Personalities in

Anesthesia
Dr. Vishak Manoj Bhaskar
 W T G MORTON
William Thomas Green Morton
(1819-1868)
Born in Charlton, Massachusetts, William T. G.
Morton was the son of James Morton, a farmer, and
Rebecca Morton

Excelled in school

clerk, printer, and salesman

 EDUCATION

Baltimore College of Dental Surgery in 1840

1843 Morton married Elizabeth Whitman of

Farmington

Quit dental joined medicine

DENTAL TO MEDICINE
TO ETHER
In the autumn of 1844, Morton entered Harvard
Medical School

attended the chemistry lectures of Dr.Charles T.

Jackson, who introduced Morton to the anaesthetic
properties of ether.

Morton then also left Harvard.

A lot of patients with root cleaning in dental treatment were
feeling pain

Morton first tested ether on animals and then upon himself to

measure the possible after effects.

When he was convinced of its safety, he decided to put it to

use on a patient.

On September 30, 1846, Morton performed a painless tooth

extraction after administering ether to a patient
ETHER DAY

Boston surgeon Dr Henry

Jacob Bigelow arranged for a
now-famous demonstration of
ether October 16, 1846 at the
operating theatre of the
Massachusetts General
Hospital which was called as
“Bulfinch building”
Dr. John Collins Warren painlessly removed a
tumour from the neck of a Mr. Edward Gilbert
Abbot

Morton tried to hide the identity of the substance

Abbott had inhaled, by referring to it as "Letheon",
 Morton went quietly to work. With this simple
equipment(A glass dome was filled with sponges
soaked in ether; the patient inhaled the vapour
through the mouth piece)
In December 1846, Morton applied to Congress for
"national recompense" of $100,000,

was complicated by the claims of Jackson and

Wells as discoverers of ether, and so Morton's
application proved fruitless.

In 1852 he received an honorary degree from the

Washington University of Medicine
Morton performed public service yet again - 1862
when he joined the Army of the Potomac as a
volunteer surgeon.

Applied ether to more than two thousand wounded

soldiers during the battles of Fredericksburg,
Chancellorsville, and the Wilderness.
 END

Morton was in New York City in July 1868 when he

went to Central Park to seek relief from a heat wave,
where he collapsed and died soon after
 The Tomb of Morton
A monument erected by citizens of Boston
over the grave of Morton in Mount Auburn
Cemetery near Boston bears the following
inscription written by Dr. Henry J. Bigelow.

William T. G. Morton

Inventor and Revealer of Anaesthetic

Inhalation

“Before Whom, in All Time, Surgery Was

Agony”

“By Whom Pain in Surgery Was Averted

and Annulled”

“Since Whom Science Has Control of Pain”

The place where the demonstration was done is
preserved as a monument known as “Ether
Dome”
The Ether Monument,
also known as “The
Good Samaritan”, is a
statue and fountain
near Boston's Public
Garden. It
commemorates the
use of ether in
anaesthesia.
John Snow
John Snow (1813–1858) is revered as a founding father of two
medical disciplines.
Anesthesiologists remember him as the physician who first made
anesthesia scientific by showing how the human body responded
to different doses of anesthetic drugs, and how anesthesia
affected the human physiology.
In addition, Snow the practicing anesthetist is widely known for
the inhalers he designed and for administering chloroform to
Queen Victoria during the delivery of two of her children.
He is also celebrated as a founder of the modern science of
epidemiology, and as an exemplar of the notion that physicians
should apply their expertise toward the amelioration of public
health problems.
During the cholera epidemic in London, 1848–49, Snow proposed
the unconventional notion that the dread disease was caused by
a particle that was ingested orally, rather than by a befouled
component of miasmatic air
John Snow, the oldest of nine children of
Francis and William Snow, a laborer, was
born on March 15, 1813, in the city of
York.
In 1827, at the age of 14 years, John
Snow became an apprentice to William
Hardcastle, a surgeon-apothecary in
Newcastle-Upon-Tyne. During this time,
he “walked the wards” of Newcastle
Infirmary.
By 1836, John Snow was ready to
undertake the required university
education so that he could add the title
“Doctor” to his name.
He enrolled in the Hunterian School of
Medicine at 16 Great Windmill Street for
a fee of £34.
At the Hunterian School of Medicine, John
Snow was taught the emerging medical
specialty of obstetrical medicine and
obtained clinical experience at the
Westminster Hospital, where he also
“walked the wards.”
An advantage of this training was that if a patient died, a
postmortem could be performed in the “dead room”
At the time, bodies were often embalmed with arsenic for dissection.
Many of the students became sick.
John Snow set up a series of carefully designed experiments and was
able to demonstrate that the inhalation of arsenic vapor caused
these illnesses.
He published his finding, and the result was a change in the practice
of preserving bodies for anatomical dissection.
This discovery also led to the discontinuation of the sale of candles
laced with arsenic. Such candles burned brighter than regular
candles, but they gave off toxic arsenic vapor as well.
Snow became a member of the Royal College of Surgeons in May
1838 and a licentiate of the Society of Apothecaries in October 1838,
at the age of 25 years

