The complicated history of modified electroconvulsive therapy (ECT) started back before anesthesia was incorporated when unmodified electroconvulsive therapy was not considered humane. When anesthesiologists started working with psychiatrists, ECT gradually regained acceptance by decreasing the obstacles inherent to this therapy despite the complexities of the anesthetics. However, the sociopolitical and medicolegal factors negatively impacted the use of modified ECT leading to a period of time when it was banned from use in the United States. Fortunately, as advances in anesthesia and technology continued to develop, anesthesiologists helped ECT regain widespread usage improving the safety profile, cost effectiveness, quicker onset of seizures, and ease of control despite its stained past. This allowed more accessibility, especially for high-risk medical patients, to a relatively safe and effective treatment for psychiatric diseases.
Letheon was the commercial name that Boston dentist William T. G. Morton chose for his ether-based "preparation" that was inhaled to produce insensibility during surgical and dental procedures. The multiple editions of Edward Warren's Some Account of the Letheon (1847) as well as Nathan P. Rice's Trials of a Public Benefactor (1859) provide the only known accounts of the meeting hosted by the physician Augustus A. Gould at which the name Letheon was chosen. Neither Warren nor Rice mentions when the meeting occurred. In all likelihood, it was held at some point in a three-week period from mid-November to just short of December 9, 1846, the publication date of the earliest known reference to the name. The absence of the word Letheon in Morton's public notices around the end of November 1846 or, indeed, in any document until his December 9 advertisement in The Boston Medical and Surgical Journal suggests a later date for the meeting than has been previously reported.
Spinal Anesthesia; Procaine; Fictions
•Like Prometheus who stole fire from the gods, Wells stole the ability to ethically manipulate consciousness from the gods of the undiscovered country of pain, suffering and death. For “The final injustice is death, the ultimate bondage. To set captives free (of pain and suffering) is the knight's pragmatic way of battling death.” Bloom. The knight in the mirror.•Horace and Elizabeth Wells give us stubborn hope and love.•Horace did not see that the discovery for him was to be both an air from heaven and a blast from hell with intents both wicked and charitable.•Scientific knowledge does not carry instruction on how to use it, for good or bad… a moral choice is required. Feynman RP. The Pleasure of Finding Things Out. Perseus Publishing.1999. 142•Like these other tragic heroes Wells’ apparent failed end is not the ultimate truth concerning him.•Horace exemplified the primal romantic motivation of all doctors expressed by Percy Shelley (Poet 1792–1822): “I wish no living thing to suffer pain.” Shelley PB. Prometheus Unbound. I.305.
•Methitural is a derivate barbiturate synthesized by the German pharmacologists Zima, von Werder, and Hotovy, in 1954.•The drug was commercialized as ThiogenalⓇ, in Europe, and NeravalⓇ (1956), in the US. In Italy, it was marketed as DiogenalⓇ.•Compared to thiopental, methitural showed a shorter half-life but in the absence of further factors of evident superiority.•In the late 1950s, due to side effects, occurring mostly during the induction and at higher concentrations, and its high costs, methitural clinically disappeared.•Probably, a better induction technique and different marketing policy would have allowed the methitural to be used for longer over the years, especially in the settings of short-term surgery.
•George Harley pioneered alcohol–chloroform–ether (ACE) mixture for anesthesia (1860).•Corydon Munson adapted his 1886 gasometer by 1888 to vaporize ACE into nitrous oxide.•From Toledo, Ohio, Munson branded his gasometer as Excelsior and his gas as ACENO.
•Scandalous divorce, litigation, and court costs left Boston dentist UK Mayo bankrupt.•Mayo added sedative herbs to improve quality and duration of nitrous-oxide anesthesia.•His 1883 patent supplemented nitrous oxide with an alcohol infusion of hops and opium.
•Colton Dental Association claimed 75,000 nitrous-oxide anesthetics with no mortality.•Edmund Andrews published that zero mortality rate in his 1870 anesthetic risks table.•His table was reprinted by EF Bunnell in an 1875 paper with two typographical errors.•JM Spencer's trade card copied Bunnell on Andrews’ table: 0% N2O-anesthetic mortality.
