Journal of Anesthesia History最新文献

Chemist and inventor Silas R. Divine (1838-1912) sold ammonium nitrate and other anesthesia supplies in New York City. He offered a carbon dioxide absorber for the purpose of rebreathing nitrous oxide. Like his colleague Gardner Q. Colton, he denied the need for nitrous oxide to be supplemented with O₂ gas.

A comprehensive investigation was undertaken to find evidence of the frequently reported, but never authenticated, “purchase of 150 inmates” from Auschwitz concentration camp by Bayer to test a new narcotic, resulting in the death of all investigated inmates. The archives of Auschwitz camp, Bayer, and the so-called former Soviet Union, where evidence of this alleged misconduct could have been saved, were investigated, but no evidence was found. Many records concerning concentration camp experiments on humans had been destroyed, but given the Nazis’ meticulous record-keeping, the death of 150 inmates should have been recorded somewhere. Unethical medical research was indeed undertaken by physicians in concentration camps in many medical specialties, but no records regarding anesthesia-related medical misconduct during the Nazi period were found despite the allegations to the contrary that have been investigated here.

Inventor J.M. Osgood enabled a fellow Massachusetts inventor, A.W. Sprague, to manufacture heat-regulated nitrous-oxide generators. These generators assisted New Yorker G.Q. Colton in opening exodontia franchises nationwide which revived the use of nitrous-oxide anesthesia.

The space race began in the summer of 1955 when the United States and the Soviet Union pledged to launch artificial satellites. The race culminated in 1969 when the United States landed the first humans on the moon. After completing his training in anesthesiology, Dr. Cloid Green forged his career as one of the physician-scientists who played an integral role by evaluating the effects of space flight on human physiology. Family members of Dr. Green were interviewed and university and society archives, literature and periodicals were reviewed.

Dr. Cloid Green received his medical training at the University of Minnesota. He earned his MD in 1946 before moving to South Dakota and working as a general practitioner. A combination of professional curiosity and the military’s request for further service led Dr. Green to complete an anesthesia residency at the University of Iowa. After training, he was assigned as the physician in charge of a bomber wing at a base near Austin, Texas, in 1957. Due to his research on the effects of high altitude on pilots, he was recruited to the Brooks Air Force Base. Dr. Green was the ranking medical official overseeing early space flights involving monkeys. After leaving the USAF, Dr. Green practiced anesthesiology at the University of Virginia before moving to Newfoundland, Canada. He became the first chair of Anesthesiology at the Memorial University of Newfoundland in 1969.

Dr. Cloid Green’s career grew alongside the specialty of anesthesiology in the 1950s. His training in anesthesiology proved to be a versatile and profoundly useful skill set as the specialty became fully recognized. Dr. Green's long and fruitful career is the perfect example of the diverse opportunities afforded by anesthesiology training.

This study evaluated 13 specific topics representing molecular targets for pain during the period 1982-2016. The evaluation was performed by measuring research efforts via a scientometric approach on one hand and by assessing successful outcomes of these efforts, as indicated by the development of FDA-approved analgesics, on the other. A number of new analgesics were developed during this period, some of them with a completely novel mechanism of action. However, the main problems with approved drugs, as well as drug candidates, are relatively low levels of clinical superiority in effectiveness and narrow spectrum of action in different types of pain, compared to opioids or NSAIDs. The most interesting feature of the scientometric analysis of the 13 analgesic discovery topics is the long-lasting growth in the number of articles. The total number of all PubMed articles persistently increased over each of many 5-year periods in every topic even without any success in the development of new analgesics. Scientometric indices of NIH-supported studies are not better at predicting successes in the discovery of new analgesics than indices applied to all publications without regard to the category of support. Thus, even the highly valued NIH-based funding system did not demonstrate a clear advantage for discovery efforts centered on pain-related molecular targets. The evaluated research efforts did not result in breakthrough analgesics that could demonstrably affect the current use of opioids or NSAIDs. Orthodox thinking—both in research and research funding—might be the main reason for the absence of breakthrough analgesics.

In The Boston Medical and Surgical Journal of 1847 (later to be called The New England Journal of Medicine), Boston chemist George Washington Frost Mellen claimed that inhaled nitrous oxide gas supports human life in the manner of oxygen gas, and he proposed the use of nitrous oxide in resuscitation from drowning and from carbon monoxide poisoning. The claim was reprinted in at least one dental journal and was long cited as justification for the use of 100% nitrous oxide for inhaled anesthesia. Advocates included anesthesia pioneer and painless dentist Gardner Quincy Colton. Though misguided as to nitrous oxide, Mellen was a prominent member of the Boston community for the abolition of slavery.

In November 1847, James Young Simpson, MD, of Edinburgh, Scotland, applied the word anaesthesia to the state of narcotism and insensibility produced by the inhaled vapors of sulfuric ether and chloroform, along with the word anaesthetic as an adjective to denote that state and as a generic term for agents capable of inducing the state of insensibility. In March 1848, Andrew Buchanan, MD, of Glasgow, Scotland, penned a letter to Simpson to suggest a more semantically precise word, the spelling of which is not clear in Buchanan's letter. We do not know whether Simpson replied to Buchanan. Simpson continued using the words anaesthesia and anaesthetic in his publications.

Between 1938 and 1951 erythroidine derivatives were seriously considered as alternatives to curare for the provision of muscle relaxation. This has been overlooked in the published history of anaesthesia. The first publication on the paralysing effect of an extract of Erythrina americana was in 1877, but this was in a Mexican journal, which was not widely read. Sixty years later erythroidine was isolated, and in 1938 it was first used clinically to treat spastic dystonia, preceding the use of Intocostrin for this purpose. By 1943 dihydro-β-erythroidine was prepared in crystalline form, which was equipotent with curarine and of acceptable duration; it was used in clinical anaesthesia in 1946. In the 1940s curare was presented in solutions with potency stated in units, determined by bioassay, which was a disadvantage compared with the straightforward mg of dihydro-β-erythroidine. However, by the early 1950s, improvement in the pharmaceutical presentation of d-tubocurarine and new neuromuscular blockers, displaced the erythroidines.