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The effect of the First World War (1914–1918) on the development of British anaesthesia*

Published online by Cambridge University Press:  01 August 2007

N. H. Metcalfe
N. H. Metcalfe*
Affiliation:
York VTS, York Hospital, Wigginton Road, York, YO31 8HE, UK
*
Correspondence to: Neil H. Metcalfe, 4 Philadelphia Terrace, South Bank, York, YO23 1DH, UK. E-mail: [email protected]
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Summary

One of the greatest but also most unfortunate ironies in life is how modern medicine owes some of its existence to the deadly cancer of war. For those whose image of armed conflict is one of disease, death and destruction, this will no doubt be a surprise. However, these very conditions have allowed military surgeons and physicians unparalleled opportunities to experiment and develop using large and dependent populations of potential patients. The catalyzing effect of war has seen the ambulance, the hospital, plastic surgery, preventative medicine and penicillin as just a few products whose history is linked to war. This paper examines whether anaesthesia, and in particular British anaesthesia, can be added to this list when focussing on the First World War (1914–1918). The anaesthesia that was being practiced at the outbreak of the First World War had not drastically altered from that of the mid-nineteenth century. Old anaesthetics given via basic facemasks could be performed by many doctors; specialists were rare. This situation, however, altered during the First World War. This is because the vast number of wounded in the war demanded the introduction of casualty clearing stations to help triage and treat the wounded quickly and efficiently. The workload of these ‘mini hospitals’ created specialist anaesthetist posts within the military. Once in place, the anaesthetists were able to help develop the relatively new concepts of blood transfusion and resuscitation. These were recognized to be vital against shock, something that had previously not been well researched or understood. While at the casualty clearing stations, Geoffrey Marshall readdressed this by studying the effects of different anaesthetic agents in varying amounts of shock. This work led to the popularity of nitrous oxide, ether and oxygen, which in turn stimulated interest in anaesthesia machines. Finally, the treating of facial wounds in casualties at the Queen’s Hospital for facial and jaw injuries at Sidcup, highlighted the possibility of endotracheal intubation, a technique that had a drastic effect on the administration of anaesthetics. Although there were no new wonder anaesthetics, something which would not occur until the neuromuscular blocking drugs of the 1940s, many of these concepts moved into civilian anaesthesia and enabled British anaesthesia to be at the forefront of anaesthesia development for much of the twentieth century.

Keywords

ANAESTHESIACHLOROFORMHISTORY OF MEDICINEINTRATRACHEAL INTUBATIONETHERWORLD WAR 1NITROUS OXIDEHISTORYMILITARY MEDICINE
Type
Review
Information
European Journal of Anaesthesiology , Volume 24 , Issue 8 , August 2007 , pp. 649 - 657
Copyright
Copyright © European Society of Anaesthesiology 2007

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Footnotes

*

Based on a presentation on the occasion of the final of the John Bullough Prize 2005 at the Sixth International Symposium on the History of Anaesthesia in Cambridge University in September 2005.