The introduction of gas warfare in World War One was impactful, as it both expanded the breadth of warfare and fueled the invention of techniques required to treat these new injuries. Gas injuries were responsible for 91,000 of 1.3 million deaths in World War One. Gassed soldiers had wounds which the world had never seen. They presented in large scale to medical tents and base hospitals across Europe. As gas casualties poured in, doctors and nurses had to treat these conditions in the best way they knew. Gas warfare changed how war was performed and how casualties of this attack were treated. The techniques learned from treating the multitudes of men with gas burns led to advances in the field of burn care, which have helped to improve mortality and reduce morbidity in hospitals across the world.
BACKGROUND:Acupuncture anesthesia was used instead of intubation anesthesia in the 1970s and 1980s in West Germany and West Berlin. In East Germany acupuncture played no decisive role.SOURCES:Different articles and papers in journals, in daily press, statements of contemporary witnesses, films, records in archives.RESULTS:As in other Western countries, acupuncture was hugely popular in the Federal Republic of Germany in the 1970s. Chief triggers were the state visits to China of the American President Richard Nixon in 1972 and shortly thereafter of West German Foreign Minister Walter Scheel and his wife Mildred, an x-ray technician. During that period observation of an operation under acupuncture anesthesia was an obligatory element in the agenda of a foreign delegation. Following this showcasing, acupuncture was widely adopted in Western surgery as an alternative to the previously exclusive employment of intubation anesthesia. While the alternative method was soon abandoned in the frontline city of West Berlin, it continued to prevail in other West German cities, e.g. Gießen and Munich. Following the Chinese example, the acupuncture effect was normally enhanced electrically. In accordance with the animosity between the USSR and the People's Republic of China, exchange between the German Democratic Republic and China was very restricted through the late 1980s. This made it easier for East German acupuncture sceptics to reject the procedure and brand it as unscientific. Those who advocated it were in a precarious position.CONCLUSIONS:Acupuncture was lauded in the West as ancient savvy destined to complement science-oriented medicine. However, the cultural transfer which accompanied the spread of acupuncture was flawed by misunderstanding and misguidance. Acupuncture anesthesia instead of intubation was not practiced in the GDR. Acceptance of acupuncture in East German medicine failed to make any headway until the last few years of the country's existence.
An Ohio dentist, Corydon Munson, patented a gasometer with an attachment for vaporizing trace amounts of volatile general anesthetics or their mixtures into unoxygenated nitrous oxide. After vaporizing a variant of George Harley's ACE mixture into nitrous oxide, Munson branded his own novel anesthetic combination as ACENO.
When teenaged Henry Jacob Bigelow was an undergraduate at Harvard College in 1833-1837, he prepared nitrous oxide gas for demonstrations to other students. Bigelow's son, William Sturgis Bigelow, related the claim, and there is an eyewitness account from Augustus Goddard Peabody, a fellow Harvard undergraduate with Bigelow. Peabody wrote to Henry David Thoreau about a nitrous frolic. College chemistry primed Bigelow to support the concept of inhaled surgical anesthesia when the idea came to Boston in 1845-1846. Bigelow's chemistry professor was John White Webster. According to Harvard alumnus Edward Everett Hale, in addition to demonstrating effects of nitrous oxide, Webster presciently treated two cases of carbon monoxide poisoning with copious volumes of synthetic oxygen gas. The career of Webster was inhibited by financial difficulties that were suspected to be contributory when he was convicted of the 1849 murder of physician George Parkman at the Harvard Medical School, then adjacent to Massachusetts General Hospital and its Ether Dome. Webster suffered the death penalty in 1850.
United Brethren minister Thomas S. McNeil formulated an analgesic nostrum in 1848, most likely from opium, alcohol, ether, and other proprietary ingredients. Massaged on externally as a pain liniment, his so-called pain exterminator could also be mixed in sweetened water and imbibed as an analgesic, antitussive, and antidiarrheal. A familiar antebellum remedy for both Union and Confederate forces in the Civil War, McNeil's Pain Exterminator would be manufactured by McNeil's pastor and then successors, for more than a half-century after McNeil's accidental drowning in 1874.
In 1812, Frances (Fanny) Burney (born in 1752 and died in 1840) underwent a mastectomy performed by Larry without anaesthesia. In the days after surgery, Burney wrote a letter to her sister, Esther Burney, describing her experience. In total, the letter is four pages long including information on before, during and after the surgery. Although this letter has been cited in numerous texts, it has yet to be analysed from multiple perspectives, shedding new light on the history of anaesthesia.
