Amos J. Wright

The First Administration of Anesthesia in Military Surgery: On Occasion of the Mexican–American War

Previous publications have reported the initial wartime use of anesthesia for surgery as occurring in either the Crimean or German–Danish conflicts after 1848. The authors have determined that this first-time use took place in the spring of 1847 during the Mexican–American war and under the direction of American military surgeon Edward H. Barton. His experiences with ether, and those of fellow surgeon John B. Porter, are described.

Alberto gutierrez and the hanging drop

p w a h c n the early twenty-first century, we may have trouble understanding how one person can perorm an epidural anesthetic and then proceed to perate on the same patient for a gastrectomy. This ouble role of surgeon-anesthesiologist was played y Alberto Gutierrez from 1932 to 1945, while he as teaching anatomy to medical students and ounding and editing both the Argentinian surgery ournal and the Argentinian anesthesia journal. His imple description of how he observed a hanging rop disappear from the hub of a needle whose tip as in the epidural space is preciously candid and evealing. Realizing that this phenomenon was just heralding sign, he systematically studied it, introuced this technique in Latin America, and offered n alternative approach to identifying the epidural pace worldwide.* Alberto Gutierrez was born in Buenos Aires in 892 into a family of surgeons; his father, an uncle, is brother, two cousins, and a nephew were sureons. Admitted to medical school in 1911, he oined the junior staff of the anatomy department n 1912 and eventually reached the rank of Distinuished Professor in 1942. In his late teens, he ssisted in the operating rooms at the “Gutierrez linic,” where all the cousins treated an elite clienele. As medicine became more hospital oriented,

The American Society of Regional Anesthesia: a concise history of the original group-its birth, growth, and eventual dissolution.

The history of the original American Society of the Regional Anesthesia is presented-its birth, growth, and eventual dissolution. Reasons for its dissolution are discussed.

“I fill three quarters of immensity! ” Satires of Early Nitrous Oxide Research

Abstract In early 1799 the twenty-year-old scientist Humphry D avy published a brief letter announcing his discovery that nitrous oxide gas could safely be respired by humans; a full account of this research appeared in the summer of 1800. 1,2 During this period Davy worked in Clifton, just outside the English seaport of Bristol, under the tutelage of Thomas Beddoes, a physician who for many years had researched the possible therapeutic uses of gas inhalation. In a ddition to patients who appeared at Beddoes’ clinic and research facility, the Pneumatic Institution, Davy and his mentor were joined in their research by more than forty healthy individuals, including S amuel Taylor Coleridge, Robert Southey, Peter Mark Roget, Thomas Poole, J ames Mackintosh, Anna Laetitia Barbauld and James Watt. 3 This work by Beddoes and Davy was quickly replicated elsewhere in England and within a few years in the United States. 4

The Puzzling Death of Reinhard Heydrich

Summary Reinhard Heydrich, SS Police chief and“Protector” of Bohemia-Moravia waswounded by a grenade fragment during anassassination attempt in Prague on May27, 1942. Eight days after undergoing emer-gency surgery, he suddenly collapsed,slipped into coma and died the next morn-ing, on June 4, 1942. The cause of his deathhas remained obscure.The present article reviews the knowndetails of Heydrich’s medical history afterthe attack. The death of his physicians,the loss of his medical records, and an in-adequate post-mortem make an accuratediagnosis impossible. Massive pulmonaryembolus with acute cor pulmonale and ce-rebral anoxia is a reasonable assumption.That Heydrich died from botulism is mostunlikely. Short Biographies of Heydrich’sPhysicians 1. Dick, Walter (1899-1990). Sudeten Ger-man born in Bohemia. MD degree fromCharles V University (Prague) in 1925.Chief of Surgery at Bulovka Hospital(Prague) from 1940 to 1945. From 1945to his retirement in 1967, was professorof surgery at the Universities ofKlagenfurt, Bonn and Tubingen.2. Hohlbaum, Josef (1884-1945). Born inGerman Silesia. From 1924 to 1940taught surgery in Leipzig. From 1941to 1945 was chairman of the SurgeryDepartment at Charles V University(Prague). Remained in Prague in May,1945, was sentenced to forced labor bythe Czech authorities and was criticallywounded by a mine while clearing abuilding in Prague. Denied treatmentby his Czech colleagues, he escaped toLeipzig where he died from his legwounds.3. Sauerbruch, Ferdinand (1875-1951).

Scophedal (SEE)Was it a Fad or a Miracle Drug

The German firm E. Merck released in 1928, an injectable mixture of scopolamine, oxycodone, and ephedrine under the name SEE. This drug, renamed Scophedal in 1942 caused deep and prolonged analgesia, sedation, euphoria and amnesia without significant respiratory or circulatory depression. Used extensively by the German and Central European surgeons in the 1930s, Scophedal enjoyed immense popularity with the Wehrmachts medical officers treating frontline mass casualties during World War II. The use of Scophedal declined after 1945, and its production was discontinued in 1987. Despite the clinical enthusiasm it raised, SEE was never critically investigated. This drug may deserve a rigorous re-evaluation.