He identified respiration and asphyxia as his areas of expertise.

He studied the effects of respiration on circulation and the chemistry

and physics of inhaled gases, with a special interest in anesthetic
gases and their application to midwifery.

He developed a trochar and cannula that allowed tapping of the

pleural space without allowing air entrainment.

As early as 1843, Snow had experimented with ether for promoting

respiration in his self-made research laboratory on Frith Street
Snow was able to introduce scientific principles
into the arena of anesthesia administration.
He designed an inhaler that would allow for the
accurate, controlled delivery of ether while taking
into account temperature changes .
In the USA, Morton struggled to patent ether but
was unsuccessful. Snow never attempted to patent
ether or any of the innovative apparatuses he
designed but instead published clear descriptions
so that others could copy his works.
Snow's expert administration of ether changed him from a struggling Solo
general practitioner into an anaesthetist whose services were in constant
demand by London's principal surgeons.
In 1847, he published On the Inhalation of Ether, a practical guide for
administration of the drug. He took a special interest in patients with
respiratory disease and devised animal studies to test his hypotheses and
then presented his findings at peer-reviewed meetings.
He logged more than 5000 anesthetic procedures in 12 years of practice.
The types of cases in order of frequency were dental extractions,
lithotomy, lithotripsy, excision of breast tumors, treatment of hemorrhoids,
repair of anal fistulae, repair of cleft lips, and anesthesia for childbirth.
Chloroform was introduced in 1847 by an Edinburgh obstetrician, James
Young Simpson. John Snow studied chloroform much as he had studied
ether.
He soon realized that accuracy of delivery and patient monitoring were
even more important when administering chloroform than when
administering ether because chloroform was much more potent.
On January 28, 1848, a 15-year-old girl named Hannah
Greener presented for the surgical resection of a toenail and
was administered chloroform, which had been poured onto a
tablecloth and held to her face. The procedure was done at
her home.
She rapidly became pulseless and died. Snow investigated
this death and the deaths that followed.
In what was one of the first peer reviews in anesthesia, Snow
concluded that Hannah's death was the result of the
uncontrolled administration of chloroform via a saturated
cloth—the first recorded death due to anesthesia—and that
scientifically engineered vaporizers should be used instead.
He published his conclusions in a letter to The Lancet and
even published the first treatise on chloroform.
on April 7, 1853, Queen Victoria asked John Snow to
administer chloroform analgesia for the delivery of her eighth
child, Prince Leopold. This was such a success that it was
repeated for the delivery of Princess Beatrice 3 years later.
Obstetrical anesthesia now had the royal blessing, and
medical and religious acceptance soon followed.
John Wendell
Severinghaus
John Wendell Severinghaus was born in Madison,
Wisconsin on May 6, 1922, under chloroform
anesthesia requiring version from a transverse lie
and foot first extraction.
His Mother’s obstetrician suspected the baby was
brain damaged, and was not relieved of that worry
until he attended the dinner at which the AOA
scholarly medical fraternity admitted Severinghaus
to membership after his first year of medical
school.
Dr. Severinghaus is Professor Emeritus of Anesthesia
at the University of California in San Francisco.
He was a Senior Staff Member of the Cardiovascular
Research Institute.
After majoring in physics he designed radar test
equipment at MIT during World War II During medical
school he developed the first electrophrenic
respirators.
He published the first measurements of the rate of
uptake of N2O during anesthesia.
He spent his career as a research anesthesiologist,
teaching in the operating rooms one day per week
plus night calls.
He developed the oxygen and carbon dioxide
electrodes invented by others to make the first
useful blood gas analysis apparatus and assisted
various manufacturers in marketing such devices.
His interests included physiology of respiration and
circulation, particularly brain and lung, blood gas
transport, acid base balance, and especially high
altitude effects on brain and lung.
He published about 250 papers and books, plus
200 abstracts of talks and Oxford.
His major honors were an honorary degree, Dr. Med. H.C.
Copenhagen, and Honorary member of the Royal College
of Anesthetists of UK.