•Recent European research - systematic presentation and historic (re)assessment.•“Modern anaesthesia” – definition, “nationalistic” narratives.•“Specialist” profession and technology: definitions, criteria, new evidence.•Epochs in anesthesia – chronology, criteria and a shared, global heritage.•The historiography of anesthesia requires a critical, international reappraisal.
Famous for pioneering the oxygenation of nitrous-oxide anesthetics, Chicago surgeon Edmund Andrews trusted the Manhattan-based Colton Dental Association's claim that they had conducted 75,000 nitrous-oxide anesthetics without a single mortality. Those statistics were cited in Andrews' 1870 journal article on anesthetic risks and then, remarkably, advertised on the business cards of dentist James M. Spencer, Jr., of Gouverneur, New York.
This paper is the continuation (Part 2) of an extensive, critical reappraisal of the international historiography on modern anesthesia and its technology. The first paper of this series provided general definitions, backgrounds and an update on recent research on one aspect of this topic: the history of professionalization / specialization (Part 1).1This paper goes on to provide a first, international comparison of entire anesthesia devices and on the history of nitrous-oxide-based anesthesia (c. 1900-1930s). Results: A comparative chronology of internationally recognized milestones of entire anesthesia machines does not suggest significant differences between the nations of continental Europe on one side, or the USA and Britain on the other. The international historiography on one of the key techniques for which these devices were designed (nitrous-oxide-based anesthesia), is likewise demonstrably biased. These findings are further evidence that a frequently held hypothesis, which suggests national dominances in these fields, is incorrect. Contributing factors and wider contexts of this phenomenon can be further confirmed: These are an under-recognition of non-Anglo-American (particularly continental-European) and of primarily surgical contributions; contemporary international conflicts and inter-professional demarcation disputes. In addition, it can be shown that these phenomena had already started around the same time (c. 1900s-1930s). There also is evidence to suggest that they were at times reciprocal and quite deliberate. The author illustrates and argues that the currently prevalent historiography on modern anesthesia requires a thorough reassessment. This should be based on a perspective of internationalism and transdisciplinary reciprocity and should recognize much broader historical contexts.
BACKGROUND:Regional and general anesthesia were widely available in the United States in the late 1960s. The risk of permanent neurological sequelae resulting from spinal anesthesia had largely been dismissed. Although many academic departments of anesthesiology had gained independent status, a significant number operated as divisions within the department of surgery. We present a case report from Peter Bent Brigham Hospital to illustrate the state of anesthetic techniques in use during the late 1960s, and the power dynamics vis-à-vis physician anesthesiologists and surgeons.SOURCES:Hospital records and interviews with individuals familiar with the case.FINDINGS:An otherwise healthy patient underwent inguinal hernia repair. The resident anesthesiologist conducted a preoperative assessment the evening prior to surgery with the patient consenting to the spinal anesthesia, a plan agreeable to the faculty anesthesiologist. The attending surgeon was one of the most prominent surgeons in America and the chairman of their department. He disapproved of the planned anesthetic. Subsequent modifications to the anesthetic plans are discussed, as is the fallout from those actions.CONCLUSION:Spinal anesthesia remained a popular anesthetic option during the late 1960s. General anesthesia with ether, halothane, and other agents an alternative. This case highlights various aspects of perioperative management during a period when many American academic departments of anesthesiology existed as divisions within the department of surgery. It also touches upon the careers of two prominent American physicians.
Born in New Hampshire but raised in Massachusetts, 14-year-old William J.A. DeLancey became "the man of the house" after the accidental death of his father. Amiable and good humored, young DeLancey supported his widowed mother and his three sisters until the girls all reached maturity. After he married, DeLancey moved to Illinois and took up dentistry, eventually settling in Centralia. Following anesthesia training back east at Manhattan's Colton Dental Association, DeLancey returned to Centralia. There he practiced the Coltonian method of testing freshly made nitrous oxide upon himself before using the gas upon patients. Before his training at Colton Dental, DeLancey had advertised in Centralia newspapers only in prose. After he began administering laughing gas to his patients and to himself, DeLancey waxed poetic and began advertising in heroic couplets in local newspapers.
