History of anaesthesia

1. 1
HISTORY OF ANAESTHESIA,
OPEN DROP METHODS, OLD
EQUIPMENTS & RELATED
PHYSICS
By: Dr. T.C.KRIPLANI
James Charles Stuart
(19-06-1566 : 27-03-1625)
“A BLACK DAY IN THE HISTORY
OF MANKIND”
1591 Edinburgh
A young woman named
Euphanie Macalyane got the
punishment for seeking pain
relief during labor. She was
burnt alive on direct order
from King of Scotland
James VI
King James of Scotland
JULY 1868 BOSTON
(Mount Auburn Cemetery)
-Mrs..E. MORTON
(GRAVE SIDE)
“My Husband’s
greatest gift
which he devoted
to the service of
mankind proved a
curse to himself
and to his
family”.
Prof. A K Sethi’s EORCAPS 2008
Queen’s University Belfast
1920-21
“Magill is Mad”
Sir I.W.MAGILL
(1888-1986)
Remarks written by the
referee on the manuscript
submitted by
Sir I. W. Magill for the
award of MD degree
from Queen’s University,
Belfast
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Q1. Tell about the history of
origin of word Anaesthesia.
Philospher Plato Pedanius Dioscoride
(428 - 348 B.C.) (100 A.D.)
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Oliver Wendell Holmes (1846)
Bailey’s English Dictionary (1721/1751)
Encyclopedia Britannica (1771)
John Eliotson (1791-1868)
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2. 2
Q.2. Who synthesised Ether ?
Raymundus Lullius (1275)
(Spanish Chemist)
Paracelsus (1540)
(Swiss Physician & alchemist)
Valerius Cordus (1540)
(Italian-pupil of Paracelsus)
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Q.3. Who gave first Anaesthesia ?
Genesis 2: 21 Creation of Eve
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Q. 4. In U.S.A. Physician's Day is
celebrated on which Date & why ?
• 30th of March every year.
• On 30-03-1842 C.W.Long
administered ether
anaesthesia.
1815-1878
Prof. A K Sethi’s EORCAPS 2008
Q.5. First Public demonstration of
anaesthesia was given by whom ?
Tell Time/Day/Date and Place.
• William Thomas Green Morton
• 10.15 A.M. Friday, 16th of Oct’ 1846
• Bullfinch Amphi Theatre M.G.H.
Boston U.S.A.
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Bullfinch Amphi Theatre M.G.H.,Boston U.S.A.
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Q.6. Who introduced Chloroform
in clinical practice ? Tell the date.
Prof. J.Y.Simpson
8-11-1847
Prof. A K Sethi’s EORCAPS 2008

3. 3
Q.7. When was the first death under
chloroform anaesthesia ?
• 28th of Jan. 1848.
• Hennah Greener, 15 yrs. Old girl operated
for removal of toe nail at Winlaton (Near
New Castle, U.K.) Anaesthesia was given by
Dr. Meggison in his office
Prof. A K Sethi’s EORCAPS 2008
Q.8. How many commissions / committees
were there to investigate the cause of
deaths under chloroform anaesthesia.
Year
Five 1864
1888
1889
1904
1911
Prof. A K Sethi’s EORCAPS 2008
Q.9. Identify the Gentleman and tell about
his contribution towards
anaesthesia.
Prof. A K Sethi’s EORCAPS 2008 Ans.
(H.E.H. Mir Mehboob Ali Khan, 6th
Nizam of Hyderabad) Born 17th August
1866 Ruled 1869 to 1911)
Died : 31st August 1911
Sponsored
1st Hyderabad Chloroform Commission – 1888
(experiment done on 128 dogs).
2nd Hyderabad Chloroform Commission -1889
(on 490 animals dogs, horses, monkeys, rabbits,
goats & cats).