References

1.Griffith, P. British Fighting Methods in the Great War. London: Frank Cass, 1996: xi.Google Scholar
2.Hadfield, CF, Edmund, H, Boyle, G. Eminent Anaesthetists. Brit J Anaesth 1950; 22: 107–117.CrossRefGoogle Scholar
3.Metcalfe, NH. The history of the military on civilian uncertainty about modern anaesthesia between its origins in 1846 and the end of the Crimean War in 1856. Anaesthesia 2005; 60: 594–601.Google Scholar
4.Metcalfe, NH. The influence of the military on modern anaesthesia from the American Civil War to the beginning of the first world war, 1861–1914. Anaesthesia 2005; 60: 1213–1217.Google Scholar
5.Macleod, GHB. Notes on the Surgery of the War in the Crimea: with Remarks on the Treatment of Gunshot Wound. London: J Churchill, 1858: 33.Google Scholar
6.Albin, MS. The use of anesthetics during the civil war, 1861–1865. Bull Anesth Hist 2002; 19 1, 4, 5–11, 26.Google Scholar
7.Burke, J. ‘Wartime’. In: Cooter, R, Pickstone, J, eds. Medicine in the Twentieth Century. Amsterdam: Harwood, 2000: 589.Google Scholar
8.Noon, G. ‘The treatment of casualties’. In: Griffith, P, ed. Methods in the Great War. London: Frank Cass, 1996: 87–112.Google Scholar
9. Papers of Sir Anthony Bowlby as consulting surgeon to the British Army in France during World War 1, letters and reports on gas gangrene and the use of casualty clearing stations, RAMC Muniment Collection 365/1 in the Wellcome Library for the History and Understanding of Medicine.Google Scholar
10. Papers of Major J.V. Bates, Department of Documents, Imperial War Museum Archives, London, MS 80/17/1.Google Scholar
11.Whitefield, IR. Doctors in the Great War. Barnsley: Leo Cooper, 1999: 201.Google Scholar
12.Horton, J. The Battle of the Somme, 1916: anaesthetics at casualty clearing stations. Proc Hist Anaesth Soc 1996; 24: 49–57.Google Scholar
13.Flagg, PJ. Anesthesia in Europe on the western battlefront. Int Clin 1918; 3: 210–228.Google Scholar
14.MacPherson, WG, Bowlby, AA, Wallace, C, English, C. Official history of the Great War: medical Services, Surgery of the War, Vol. 1. London: HMSO, 1922: 109, 178–185.Google Scholar
15. Papers of Lady D’Abernon, Department of Documents, Imperial War Museum Archives, London, MS 92/22/1.Google Scholar
16.Howell, WB. ‘Experiences of an anesthetist at the front’. In: McMechan, FH, ed. The American Yearbook of Anesthesia and Analgesia, 1917–1918. New York: Surgery, 1918: 218–225.Google Scholar
17.Thomas, KB. The Development of Anaesthetic Apparatus. London: Blackwell, 1980: 143, 145, 149, 190, 196.Google Scholar
18.Evans, B. A doctor in the great war: an interview with Sir Geoffrey Marshall. Brit Med J 1982; 285: 1780–1783.Google Scholar
19.Marshall, G. Anaesthetics at a casualty clearing station. Proc R Soc Med 1917; 10: 17–36.Google Scholar
20.Marshall, G. Anaesthetics for men with wounds of the abdomen. Lancet 1917; 1: 640–641.Google Scholar
21.Heddy, WRH. Anaesthetics in the field. J R Army Med Corps 1918; 31: 76–79.Google Scholar
22.Anon. First aid use of anaesthetics in the German army. Brit Med J 1914; 2: 639.Google Scholar
23.MacPherson, WG. Medical Services General History. Vol. 1. London: HMSO, 1921: 180.Google Scholar
24.Guedel, AE. Foreign ether, chloroform and ethyl chloride: anesthetic service. Q Suppl Anesth Analg, Am J Surg 1918; 32: 38.Google Scholar
25.Courington, FW, Calverley, RK. Anesthesia on the Western Front: the Anglo-American experience of World War One. Anesthesiology 1986; 65: 642–653.Google Scholar
26.Shipway, FE. The advantages of warm anaesthetic vapours and an apparatus for their administration. Lancet 1916; 1: 70–74.Google Scholar
27.Corfield, C. Six months anaesthetic experience at a CCS on the Somme. Practitioner 1917; 24: 251–254.Google Scholar
28.Cope, DK. ‘The international medical congress of 1912, World War I and the transatlantic triangle’. In: Fink, BW, ed. The History of Anaesthesia Third International Symposium. Illinois: Wood Library-Museum of Anesthesiology, 1992: 111–115.Google Scholar
29.Boyle, HEG. Nitrous oxide–oxygen–ether outfit. Lancet 1919; 1: 226.Google Scholar
30. Photocopy of the notebook of Private John J. Kershaw, RAMC, (with 29 Infantry Brigade?) containing notes on lectures about physiology, diseases, hygiene, diet, etc., and accounts of his pay, RAMC 924:6 in The Wellcome Library.Google Scholar
31.Page, CM. A Medical Field Service Handbook. London: Hodder & Stoughton, 1919: 98–100.Google Scholar
32.Boulton, TB. The contribution to modern anaesthetic management of William Lorenzo Moss, a cousin of Crawford W Long. Surv Anesthesiol 1993; 37: 122–130.Google Scholar
33.Hutin, A. Principe d’une nouvelle methode de transfusion muqueuse. J Med de Bruxelles 1914; 19: 436–439, quoted in Boulton TB. The contribution to modern anaesthetic management of William Lorenzo Moss, a cousin of Crawford W. Long. Surv Anesthesiol 1993; 37: 122–124.Google Scholar
34.Archibald, E. A note upon the employment of blood transfusion in war surgery. J R Army Med Corps 1916; 27: 636–644.Google Scholar
35.Robertson, OH. Transfusion with preserved red blood cells. Brit Med J 1918; 1: 691–695.Google Scholar
36.Westhorpe, R. ‘The introduction of a mobile resuscitation service – 1918’. In: Fink, BR, ed. The History of Anaesthesia Third International Symposium. Illinois: Wood Library–Museum of Anesthesiology, 1992: 435–438.Google Scholar
37.McMechan, FH. The American Yearbook of Anesthesia and Analgesia, 1917–1918. New York: Surgery, 1918: 1.Google Scholar
38.Guedel, AE. Regarding the significance of the position and movements of the eyeball. Am J Surg 1920; 34: 53–57.Google Scholar
39.Magill, IW. Blind nasal inhalation. Anaesthesia 1975; 30: 476–479.Google Scholar
40.Bowes, JB, Zorab, JSM. ‘Sir Ivan Magill’s Contribution to Anaesthesia’. In: Rupreht, J, van Lieburg, MJ, Lee, JA, Erdmann, W, eds. Anaesthesia: Essays on its history. Berlin: Springer, 1985: 13–17.Google Scholar
41.Pallister, WK. ‘Sir Ivan Whiteside Magill (1888–1986)’. In: Atkinson, RS, Boulton, TB, eds. The History of Anaesthesia: Proceedings of the Second International Symposium on History of Anaesthesia. London: Royal Society of Medicine, 1989: 605–609.Google Scholar
42.Magill, IW. A portable apparatus for tracheal insufflation. Lancet 1921; 1: 918.Google Scholar
43.Magill, IW. Endotracheal anaesthesia. Proc R Soc Med 1929; 22: 83–87.Google Scholar