His UCSF laboratory became a major center for testing

accuracy of pulse oximeters, an activity that continues to
date at age 80, despite moving to alternate space 4
times.

He acts as a physiology referee to various medical

journals and edits a column summarizing interesting high
altitude papers for the Journal of High Altitude Medicine
and Biology.
Henry Edmund Gaskin
Boyle


Born in Barbados, Boyle was educated at Harrison College before
attending St. Bartholomew’s Hospital in London, qualifying in 1901.
He was appointed Senior Resident Administrator of Anaesthetics in May
1905 and then Non-Resident Assistant Administrator of Anaesthetics, a
post he kept for the next 13 years.
In 1907 Boyle published the first edition of his book Practical
Anaesthetics, which ran for 2 more editions.
After further research and publications about intratracheal insufflation
anaesthesia, he developed his machine, which was a modification of
Gwathmey’s continuous flow apparatus.
This apparatus, which Boyle continued to modify for the next 20 years,
became synonymous with British anaesthesia.
In 1920 Boyle was awarded an OBE for his work in the
RAMC caring for wounded soldiers during the war.
Following a trip to North America, he brought back the
Sorensen electrical suction apparatus – which had a
tremendous impact in ENT surgery –
and the Canadian Davis mouth gag, which
subsequently became known as the Boyle-Davis gag.
He was on the Editorial Board of the British Journal of
Anaesthesia from 1923 and a founder member of the
Association of Anaesthetists.
Boyle retired to Godalming, Surrey, in 1939, where he
died two years later.
 RALPH MILTON WATERS

Born in north bloomfield, ohio

He gradually became interested in anaesthesia so by
1916 he decided into specialize.
In 1923 he acquired an anaesthetic practice in Kansas
city where he remained for 3 years.
His contributions to the growing speciality were numerous
and important
1) insistence of proper training programmes for young
anaesthetists
2) encouragement of careful note keeping in
anaesthesia by means of punch cards
3) introduction o cyclopropane into anaesthetic practice
4) development off to and fro carbon di oxide
absorption system
5)a re evaluation of chloroform
6 pioneering use of thiopentone in endo tracheal
intubation
 JAMES YOUNG SIMPSON
A BLESSING TO OBSTETRICS

James young simpson born in Bathgate on 7th june 1811 a

successful obstetrician in Edinburgh, Scotland had been among
the first to use ether for pain relief in labor on 19 th January 1847.
However ether was slow in effect and there was added risk of
explosion when administerd in a room containing open fire.
He Therefore sought of a more pleasant and rapid acting
anaesthetic.
David waldie suggested chloroform , they promptly fell
unconscious and when they awoke they were delighted.
Simpson quickly set about encouraging the use of chloroform on 8
th nov 1847.
It was john snow an English contemporary of Simpson who
achieved fame as an obstetric anaesthetist by treating queen
Victoria.
In 1838 he designed air tractor known as vaccum extractor to
assist child birth.
 ARTHUR ERNSTER GUEDEL
Born in 1883 june 10 and graduated from medical school of university of
Indiana in 1908.
Gave anaesthetics in france during first world war and made notes on which
his book his based.
Known for his studies on uptake and didtribution of inhalational anaesthetics
as well for defining various stages of anaesthesia.
He is better known today for his design off oropharyngeal airway and made
many contributions such as including an early description of self
administration of nitrous oxide and air for obstetrics and minor surgeries,
description of anaesthetic properties of ether,classical description of clinical
use of cyclopopane, re introduction with rm waters cuffed endotracheal tube.
Stages of anaesthesia:
1.