The Myth of Baby “Anaesthesia”

James Y. Simpson (1811–1870), the young professor of midwifery at the University of Edinburgh, became chairman of that department at age 28. He discovered the anesthetic properties of chloroform on the evening of November 4, 1847, while inhaling it with two colleagues and some family members in his dining room at 42 Queen Street, Edinburgh. Four days later he administered chloroform for a few minor operations, and the next day, November 9, he performed the first delivery under chloroform. He reported the details of the event at the November 10 meeting of the Edinburgh Medico-Surgical Society and a few days later in two medical journals. 2–3 The patient was an anxious young woman who had barely slept the two previous nights. Her first baby had been delivered by craniotomy after a three-day labor. She went into labor for the second child two weeks before her due date. Three and a half hours after the onset of her contractions, Simpson poured half a teaspoon of chloroform on a handkerchief rolled into a funnel and repeated that dose 10 to 12 minutes later. Twenty-five minutes after the onset of anesthesia, the unconscious mother delivered a healthy baby. When she awoke, she initially did not believe that she had given birth. Allegedly the grateful mother christened her child “Anaesthesia”; and Anaesthesia, when 17, sent her photograph to Simpson, who proudly placed it over his desk. 4–7 The source of that story seems to be Simpson’s biography published in 1896 by his daughter Eve. Simpson certainly never mentioned the fact in his abundant publications or correspondence. The son of the “Chloroform Baby” disposed of that story in a 1948 letter he sent to the Scottish newspaper The Scotsman. He explained that Simpson’s parturient had been Jane Carstairs, the wife of Dr. William Carstairs, a physician retired from the Indian Medical Service and living in Cupar, Fife. She had come to Edinburgh to be under Simpson’s care. Her child was baptized Wilhelmina on Christmas day, 1847. Wilhelmina married in 1868 and died in 1910. “Anaesthesia” and “St. Anaesthesia” were affectionate nicknames Simpson had given the baby. The origin of the photograph (fig. 1) is controversial. In 1911, Alexander S. Simpson, J.Y. Simpson’s nephew and successor to the Chair of Midwifery, claimed that Wilhelmina had been photographed at the age of 17 by a Mr. Roger, and that the picture had been sent to J.Y. Simpson by his friend, Dr. John Adamson, of St. Andrews. However, Douglas Guthrie, M.D., F.R.C.S., Ed. (University of Edinburgh), one of the organizers of the 1947 Simpson Centenary, quotes a letter (unfortunately without giving a date or an addressee) written by a Dr. R.O. Anderson who claimed that his father, Dr. John Anderson, had taken the photograph in 1860. Thus Wilhelmina at the time would have been 13, not 17 as claimed elsewhere.

The early history of methadone. Myths and facts.

This review refutes some enduring myths surrounding the discovery of methadone and presents the known accurate facts of its creation and its early development in Germany, the United States and Great Britain from 1939 to the early 1960s.

Alberto Gutierrez: Beyond the Hanging Drop

It is not surprising that many of the earlier contributions to regional anesthesia were made by surgeons, as they had operated under less than ideal conditions with the general anesthetics of the time. Bier, Cushing, Matas, Braun and Pages among others, developed expertise in infiltrating local anesthetics and regional anesthesia to be able to complement their operations trying to achieve better and safer operating conditions. The Argentinian, Alberto Gutierrez (figure 1) was an accomplished author, anatomist and surgeon; like those named above; he initially looked for alternatives to the general anesthetics (ether or chloroform) prevalent in the early YX Century. In order to facilitate and improve the care of his patients, he became acquainted with epidural anesthesia. And by careful observation, he once noted the disappearance of a drop of fluid hanging from the hub of a needle. From then on, he began to study why and how it happened. As he became more passionately involved with “extradural anesthesia,” he not only joined a group of physicians practicing anesthesia, but also founded and edited their journal and participated in their congresses. For the last half century, he has received greater recognition for his description of the “hanging drop method” to identify the epidural space than for the many contributions that he made to the surgical literature.

John H. Packard’s Primary Ether Anesthesia

ETHER has long been known to cause a short period of analgesia before inducing unconsciousness and surgical anesthesia. In 1794, Thomas Beddoes had already provided relief with a short inhalation of ether for a young woman suffering from a painful mastitis John Snow also alluded to that initial analgesic stage in his 1847 book on ether. Deep anesthesia was rarely sought or reached in the early days of ether, and many operations were done in the agent’s initial stage. The first two patients anesthetized by Morton at the Massachusetts General Hospital and several of Long’s patients in Georgia inhaled ether for 3 or 4 min only, moved and groaned during their surgery, and remembered feeling the incision although they denied experiencing any pain. During the first operation done under ether at the Pennsylvania University Hospital (a leg amputation) the anesthetist, Dr. James Darrach, inadvertently rendered his patient unconscious, which prompted the surgeon, Dr. George W. Norris, to yell at him “take that damned thing away, Darrach!” The systematic use of ether’s early analgesic stage became popular in Germany after P. Sudeck in 1901 introduced a procedure that he called “Aetherrausch.” Sudeck is generally considered to be the inventor of ether analgesia. However, in 1872, 29 yr before Sudeck, John H. Packard of Philadelphia had reported an almost identical technique. Packard called his method “first insensibility to ether” or “primary anesthesia.”