This short clinical note in 1933 described a device that is still used today. Arthur Guedel received patent # 2,000,034 for the rubber oral airway. He did not become wealthy from his many inventions.

Would you pay homeless people to experiment on them? William Morton had that idea 2 months prior to “Ether Day”. Morton had given ether to worms, insects, fish, caterpillars, and dogs, but he was desperate to give ether to humans. (Image - text from W. P. Leavitt, August, 1846).

On this day (179 years ago) William T. G. Morton demonstrated ether anesthesia. His wife expected him to happy!! But he was paradoxically depressed (see her text from McClure’s magazine). “Ether Day” was the first day of an unpleasant future for the man who invented anesthesia.

A physician might replace the terms “BCE” and “CE” with “BA and “AA” (Before Anesthesia and After Anesthesia - image). In 4 days (10/16/25) it will be 179 AA. A portion of the population in the BA era would rather suffer than submit to the pain of surgery.

George Crile understood enhanced recovery after surgery (ERAS). He thought a fast recovery from surgery depended on whether the surgeon was gentle with the tissues (image: excerpt from his 1914 book). His aphorism: “Sow roughness, and reap a harvest of post operative distress”.

The Jackson and Morton “ether” patent is shown in this image. It was filed 27 days after the famous October 16, 1846 ether demonstration at MGH. They described: 1. Placing an ether soaked sponge in the mouth or 2. using a flawed ether inhaler. Neither idea could be enforced.

Anesthetists who used chloroform regularly in the late 19th century (Buxton and others) denied that chloroform could be used to render a subject unconscious against their will. (Image from a Conan Doyle story entitled HIS LAST BOW showing Holmes rendering Von Bork unconscious)

Jean L. Marie Poiseuille (1797- 1869) measured the height of a mercury column after it was connected to an artery (image from his 1828 publication). Since that time blood pressure has been measured in millimeters of mercury.

One tactic to attract medical students into the specialty of anesthesiology is to show them the emblem of the Association of Anesthetists of Great Britain (image). The Latin translation: “It is divine to relieve pain”. Divine: superhuman or surpassing excellence (Webster).

New innovations sometimes seem so absurd that they seem hilarious. See Harold Griffith’s written comments about the idea of using curare during anesthesia. (From H. R. Griffith: Lancet 2:74, July, 1945).

In his best selling book “An inside Job”, Daniel Silva asserts that unequal sized pupils in a Leonardo da Vinci painting (image) is an alluring feature. We now know that anisocoria (unequal pupils) can be a sign of disease and requires consultation by a neuro-ophthalmologist.

Dogliotti described lumbar epidural in 1939 but did not suggest it for labor analgesia. The idea was slow to develop. Caudal analgesia for OB was described in 1942, but 10 years later it was considered to be dangerous and not necessary. (Image - JP Greenhill - OB analgesia, 1952)

Gaston Labat (1876-1934) was the “Father” of regional anesthesia in the US. He designed his own syringes that had eccentric tips (image) in order to perfect the art of raising wheals. Wheals were not used on the palms or soles because in those areas raising a wheal was painful.

Epidural dilute local anesthetics can produce some degree of motor block after long duration infusions. 60 years ago Philip Bromage (1920-2013) devised this scale to assess the degree of motor block prior to a trial of ambulation.

In his book from 1963 (Anatomy for the Anesthesiologist), William Dornette, MD recommends placing the bite block between the molars (B) instead of in the midline (A). The upper incisors are less firmly rooted compared to the molars and can damaged during an episode of trismus.

1. You measure the pupillary light reflex before going to sleep (A). 2. You wake up during the night and measure it again (B). 3. You measure it again 15 min after awakening in the AM (C). Explain the lack of pupillary re-dilation during the night.

Galen (129-216 CE) wrote 16 books on the pulse. Maybe the modern physician can learn this lost skill. So I asked “Copilot” to draw me an image illustrating his technique. His fingers lie over the flexor carpi radialis muscle not even close to the radial artery 😩.

John Mayow (1640- 1679) suspended a mouse in a bell jar over water. The water rose into the jar. He concluded that the mouse extracted a portion of the air and the water replaced it. 100 years later Joseph Priestly discovered oxygen.

130 years ago a technician would know how to electrically stimulate each individual muscle. This diagram shows where to place the surface electrodes to activate the muscles innervated by the radial nerve. These interventions were used to prevent muscle wasting (Landois - 1891).

Suspecting drug intoxication, the police, firefighters, EMTs (and parents) look at the pupil of the eye. This diagram lists drug effects on the pupil and where they act.