1. from beginning of induction to loss of consciousness.

2. from loss of consciousness to onset of automatic breathing. Eyelash reflex disappear but
other reflexes remain intact and coughing, vomiting and struggling may occur.
Respiration may be irregular with breath holding.
3. Stage of surgical anesthesia
4. From stoppage o respiration tilldeath . Anaesthetic overdose cause medullary paralysis
with respiratory arrest and vasomotor collapse. Pupils are widely dilated and muscles are
relaxed.
In 1937 he first edition of his textbook inhalational anaesthesia published.
in 1941 he became the first American to be awarded the prestigious tickman
medal for original work in anaesthesia by royal society if medicine London.
Sir Ivan Whiteside Magill
(23 July 1888 – 25
November 1986)
Ivan White Magill was born in Larne, Norther Ireland
in 1888.
Under the care of Harold Gillies,he started to give
anesthesia for reconstructive surgeries face and jaw
for wounded souldiers.
After trial and error he devoluped tracheal
intubation,initially using two narrow gum-elastic
tubes(ether insuffulation under positive pressure)
and then single wider bore tube (for spontaneous
breathing)
Devoluped technique for nasotracheal intubation
which enabled the patient to be take to the level of
anesthesia for laprotomy with ether.
In addition tube provided clear airway, prevented
laryngospasm and protected lng from foreign bodies.
Over the years he devoluped equipments and
techniques for saftey of his patients
Laryngoscope and laryngeal forceps
Magills breathing circuits for spontaneous
breathing
Methods of introducing anesthetics in
thoracis surgery through ETT
Bronchial blockers for control of pulmonary
secretions and one lung anesthesia
Leading part in forming an Association of
anesthetists,Great Britain and Ireland
Instituted an examination for Diploma in
Anesthesia and starting a Faculty of
anesthesia in Royal college of surgeons of
England.
• Endotracheal tube, anaesthesia (The Magill
endotracheal tube, oral & nasal designs)
• An anaesthetic breathing system (Magill circuit and
expiratory valve)
• Intubating forceps (Magill forceps)
• Laryngoscope a straight bladed version
• Catheter mount (endotracheal tube-to-circuit connector)
• Endotracheal tube connectors, oral & nasal versions
• Magill tracheal spray (glottic anaesthetic)
• Single-lung anaesthesia
• Endobronchial tubes and bronchial blockers
• Bobbin flowmeters
• Helped establish the Diploma in Anaesthesia
• Helped found the Association of Anaesthetists in
1932
• Initiated the foundation of Association of
Operating Theatre Technicians in 1945 (Now the
College of Operating Department Practitioners)
Sir Robert Reynolds Macintosh (October 1897–
28 August 1989)
Born in Timaru, New Zealand, he travelled to Britain at
the start of First world war.
He abandonded his career in surgery to become a
successful Dental Anesthetist.
He was the first and foremost clinical anesthetist and
he Authored the book “Essentials of General
anesthesia”
His name was associated with many parctical pieces of
equpments , most famous being Macintosh
laryngoscope.
Together with, Dr Kurt Mendelssohn and Dr
H.G.Epstein, designed and built the oxford vaporiser, a
simple, portable, and accurate means of delivering
varying concentrations of ether
He was made honorary Fellow of Fauculties of
Anesthetists in England,Ireland and Australia and he
was Knighted in 1955
 August Karl Gustav Bier
(24 November 1861 – 12 March 1949)
Bier, was born in Waldeck,Germany in 1861,Graduated in 1889 and
became assistant to Professor of Surgery,Von Esmarch.
Whilst he supervised the transition antiseptic to aseptic technique in
operating room.
He became familiar with the work of Heinrich,who devoluped lumbar
puncture for routine neurological investigations.
August 16, 1898, August Bier performed the first operation with spinal
anesthesia at the Royal Surgical Hospital of the University of Kiel,
Germany
He , along with his assistant , Dr.Hildebrandt, used “self-experiment”
administered by his assistant to further investigate some of the problems
he encountered with the first administration in patients.
He invented method of treating Chronic inflammation by the method of
passive hyperemia with Esmarch’s bandage.
Intravenous Procaine analgesia.
In 1908, Bier pioneered the use of Intravenous regional anesthesia a
technique which is commonly referred to as a "Bier block"
Bier is also considered to be a pioneer in the field of Sports medicine,
organized the first lectures in sports medicine at the University of Berlin in
1919.
 Professor Charles
Jackson(1805 - 1880)
Professor Charles Jackson was the inventor of the telegraph
and anaesthesia, in his own eyes at least. He was certainly
a polymath: a chemist, physician, mineralogist and world-
class geologist.

