said: "When you are up to your waist in alligators, it is difficult to objectively review your decision to drain the swamp" [Carnes]#. As I now emerge from that swamp, I can at last offer a hindsight answer: I am unabashedly proud to have been an anesthesiologist these forty five years. I'm not only proud of the medical details of our everyday practice, but I'm proud of my anesthesiology colleagues. I am proud of your talents; proud of the thousands of personal sacrifices I have seen you make for your patients; and I am proud of the gifts that you and your forebears have contributed to Mankind. As I look back on the multiple and varied accomplishments of Anesthesiology, not only just in my own professional lifetime, but throughout our existence the picture emerges of a dedicated group struggling toward the achievement of the status of "professionalism" in anesthesiology. In 1940, on the very first page of the first issue of our now highly respected journal "Anesthesiology", Howard W. Haggard deeply explored many of the problems in professionality facing clinical practitioners of anesthesiology. Sadly, many of his observations are distressingly familiar and unsolved even today 1940 [Haggard]! Admitting that, I nontheless believe that, although the struggle continues, we in anesthesiology have realized many amazing victories. I intend to point out a sampling of these successes to you today, and to try to convince you that the attainment of "professionalism" in anesthesiology is an ongoing struggle which is not only worthwhile, but one to which you each have a duty to contribute. 2 ++Slide: Defining Professionalism"++#3 What IS "professionalism", and why do I value it so highly? Recently Dr. Mark Lema, former editor of the ASA Newsletter, suggested a comprehensive list of many characteristics of professional behavior in anesthesiology [Lema]. Dr. John Steinhaus, my friend and former ASA President, uses an entire chapter of his book "Medical Care Divided", to attempt to describe "professionalism" in anesthesiology [Steinhaus]. Dr. Norig Ellison, another past ASA president has contributed yet another good discussion [Ellison].
Journal of Anesthesia History, 2020
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Of all milestones and achievements in medicine, conquering pain must be one of the very few that has potentially affected every human being in the world. It was in 1846 that one of mankind's greatest fears, the pain of surgery, was eliminated. Anesthesia is one of the most important discoveries in the history of medicine and has completely revolutionized the quality of healthcare that patients can receive. In fact, it's almost impossible to imagine healthcare without the application of anesthesia.Today every single person benefits from painless surgeries and medical procedures, thanks to the remarkable discoveries in the field of anesthesia dating all the way back to 4000 BCE. Although the chemicals used as an anesthetic have significantly changed, many of the modern applications such as nitrous oxide and intravenous anesthetic are a result of discoveries in the 1600s and 1700s. [1] Now patients have several anesthetic options, from gas to IV, accommodating any kind of procedure they require. Anesthetic application is one of the most valuable components of modern healthcare and continues to be one of the leading interests in the medical field.Despite their necessity in modern medicine, scientists aren't sure exactly how anesthetics work. The best theory suggests that they dissolve some of the fat present in brain cells, changing the cells' activity. But, the precise mechanisms remain unknown. For now, next time you find yourself under the knife, just be happy they do. [2]
Revista de la Federación Odontológica Ecuatoriana
have been accorded varying degrees of credit for the discovery and introduction of anesthesia. I shall set forth briefly and objectively the part played by each so that the reader may judge the merits of each. Early Pioneers of conversation among Borlase and his associates, to all of which young Davy was an attentive listener. His interest was particularly aroused by the discussions of nitrous oxide which had been branded as dangerous by the American chemist and physician, Dr. Lantham Mitchell. The element of mystery and danger surrounding the gas intrigued Davy, and he began experimenting with it secretly. He first discovered that nitrous oxide induced a feeling of Humphrey Davy well being and cheerfulness which Humphrey Davy, at seventeen increased untilhe became convulsed years of age, became apprenticed with laughter. Hence the origin of to John Bingham Borlase, a promthe term "laughing gas." inent surgeon of Penzance. At this Davy's experimental work on time many newly discovered gases gases was brought to the attention were being used in medicine for the of Dr. Beddoes, head of the Pneutreatment of diseases and hence matic Institute of Clifton, who furnished the most frequent topicSpromptly offered him the post of
Mending Bodies, Saving Souls: A History of Hospitals, 1999
This chapter depicts the “discovery” of ether anesthesia at the Massachusetts General Hospital within the context of Boston medicine, surgery and dentistry, discussing the local struggles for professional and cultural identity within an environment of sectarianism and professional secrecy. For this purpose, the narrative uses the story of Alice Mohan who actually became the first patient submitting to full ether inhalation for the amputation of her right leg. Mohan’s successful major surgery, performed on November 7, 1846, followed a prior, famous but brief attempt to remove Gilbert Abbott’s congenital neck tumor that forever put Boston and America on the list of pioneering surgical achievements. More than Abbott’s case, Mohan’s long pre-operative hospitalization and botched treatments provide a rare view into the state of contemporary medical therapeutics and the evolution of the Massachusetts General Hospital.
