3 - History of Anaesthesia Society

In the early pst-mr perid the necessary drugs and volatile
anaesthetics rapidly became available. Tnis :ms not the case for
compressed gases. Initially the simplest app-ratus were used. For ether
it was the Oxford vaoorisor4 which w.as used for ocen thoracic
operations. Tric'7loroethylene was administered with a mst elementary
air draw-over bottle, fittail with one-way valves as designed by H R
~tarrztt.~
Anaesthetics were usually given in the deprtments of surylery, but in
th-se deprtments doctors were apyinted to do surgery. The only work
available for an anae5thstist was voluntary work. The ansesthetist was
needed hlt not b~md by any contract. Nevert5eless. recplations and a
sense of responsibility ensured that an anaesthesia assistant was
reqularly employed. This proved unsatisfactory as the departments of
El?'l', gvnaecoloq.] and others which had surqicsl activity, were dependent
for anaesthesia on t'le qoodwill of the department of surgery.
As only a handful of anaesthetists existed, mst sllrOery continued to be
done in t'le 'tradition31 my1. Difficult or imprtant cases were pupd
in special sessions for which an anaesthetist was requested. Rs an
example of a 'difficult case' the follaqing may be renortd. A strong
muscular stevedore had a tumour on the na,p of his neck, of the size of
a fist, lying ?elm a canpletely bld, shiny scalp. Abut ten years
previously the scalp had been irradiated for depilstion to treat a
refractory skin condition. The demtolgical condition had been cured
but the man had remind totally bald. The twour also seemed to be the
result of an excess of X-rays. In addition, wor'c in the harbour was
mostly mnual at the time, causing sustained dehydration. The patient
attentively canpensated for this loss of fluid with cool refreshing
beer. Excision of the tumour by electrocautery had to be performed with
the patient in the prone position. A junior assistant in surgery was
entrusted to give intravenous anaesthesia with Evip (hexobarbitone).
l3e drug prhced ~lnconsciousness as expzted. l3ut when the electrocautery
was applied the st2vedore ros? frighteningly on the table.
Repeated injections and further attempts at surgery brought the saw
result. After a total dose of 1G had been injected in vain, it was
decided to postpne t5e case for a 'special session'. Wen this took
plqce, the faces of several members of staEE could be seen peering into
the t'leatre from behind a dindow. Tile look on the faces could be
described as that of Wnrcins in the amphitheatre watching fighters facing
wi-ld teas ts, ' quaerens quem devoritl , wondering w'lo will .#in against
\++a>. The pWient, a known alcoholic, had now received an appropriats
premedication. '~e ;gas given a fair dose of the lruch mre powerful
Pentothal, follov~~? by trichloroet!iylens in air. He then had a blind
naso-tracheal inttihation, was turncd on his stomach and had the tumur
renoved in a qudrter of an hour.
Aprt from prlctical demonstrations to hosi>itals, the advantages of
modern ana~?st:~esia 3ls0 ne?d to be rep~rted to medical societies. Since
1940, surtsi.~eJ progress in me;licine had been interrupt,-4 in occupied
Europe. Advances in the treatment of inf~xtion, in anti-thymid drugs
and in parenteral nutrition were poorly known on the Continent; this