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The Genesis of Surgical Anesthesia

1998; Lippincott Williams & Wilkins; Volume: 87; Issue: 2 Linguagem: Inglês

10.1097/00000539-199808000-00072

1526-7598

Leroy D. Vandam,

Medical History and Innovations

SECTION EDITOR: NORIG ELLISON The Genesis of Surgical Anesthesia, N. A. Bergman. Park Ridge, IL: Wood Library Museum, 1998, ISBN 0-9614932-0-0, 448 pages, $85.00. Having triumphantly endured a sesquicentennial just 2 yr ago, anesthesia and the history of it continue to fascinate its adherents. Rightfully so! Has there ever before, or since, been a medical epoch so replete with romance and drama, controversy and rancor, and by no means least-a remarkable beneficence for humankind? Thus, over the past decade or so, we have witnessed several international congresses dedicated to the history, the inception of intellectually vigorous anesthesia history societies, and publication of a spate of publications devoted to the subject. A primary instigator of this ferment has been the Publications Committee of the Wood Library Museum (WLM) of the American Society of Anesthesiologists guided by the redoubtable B. Raymond Fink of the University of Washington. Readers of this book review should avail themselves of the publications' prospectus of the WLM in order to add aesthetic breadth to the otherwise hectic daily pursuits of clinicians in the field. Norman Bergman's Genesis of Surgical Anesthesia is not only a tour de force but a radiant jewel in the crown of the WLM, composed by the energetic, erstwhile chairman of the anesthesia department at the University of Oregon. His benign visage greets us as a frontispiece. This work is tendered in a format of Harvard Crimson fabric with gilt intaglio to highlight the lettering, floral design and borders. As we scrutinize the intellectual content, a comparison with earlier works of this genre may be useful. As stated, Bergman's Genesis reaches back to the dimly perceived origins and extends through the era of W. T. G. Morton's demonstration. A forerunner of this broad scope is Rene Fulop-Miller's Triumph over Pain, translated from the French, published by the old firm of Bobbs-Merrill in the 1930s, then a Literary Guild of America selection. The narrative in one sense is a roman a clef with all the dramaturgy that might have illumined the more sober style of Genesis. A work of the 1940s is Thomas E. Keys' The History of Surgical Anesthesia by the librarian at the Mayo Clinic (Schuman's and now a reprint in the WLM Series), of similar coverage to Genesis, however in a spare, crisply written style. Noteworthy, too, is an introductory essay by Chauncey D. Leake, long-time narrator on the history of anesthesia, and a concluding chapter on the future of anesthesia by Noel A. Gillespie, both men closely associated with the University of Wisconsin in the heyday of Ralph M. Waters. Finally, there is the classic: Barbara M. Duncum's The Development of Inhalation Anaesthesia (1846-1900) (the Wellcome Historical medical Museum 1947, also on the WLM roster). Actually, the territory traversed is close to that of Genesis, with a felicity of style and a plethora of meaningful illustrations clearly reproduced. Upon this literary heritage what has Bergman wrought (echoes of the first book of the Old Testament)? Beginning with a recitation on the devices, practices, and medicaments used by the ancients to assuage pain, one reads on about medicine before 1600. Greek and Roman to be sure, but why not the Egyptian, Chinese, or Arabic? Now we veer into physiological and chemical innovations of the 1600-1800 era: The names of Paracelsus, van Helmont, Harvey, Boyle, Hooke, Lower, Mayow, Hales, Boerhaave, Black, Cavendish, and Rotherford should strike a memory chord in the minds of most physicians. Subsequent chapters, beginning with Priestley, realistically cover the gamut of pneumatic medicine as begun and practiced in England, then transplanted by colonial physicians, John Collins Warren among them. As Bergman states in his preface, his treatment of this development is perhaps the most comprehensive ever. The meticulous, biographical detail, personal anecdotes of family life and personal traits of the "movers" involved account for the extensive time spent by Bergman in his researches at home and abroad. For the record's sake, we need to remind the reader of Lavoisier, Withering, William Latham Mitchell, Thomas Beddoes, James Watt, Josiah Wedgewood, and most of all directly connected with anaesthesia-Humphry Davy. A brief account of the Lunar Society of Birmingham, of which your reviewer had been unaware, reveals that its constituency comprised people who had served in a somewhat peripheral and tentative position in relation to anesthesia. These men, some mentioned above, were among the prime movers in the industrial revolution, all of whom had demonstrated success in some endeavor and who were prepared to experiment with the ideas of others. Finally, one enters into that remarkable era of the clinical introduction of anesthesia in the early 1840s which concept according to sociologists of science had been "in the air" for many a year: ergo, the Americans William E. Clark, C. W. Long, Horace Wells, and W. T. G. Morton and the first physician anaesthetist, Englishman John Snow. The references in Genesis are meticulous: first by author, then by chapter, and capped by an index of personal names. This reviewer has an idea on how to consume Genesis. Let the reader include this volume on a vacation reading list, devoting an obligatory period each day to the pleasure of browsing. If not feasible, harbor the opus as a ready reference on one's library shelf, to settle many a disputed historical conundrum. Leroy D. Vandam, MD Department of Anesthesia; Brigham and Women's Hospital; Boston, MA 02115