Prof. A K Sethi’s EORCAPS 2008
Q.10. The seven foundation stones of
anaesthesia (rated by W.S.Sykes) in
order of merit are:-
Prof. A K Sethi’s EORCAPS 2008
2. HORACE WELLS
3. W. T. G. MORTON
4. HUMPHRY DAVY
5. C. W. LONG
6. J. Y. SIMPSON
7. C. T. JACKSON
SEVEN
FOUNDATION
A
N
A
E
S
T
H
E
S
I
A
1. HENRY HILL HICKMAN
STONES OF
ANAESTHESIA
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4. 4
1. Dr. HENRY HILL HICKMAN
(1800 -1830)
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2. DR. HORACE WELLS
(1815 -1848)
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3. DR. WILLIAM THOMAS GREEN MORTON
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4. SIR HUMPHRY DAVY
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5. DR. CRAWFORD W. LONG
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6. DR. J. Y. SIMPSON
(1811 - 1870)
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5. 5
7. MR. CHARLES T. JACKSON
(1805 - 1880)
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Q.11. Who is known as father of General
Anaesthesia ?
John Snow
(1813-1858)
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John Snow
gave
anaesthesia
to her at the
birth of
Prince
Leopold (8th
child)
in 1853 and
in 1857 at the
birth of
Princess
Beatrice (9th
child)Queen Victoria (1819-1839-1901)
Prof. A K Sethi’s EORCAPS 2008
Q.12. Who is known as father of
Intravenous anaesthesia ?
Prof. Helmut Weese
(1932 introduced Hexobarbital (Evipan)
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Q.13. Who is known as father of
spinal anaesthesia ?
August Karl Gustav Bier
(1861-1949)
16th of August 1898
(Keil Germany)
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Q.14. Who is known as father of
local anaesthesia ?
Dr. Heinrich Friedrich Wilhelm Braun
(1862-1934)
-Introduced Adrenaline
(chemical tourniquet) with
local in 1902
-Pioneer of new drug
Procaine, Textbook of
local Anaesthesia
Prof. A K Sethi’s EORCAPS 2008

6. 6
Q.15. Who is known as father of injectors ?
What is Venturi’s principle?
* James Thompson (1852)
(Brother of Lord Kelvin)
* U = 1/2 D x V2
U - Pressure drop
D - Density
V - Velocity
Giovanni Batista Venturi
(1746-1822)
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Q.16.What is coanda effect ?
• In 1932 Henri Coanda
described the
phenemenon of wall
attachement.
• Jet being diverted
towards wall and
being attached.(Digital
logics)
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• Small puff of gas injected at the site of
bubble will deflect the main jet to opposite
wall.
• Used in ventilators. (Fluidics)
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MR. HENRY COANDA (1910)
AT 25 YRS
MR. HENRY COANDA
AT 71 YRS
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THE JET PLANE MADE BY HENRY COANDA
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Q.17. Who is known as father of
oximetry?
Carl Matthes
1935 U.S.A.
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7. 7
Q.18. Who is known as father of
C.P.R.?
Dr. Peter Safar
(12-04-1924 - 03-08-2003)
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Q19. Who is known as father in-law
of anaesthesia ?
Alexander Wood
(1817-1884)
In 1855 he
injected solution of
morphia near the
nerve for pain relief
for the first time.
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Q.20. When was the 1st local anaesthetic
(Cocaine) introduced clinically.
15th of September, 1884
Opthalmic Congress
Heidelberg, Germany
Carl Koller
(1857-1944)
Intern at Allegemeine
Krankenhaus (Vienna)
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Q.21. Which fluorinated Hydrocarbon was
first to be introduced for anaesthesia?
Fluroxine (Trifluoro ethyl Vinyl Ether)
10-04-1953, synthesided by John C. Kranz (Jr)
University of Maryland
Gave open drops to – Dr. Max S. Sadove,
Anaesthesiologist at the University of Illinois
(Member of Walter Reed Society)
Prof. A K Sethi’s EORCAPS 2008
Q.22. Who introduced relaxant (curare)
into anaesthesia practice (Date, Place
& Year) ?
