Essentials of Anaesthesia for Undergraduates R Chandrasekaran, R Lakshmi
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History of AnaesthesiaCHAPTER One

The true meaning of Anaesthesia is “Insensitive to pain”. The branch of medical science dealing with this is called “Anaesthesiology”. The surgical Anaesthesia was made possible around 150 years back. Alcohol, Opium, Cannabis and mandragora, were used to relieve pain. Before anaesthesia was discovered, surgery was a terrifying last resort.
Joseph Priestly (1733–1804) discovered Oxygen in 1774 and called it dephlogisticated air. Lavoisier called this gas as Oxygen and later he discovered Nitrous Oxide.
Sir Humphry Davy (1778–1829) worked on this Nitrous Oxide and documented the analgesic efficacy of this gas and called it as Laughing Gas.
Ether, originally called as sweet Oil of Vitriol was prepared by Valerius Cordes. It was used clinically for anaesthesia by Crawford Long in 1842 but failed to publish their results.
W. T. G. Morton (1819–1868) was instrumental in the introduction of ether as an anaesthetic agent. He made the public demonstration of painless removal of the tumour from the jaw of the patient James. This historical event happened on 16 October 1846, at Massachusetts General Hospital. This day is being celebrated till date as “Ether Day”.
Chloroform, another anaesthetic agent was discovered by Jean Pierre Marie and it was widely used in human beings by Dr James Simpson in 1847 in midwifery. Later due to its cardiac 2toxicity, this drug was removed from the anaesthetic arma-mentorium.
In 1855 Cocaine was isolated from the leaves of Erythroxylum Coca, the first local anaesthetic agent known to the world. Karl Koller in 1884 used this drug widely as local anaesthetic in eye surgery. Because of its addictive potential, it was replaced by Lignocaine and Bupivacaine.
In 1898 August Bier introduced first planned spinal anaesthesia in man, which has taken a very important place in modem anaesthesia.
Until end of nineteenth century the method for administration of anaesthesia was crude and primitive which ended up with many causalities. There was a major breakthrough when instruments were devised for administration of various anaesthetic agents. Coxeter, an instrument maker, introduced gadgets that could control the flow of Nitrous Oxide and Oxygen. In 1917, HEG Boyle made the first Gas-Oxygen machine with the help of Coxeter, which became the first Boyle Apparatus. No other machine could replace this Boyle's apparatus till today and has become an important gadget in all operation theatres.
In 1920 Arthur E Guedel described the signs and stages of anaesthesia.
In the same year Magill introduced endotracheal anaesthesia using muscle relaxants. The introduction of various muscle relaxants like Tubocurarine, Gallamine, Suxamethonium and Pancuronium produced enormous expansion in the techniques of anaesthesia. Barbiturates were synthesized in 1864 on St. Barbara's day from Barbituric acid. Dr JS Lundy introduced this in anaesthesia practice and was instrumental in describing the balanced anaesthesia.
Balanced anaesthesia is a technique by which a delicate balance is obtained using various drugs and techniques with the aim of producing good analgesia, narcosis and surgical relaxation keeping in mind the safety of the patient.
In 1923 Waters improvised the carbon dioxide absorption system in the Boyle's machine. With the good understanding of the physiology of various systems and the changes that 3occur during anaesthesia, the anaesthesiologists have acquired ability to administer safe anaesthesia.
In modern times, the growth and scope of Anaesthesiology has expanded enormously with the introduction of new drugs, techniques, monitoring devices and anaesthesia equipments.
Anaesthetists are now highly trained physicians who can provide the best of care to the patients in critical care units, pain clinics, accident and trauma ward, labour ward and in cardiopulmonary resuscitation. The advancement in surgery is due to advancement in anaesthesia. The modern anaesthesiologists have updated their skill and knowledge to keep in pace with the added additional responsibility of coping with the advancement in the surgical specialities and help in the updating their knowledge and skill.