Jackson studied medicine at Harvard Medical School

Jackson set up a private medical practice. But he gave it up

in 1836 to establish a private laboratory dedicated to
analytic chemistry.

In 1844, Jackson demonstrated before several of his

chemistry classes that inhalation of sulphuric ether causes
loss of consciousness. One of his students was William Morton, a
dentist seeking to expand his medical knowledge.
After Horace Wells' demonstration of nitrous oxideanaesthesia
failed through under-medication, Jackson was
approached by his former student for advice.

After Morton's public success in what is now the

Ether Dome, Wells said he had inspired them both;
and then Crawford Long belatedly announced in print that
he had been using ether anaesthesia for several
years. Whatever the full story, it seems that
Jackson advised Morton to try using a stronger
agent than nitrous oxide for surgery, namely diethyl ether
.

Jackson later excoriated his former student Morton

as a forger and swindler who had stolen all the
credit for himself.
 Horace Wells(1815 -
1848)
was a compassionate dentist . In the aftermath of an
Horace Wells
especially agonising dental operation, he would sometimes stop
work for several weeks, too traumatised by the need to inflict
such terrible pain on his patients to continue.
On 10th December 1844, Wells and his wife Elizabeth attended
a stage-show laid on by "Professor" Gardner Quincy Colton. After watching
an acquaintance, Sam Cooley, injure his leg without batting an
eyelid, Wells recognised that nitrous oxidemight prove a godsend to
surgical medicine as well as popular entertainment.
Wells decided that the first guinea pig should be himself. An
erupting wisdom tooth had been troubling him for some time.
This seemed the ideal occasion to remove it. Both Colton and
Wells' partner Dr Riggs were initially reluctant to contemplate
using the higher dosages of nitrous oxide needed to induce
insensibility rather than intoxication and euphoric excitement.
But Wells insisted. The extraction was a success. Wells enlisted
Colton's help in teaching him how to manufacture and
administer nitrous oxide to his patients.
The technique was crude, yet it seemed safe and
effective. With the assistance of Riggs, Wells administered
nitrous oxide from an animal bladder via a wooden tube
into the patient's mouth while his or her nostrils were
compressed. After performing more than a dozen
extractions under nitrous oxide anaesthesia over the next
month, Wells felt ready to share his discovery with a
wider audience. In the Hartford Courant (9th Dec. 9,
1846), Wells explained what happened on the appointed
day.
Unfortunately for the experiment, the gas bag was by
mistake withdrawn much too soon, and he was but
partially under its influence when the tooth was
extracted. He testified that he experienced some pain,
but not as much as usually attends the operation. As
there was no other patient present, that the experiment
might be repeated, and as several expressed their
opinion that it was a humbug affair.
Badly emotionally bruised, Wells didn't give up. He
continued his attempts to promote nitrous oxide
anaesthesia, even travelling to Europe in the hope of
finding a more receptive audience.
But by the time Wells returned to the USA, the surgical
scene had shifted dramatically. Ether anaesthesia was
firmly established by Morton .
In January 1848, Wells self-experimented with
chloroform for a week. He became addicted and
increasingly deranged. One day, delirious, Wells
rushed out into the street and threw sulfuric acid over
the clothing of two prostitutes. He was committed to
New York's infamous Tombs Prison. As the influence of the
drug waned, Wells' mind started to clear. In despair,
he realised the horror of what he had done. Wells then
committed suicide, slitting an artery in his leg with a
razor after inhaling an analgesic dose of chloroform to
blot out the pain.
Crawford Williamson
Long(1815 - 1878)
Physcian accredited with the discovery of Surgical anaesthesia.
He experimented with sulphuric ether as anaesthesia and
succeeded in removing a tumor from the neck of a man in 1842.
Long didnot publish his studies nor did he keep it to himself as
secret ,so he was accused of Performing witchcrafts.
4 years later he came accross a dentist William Morton who
performed painless dental extraction using ether as anaesthesia.
By the time Long presented his findings,in 1849 Charles jackson
and Horace Well were claimed as discoverers of anaesthesia.
Long died in june 16,1878.
ON june 18,1879 National Eclectic Medical association passed a
resolution stating Long as the discoverer of anaesthesia.
Virginia Apgar
She was born June 7th, 1909 in Westfield,
New Jersey