23rd January 1942
Montreal (Canada)
By Harold R Griffith
& Enid Johnson
Dr. Harold Griffith
1894-1985
Prof. A K Sethi’s EORCAPS 2008
Q.23. What do you know about Pearl Harbor
disaster in relation to anaesthesia ?
• Many deaths due to use of Thiopentone in
shocked patients (1941). Cyanosis – Respiratory
failure – death of young patients.
• 1943 (Anaesthesiology) - Halford quoted
Intravenous Anaesthesia is an ideal method for
“euthanasia” in war surgery.
• 1943 (Anaesthesiology) Adam & Gray reported
successful administration of drug in deep shock
• 1943 – Anaesthesiology – editorial “possibly the
fault lay with the administration rather than with
the drug.
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8. 8
Q.24 When was father of our nation Mahatma
Gandhiji operated for emergency
appendicectomy? Who gave anaethesia ?
* 12th of Jan, 1924, Sasoon Hospital, Poona.
* Dr. Date gave anaesthesia
* Col. Maddock operated.
Prof. A K Sethi’s EORCAPS 2008
Q.25. In which year association of
anaesthetists of G.B. & Ireland
was formed (became national) ?
• 1932
Prof. A K Sethi’s EORCAPS 2008
Q.26. In U.S.A. “Long Island Society of
Anaesthesia” became national in
which year?
• 1935
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Q.27. When Indian Society
of Anaesthetists was
formed ?
• 1947
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Q.28. When World Federation of
Societies of
Anaesthesiologists
(W.F.S.A.) was formed?
• 1951 Sept.
• 1st Conference 1955
Scheveningen,
Netherlands.
Dr. Harold Griffith
(First President)
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Q.29. When was Asian &
Australasian Regional
section of W.F.S.A.
formed?
• 1960 Toranto, during second
world congress
• First Conference at Manila,
(Phillipines) 1962.
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9. 9
Q.30. When was South Asian
Confederation of
Anaesthesiologists (SACA)
formed ?
• 1991 at Delhi
• First congress, Dhaka, Bangladesh
1993
Prof. A K Sethi’s EORCAPS 2008
Q.31.When was the publication of
following journals started ?
A). Anesthesia Analgesia
(now Anesthesia
Analgesia Curr.Res.)
B). Brit.J.Anaesth.
C). Anesthesiology
D). Anaesthesia
E). Ind.J.Anaesth.
• 1922
• 1923
• 1940
• 1946
• 1953
Prof. A K Sethi’s EORCAPS 2008
Q.32. In U.K. which year the
following courses were
started ?
- D.A. -
- F.F.A.R.C.S. -
(Now F.R.C.A.)
*1935
* 1947
(1st exam
in 1953
(three Indians
passed)
Prof. A K Sethi’s EORCAPS 2008
Q.33. In India following courses were
started in which year ?
- D.A. -
- M.S.(Anaesth.) -
- PhD. (Anaesth.) -
* 1946
(Bombay Unv.)
* 1955
(Muzaffarpur Unv.
Darbangha Med. Coll., Bihar)
* 1958
Prof. A K Sethi’s EORCAPS 2008
Q.34. Who was Dr. T.N. Jha ?
* Prof. Of Anaesthesiology
Medical College, Darbhanga
(Bihar)
* 1983 - Best PG paper
Award started
* Played key role in starting
M.S.(Anaesth.) in 1955,
Darbhanga Medical College
(Muzzafarpur University)
01-03-1923 - 30-07-1979
Prof. A K Sethi’s EORCAPS 2008
Q.35. Identify this. How much % of vapour
maximally it gave ?
*Morton’s
Inhaler
* 24%
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10. 10
Q.36. Identify these masks and droper.
Schiemmelbusch
(1890)
Yauncher’s
Bellamy Gardner Droper
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Q.37.How many layers of Gauge/Lint are
put over the mask for open drop
technique.
* 12-16 layers of gauge
* 1 layer of lint
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Q.38. What were the common inhalation
anaesthetic agents used for open drop
technique. Should one trickle oxygen
under the mask ?
