Volume 9b - History of Anaesthesia Society

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Dr T B -ton (Oxford) George Washingtan Crile (Fig.l), the founder of the mrld renawntd Cleveland Clinic in Ohio, wss one of the great pioneers of modern surgery. The Mayo brothers and Harvey Cushinq were his contemooraries in the United States and, in some mys, he was more fmus and influential in his own corrntry than they were. Olildhcad and edmaticn Crile was the son of an industrious and successful fanner. He was km near the smsll tawn of Chili in Ohio in 1864 and mrked his my t:~rough college and medical school by doubling as a school teacher. He ms awarded L9e MD degree by the Wmster Mdic31 SCao01 in Cleveland. Tnis mall insvtution ms later absorbed into the Western Reserve University. Crile's underqradu-ltn medical studios had consi.jt,& of an a~prenticeshin Issting a year, followed by a tot21 of eight mnths of didactic instruction spread over two years. Yedical courses as short as this were not unusual in the (JSA in the 1383's. 'he Wooster School did rlot psssss a microscope and Crile had to assist in resurrecting cadavers for dissect ion f ran pi ipr graves. He seems to have been c e l l satisfied with the tuition he had received rorn fledicated tutors 11m~ver. f mly mqical career Crile joined a surgical practica in Clevel3nd soon after q~alification at what he $ describes as the 'hqrse and ' \ /W .P! hignl era of surgery. Hospitals were smal-l and basic and many operations were carried out irl the ytients' beds or on the kitcnen tables in their am hhome. me surqery of tram fmin Fig.1 Gmrge Qile industrial accidents fc1nu?-1 a
l?rqe prorxrtion of surgical practice at the time. Severe tra~mtic shock, far which treatment was very elementary, was cmnplace and often fatal. The nature of shock, the aetiology of which was not ~mderstmd w:l?n he q~slified, and its treatment became a life-long stlldy for Crsle. Clorton's s~mhal dermnstration of ether anaesthesia in 1846 had enabled surgeons to carry out 'xdy surface and orthopedic operations, which they had Wen undertaking without anaesthesia, with greater facility, but the dan~er of sepsis prevented further surgical developat. TFle extension of the surrlfeon6s territory, particularly into the aMomen, had to wait the developent first of Lister's antiseptic technique in the 10601s, and later of aseptic smjery. Crile had the benefit of these discoveries then he started to practice in the 18RO's at a time when sirjery was rapidly developing: For example, Reginald Fitz had descri t3e surnicsl treatment of appendicitis the year before Crile qualified 9 and he w,3s an early protagonist of the technique, despite his youth and the consh-ierable controversy surrounding the operation. Crile carried out tnany major procedures in the 901s, including early laryngectcmies and thyroi3ectomies but these operations required deep and greatly prolonged etherisation and also occasioned greater blood loss than had hen pr4eviously experienced; in the a'osence of intravenous fluid replacement, the danger of postoprative shoc!c in elective surgery was a constant :ntentF?~l hazard which frequently resulted in a fatal outcame. Crile's interest in the prohlem was stimulated further and he began an- l research in primitive surroundings. l George Crile was an officer in the Reserve, and he was therefore called upn to serve in the Spanish-American war of 1898, when Cuba was liberated frm wish control and Puerto Rico was ceded to the United States. The standard of :IS Army hygiene was low and many soldiers died of yellow fever and dysentery. Crile greatly reduced the rate of infection in the rmits which were his immediate responsibility by insisting on elementary preventative measures. l CMparatively few soldiers were wounded in the fighting, but Crile mentions one case of ruptured spleen in a troopr who was kicked by a horse. The only resuscitative fluid available was saline administered subcutaneously. Crile re~rted that the patient survived the operation, 'but tells us laconically that what he described as the 'inevitable change1 occurred some hours after the operation, and the patient died.' The kinetic theory of shock and anoci-association Crile returned to civilian practice and %came an Associate Professor at the bkeside Hospj~in 1901 and developed what he called the kinetic theory of shxk. He b c m convinced that shock was the result of exha~~stion of the brain as a result of bombardment with nociceptive stimuli origimting both from the tramtic wound or the operation site and as the result of fear.
Page 1: ANAESTHESIA SOClETY *-
Page 6 and 7: He thereEore advocated very gentle
Page 8 and 9: George Washington Crile (1864-1943)
Page 10 and 11: Fhnento8, February \$, and 18,18~19
Page 12 and 13: First President of the Association
Page 14 and 15: landings, he was posted to teach ai
Page 16 and 17: h e of the main problems in the ear
Page 18 and 19: Drs C Weisser & G Sprotte (Wurzburg
Page 20 and 21: Kirschner's clinical observations r
Page 22 and 23: ack to old Fakirs and yogis used au
Page 24 and 25: plblished m y articles on this appr
Page 26 and 27: Drs M Goerig, K Ayisi, J Schulte am
Page 28 and 29: Cne of the most pramin~nt and raprt
Page 30 and 31: A .€?W years later, a zmwrable in
Page 32 and 33: In &ern anaesthesia, the knzodiazep
Page 34 and 35: Dr M Kus (LYacori) An un-.rlanted s
Page 36 and 37: Dr R W Patterson (Los hgeles) Reprt
Page 38 and 39: camation of mental illness and crim
Page 40 and 41: plblic atmut the activities of tj~e
Page 42 and 43: Gmrg Hirschel Cacq rlirschel wa? ho
Page 44 and 45: Drs L Va~quez, J Carcellar, J Frent
Page 46 and 47: An appreciation fraa Dr Jean M HDrt
Page 48 and 49: Dr C K Adm Dr A K Adam3 CBE Dr C N
Page 50 and 51: Dr P J Stow Dr B ?I Q Weaver Mr B R

Volume 9b - History of Anaesthesia Society

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