She was an American physician who

specialized in Anesthesia and Pediatrics

She is mostly known for implementing the

“Apgar score”
 What is Apgar score?

It is the test that helps determine the health of a

newborn baby

To better determine this fact, a test is conducted

on five criteria summarized in the name of Apgar

Dr. Virginia’s last name Apgar is used as a

mnemonic learning aid
 Acronym Significance
Appearance - Skin color

Pulse - Heart rate

Grimace - On stimulation

Activity - muscle tone

Respiration
 Origin and Purpose

It was implemented in 1952 by Dr. Virginia Apgar

as a simple and repeatable method of usage

It helps assess quickly and summarily the health of

newborn children immediately after birth (1mins
and 5 mins,every 5 mins thereafter until stable)

The test is conducted in a scale of zero to 2

summing up the 5 main criteria

The resulting scores are ranged from 0 to 10

Chart and score Interpretations

Scores below 5 are critically

low and requires neonatal
resuscitation.
From 5 to 7 are fairly low
8 to 10 normal
 Test on a premature baby

Premature babies usually have lower

Apgar scores than full term babies

They usually have a lower muscle tone

(activity)
 Facts
Virginia Apgar was one of four women to enter Colombia
University college of physicians & Surgeons in 1929 after
graduating from Mount Holyoke College

Graduated fourth in class in 1937

First woman to be a full professor at Columbia University College in

1949

1953-Apgar test

In 1959, She obtained a master’s degree in Public health from John

Hopkins

March of Dimes

She advocated for universal vaccination of rubella and Rh testing.

1972-She published a book “Is my baby alright?”

 FACTS

In 1995, she was inducted into National Women’s Hall

of Fame

Until this day her method of determining the health of

a baby born is still used effectively and is named after
her

The Virginia Apgar award is given annually by the

academy of Pediatrics

She was never married

Apgar died in New York city on august 7th, 1974 at the

tender age of 65
 FACTS

Born on 7th

Died on 7th

Played Violin and also created one

Interesting remarks
The acronym that her last name formed is also
valuable for three languages (German, Spanish,
&French)

A- Atmung, Aparienca, Apparence

P- Puls, Pulso, Pouls

G- Grundtonus, Gesticulacion, Grimace

A- Aussehen, Actividad, Activite

R – Reflexe, Respiracion, Respiration

FIRST AND SECOND CHOLOROFORM
COMMISSION
 FIRST CHLOROFORM COMMISSION

The first administration od ether and chloroform were in March 1947 and
January 1848 respectively

During 16 years of their use ,there were 393 deaths due to chloroform and
48 were due to ether.

There was a controversy between two medical school Edinboroug and

London

In 1885,Edward Lawne in Hyderabad claimed he administered chloroform

anaesthesia to 40,000 people without single fatality and formed the 1st
Hyderabad Chloroform Commission.

141 animal experiments were done and concluded that chloroform may be
given safely and its respiration which has to be carefully attended
 Second choloroform committe

Formed in 1890 by a representative,Lancet

They did clinical study on 54 humans

They concluded that Edinburgh school was right

However in India, chloroform was the only

anaesthetic agent till 1928

Use of chloroform came to an end when Goodman

Levy demonstrated when it is used with adrenaline
it causes ventricular fibrillation
THANK YOU.