* Ethyl Chloride
* Ether
* Chloroform
* Yes always because the
partial pressure of O2 goes
down under the mask.
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Q.39. Tell about Ethyl chloride :-
-Boiling point
-S.V.P. at 20° C
-Blood : Gas part. coeff.
-Vol % required for
induction.
* 12.5°c
* 988mmof Hg
* 2
* 3-4.5 vol%
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Q.40. Tell about Chloroform :-
-B.P.
-S.V.P.(at 20°c)
-Blood : Gas part.coeff.
-M.A.C.
* 61°c
* 150mm of Hg
* 8.4
* 0.7
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Q.41. Tell about Ether (Diethyl) :-
-B.P.
-S.V.P.
-Blood : Gas part. coeff.
-M.A.C.
-Vol % required for Induction
-Vol % required for
maintenance
* 35°c
* 425mm of Hg
* 12
* 1.92%
* 18-20%
* 4-6%
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11. 11
Q.42. How much is the latent heat of
vaporisation of Ether (Diethyl) ?
65 Cal/ml3
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Q.43. How much is the heat loss during
following techniques of anaesthesia:-
- Open drop
- Semiclosed
- Oxford & E.M.O.
- Circle system
- To & Fro (Water's)
* 300 Cal/ml
* 250 Cal/ml
* 220 Cal/ml
* 180 Cal/ml
* Negligible
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Q.44. Identify the Equipment. What is the
mechanism of Heat conservation in this
equipment.
OXFORD VAPORISER
1941 designed by Macintosh
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Q.45.Identify this equipment.
Prof. A K Sethi’s EORCAPS 2008
E.M.O(Epstein,Macintosh,Oxford
Vaporiser)
• Made in 1952.
• Wt=6.5kg.
• Total ether = 450ml(150ml
+ 300ml)
• Ether 1-20%
• Thermocompenstion (15-
30 degree celsius)(sealed
ether capsule)
• 1200ml water.
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Q.46. Identify the equipment. How warm ether
or chloroform was delivered through
this ?
* Shipway apparatus (Sir Francis Shipway 1916)
* Vapour was pass through thermos flask filled
with hot water.
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12. 12
Q.47 Identify this equipment made for giving
chloroform. How at times fatal
complications occurred with this equipment.
1867. Junker’s Bottle
Fatal complications due to wrong connections
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Q.48. Identify the machine. Which type of Machine
this is ? When and why this machine was
discontinued
Minnitt’s gas air machine (R.J.Minnitt, 1933 discontinued
in 1970)
Maximum upto 50% of N2O with air
Q.49. Identify this machine. Which type of machine
this is .This machine was used for.........anaesthesia ?
Walton five
Intermittent type
Dental Anaesthesia
1st appeared in 1925
5th appeared in 1958
Prof. A K Sethi’s EORCAPS 2008
Q.50 Which system is not there in this machine? When
was that system incorporated in Boyle's Machine?
* Pin Index System
* Incorporated in 1952 in
Boyle’s Machine
(suggested by Prof.
Woodbridge in 1939)
Prof. A K Sethi’s EORCAPS 2008
Q.51. Identify the cylinders. What is the
Pin-Index No. of these cylinders ?
Cyclopropane – 3 6
CO2 – 1 6
Prof. A K Sethi’s EORCAPS 2008
Q.52. In which year the Oxygen & Nitrous
Oxide cylinders were made ? Tell the
composition of modern cylinders ?
1865- Brass bound with Copper cylinders (Barth & Coxeter
London)
1870- Cast Iron Cylinders (S.S. White & Philadelphia)
1946- Mangnese Steel - Now Molybdenum steel &
Aluminium Alloy.
Iron remaining Silicon 0.3% Chromium 0.8-1.1%
Carbon 0.3-0.4% . Sulpher 0.35% Molybdenum 0.15-0.25%
Maganese 0.4-0.9% Phosphorus 0.35%
Prof. A K Sethi’s EORCAPS 2008