Regional Anesthesia and Pain Medicine, 1999
Anesthesiology, 2010
2020
According to the definition of the International Association for the Study of Pain (IASP), pain is defined as: "Unpleasant subjective feeling and emotional experience associated with current or potential tissue damage of a particular localisation", which, as such, poses a challenge for epidemiological research to determine its frequency and prevalence. We have all heard the motto that surgery has experienced its unprecedented development on the wings of anaesthesia. This is most certainly the case, since it is precisely the pain that prevents any invasive procedure on the human body, hence the very elimination of pain has opened up the way for the application and development of surgery. For this reason, the skill and now the science of anaesthesia are epochal civilizational achievements, which is why it is worth remembering the attempts and successes of its application. The very beginning of mankind cannot be imagined without the humans facing some sort of pain. As long ag...
Journal of Clinical Anesthesia, 2002
The spread of regional anesthesia in America was greatly facilitated by the work of Gaston Labat. Recruited to work at the Mayo Clinic, Dr. Labat there published his seminal textbook, Regional Anesthesia, in which he laid out his techniques to the next generation of physician specialists, notably John Lundy, Ralph Waters, and Emery Rovenstine. It was Rovenstine who was responsible for creating the specialty of anesthesiology in the 1920s and 1930s. John Lundy continued Labat's work at the Mayo Clinic when Labat left for Bellevue Hospital in New York. There, while teaching, Labat further developed and refined his techniques for delivering regional anesthesia.
Anesthesiology, 2016
Taking the examples of the pioneers Carl Ludwig Schleich, Carl Koller, and Heinrich Braun, this article provides a first exploratory account of the history of anesthesiology and the Nobel Prize for physiology or medicine. Besides the files collected at the Nobel Archive in Sweden, which are presented here for the first time, this article is based on medical literature of the early 20th century. Using Nobel Prize nominations and Nobel committee reports as points of departure, the authors discuss why no anesthesia pioneer has received this coveted trophy. These documents offer a new perspective to explore and to better understand aspects of the history of anesthesiology in the first half of the 20th century.
Indian Journal of Clinical Anaesthesia (IJCA) publishes definitive, peer-reviewed articles devoted to the clinical practice of anaesthesia. IJCA publishes a wide range of articles in the discipline of anaesthesiology including basic science, translational medicine, education, and clinical research to create a platform for the authors to make their contribution towards the field without restrictions/barriers of subscription and language. IJCA addresses all aspects of anaesthesia practice, including anaesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anaesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. This Journal is an Open Access journal and aims to publish research articles, reviews, case studies, commentaries, short communications, and letters to the editor on various aspects of anaesthesiology and perioperative medicine and making them freely available worldwide.
Current Opinion in Anaesthesiology, 2012
Purpose of review Anesthesia for ambulatory surgery has come a long way since 1842 when James Venable underwent surgery for removal of a neck mass with Crawford W. Long administering ether and also being the surgeon. We examine major advances over the past century and a half. Recent findings The development of anesthesia as a medical specialty is perhaps the single most important improvement that has enabled advances in the surgical specialties. Moreover, improved equipment, monitoring, training, evaluation of patients, discovery of better anesthetic agents, pain control, and the evolution of perioperative care are the main reasons why ambulatory anesthesia remains so safe in modern times. The development of less invasive surgical techniques, economic factors, and patient preferences provided addition impetus to the popularity of ambulatory surgery. Summary Beyond the discovery in the mid-19th century that ether and nitrous oxide could be used to render patients unconscious during surgical procedures, subsequent developments in our specialty have added modestly, in a stepwise manner, to reduce mortality and morbidity associated with its use. These improvements have allowed us to safely meet the steadily increasing demand for ambulatory surgery.
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