History of anaesthesia: Journals & articles

Papua New Guinea is a Pacific country that remains an enigma to the world at large. Despite massive geographical challenges due to mountainous terrain, remote islands, poverty, and with 80% of the population of over eight million living in rural villages, Papua New Guinea has managed to develop national medical and postgraduate specialty training. The first recorded anaesthetic was administered in Papua New Guinea in 1880 and the first anaesthetist trained in 1968. The University of Papua New Guinea graduated its first diploma in anaesthesia candidate in 1986 and its first master of medicine candidate in anaesthesiology in 1991. As of December 2021, there have been 82 diplomas and 40 masters of medicine awarded. We review the factors and influences bearing on the development of physician anaesthesia training in Papua New Guinea over this period. Many of the people involved have contributed information used in this article.

The Presidential Address of the outgoing President of the Australian Society of Anaesthetists (ASA) was renamed the Geoffrey Kaye Oration in 1986 after the first and longest serving Secretary of the Society.1 The development of the specialty of anaesthesia in Australia benefitted from his ‘unique talents in research, teaching and organisation’, which were accompanied by his ‘dedication and capacity for hard and unremitting work’.2
On 19 January 1934, Geoffrey Kaye (1903–1986) and six other men stepped away from the Fourth Australasian Medical Congress of the British Medical Association to Hadley’s Hotel in Hobart and founded the ASA. This was undoubtedly a challenging time for the specialty but very much a cherished moment. This event created the fourth medical organisation in Australia and a split from the British Medical Association. Anaesthesia had been overlooked and not included in the initial scientific program of the Congress. This step, of forming a separate anaesthesia organisation, marked in Australia that anaesthesia, ‘for so long merely the handmaiden of surgery, was now itself a science and an art and for its practice there must be training and teaching’ and it would be the newly formed ASA which would steer this course.2
Since that day in 1934, the Annual General Meeting of the ASA has almost always been held in conjunction with the National Scientific Congress (NSC). Annual General Meetings and Congresses mark time for organisations such as ours. Whilst reflecting on the Congresses that have marked my time as President, there are two moments that I would like to share with you today.
The first is the 2019 NSC in Sydney, convened by Dr Anne Jaumees. During the NSC a colleague asked me what number female President of the ASA I would be. As I had been in an Acting President role for a good part of the year, I was embarrassed that I didn’t know the answer, but I quickly looked it up. Five. I am the fifth woman to be President of the Australian Society of Anaesthetists and the 46th President.

In April 1915, a 34-year-old sergeant in the British Army was among the thousands of allied troops attacked with chlorine gas during the second Battle of Ypres. While he survived, and ‘expected to recover in a day or two’, the previously healthy infantryman, who ‘had done heavy work all his life, and was a good athlete, having rowed and swum in races’, was left with persistent breathlessness, tightness.

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.

The most recent estimates, published in 2016, have indicated that around 70% of anaesthesia providers in Papua New Guinea are non-physician anaesthetic providers and that they administer over 90% of anaesthetics, with a significant number unsupervised by a physician anaesthetist. Papua New Guinea has a physician anaesthetist ratio estimated to be 0.25 per 100,000 population, while Australia and New Zealand have a ratio of 19 physician anaesthetists per 100,000, which is 75 times that of Papua New Guinea. To reach a ratio of seven per 100,000, recommended as the minimum acceptable by the Lancet Commission in 2016, there will need to be over 35 practitioners trained per annum until 2030, at a time when the average annual numbers of recent years are less than three physicians and less than five non-physician anaesthetic providers. We review the development of anaesthesia administered by non-physician indigenous staff and the stages of development from heil tultuls, dokta bois, liklik doktas, native medical assistants, aid post orderlies, and Anaesthetic Technical Officers up to the current Anaesthetic Scientific Officers having attained the Diploma in Anaesthetic Science from the University of Papua New Guinea.

A number of Charles Darwin's biographies record the administration of chloroform by Darwin to his wife Emma, during her labour and delivery of her eighth child, Leonard. This occurred on 15 January 1850, a little over two years after James Young Simpson in Edinburgh described the analgesic action of inhaled chloroform. An online search of more than 9000 items of Darwin's correspondence at Cambridge University and other sources revealed that he was an active proponent and user of chloroform in midwifery, for euthanising animals he studied, as well as in botanical studies of carnivorous plants. He also discovered that the concurrent inhalation of chloroform, during its administration to his wife, alleviated his distressing anxiety which he suffered when present at her earlier confinements.

The lack of radio navigational aids in early Royal Flying Doctor Service aircraft in Australia occasionally resulted in aircraft being stranded at a remote site with a critically injured patient due to weather and other conditions. For a brief period in the 1950s, at least one Royal Flying Doctor Service pilot was trained to administer anaesthesia to critically ill patients who could not be immediately evacuated. The aim of this paper is to describe the circumstances in which this arose and how it worked in practice. This is based largely on the recollections of pilot anaesthetist Captain Keith Galloway, who shared his recollections during interviews with the authors.

Pandemics have ravaged human civilization at regular intervals for the past 2000 years killing millions of people worldwide [1]. With each pandemic, healthcare workers and hospital systems have borne the brunt of these outbreaks fulfilling their moral responsibility to treat and give a healing touch to already distressed situations. Each outbreak has tested the exceptionally very high level of skill, expertise as well as the professional commitment of healthcare workers.

Anesthesiology reflections from the Wood Library-Museum.

When Thomas Trotter retired from his long career as physician to the Channel Fleet in 1804, he published his earlier MD thesis—an essay on drunkenness. While Trotter was not the first to recognise the problem of addiction, or to suggest potential treatments, his manuscript was the first book-length discussion on the subject—and the first to suggest that addiction was ‘a disease of the mind’. His seminal work probably had little impact at the time—the medical profession, and the general public, were more supportive of the moralistic tone promoted by Benjamin Rush in his 1785 pamphlet ‘Ardent Spirits’.

The Journal of Anesthesia History is an international peer-reviewed journal dedicated to advancing the study of anesthesia history and related disciplines. The Journal addresses anesthesia history from antiquity to the present. Its wide scope includes the history of perioperative care, pain medicine, critical care medicine, physician and nurse practices of anesthesia, equipment, drugs, and prominent individuals. The Journal serves a diverse audience of physicians, nurses, dentists, clinicians, historians, educators, researchers and academicians.