Abstract
Dr Pither makes the valid point that it was the use of new anaesthetic agents – ether, chloroform and cocaine, largely replacing alcohol and opium – that allowed the flowering of intestinal surgical techniques in the later half of the 19th century but misleads about the status of those administering these drugs.
Medical students, junior medical assistants and even porters held the Schimmelbusch mask and applied drops of ether or chloroform under the watchful eyes of the surgeon during surgical and obstetric procedures until the middle of the 20th century.
The first use of anaesthetic agents in the 19th century was invariably by surgeons. Crawford Long, an American surgeon from Georgia, used ether to excise a neck tumour in 1842 (predating by four years the dentists Morton, Jackson and Wells in Boston).
Simpson, a Scottish obstetrician, first used chloroform to ease birthing pain in 1847.
Berkeley GA Moynihan (1856–1936) at Leeds famously gave a shilling to his anaesthetist for every Guinea he charged for an operation.
Consultant status of anaesthetists was achieved with difficulty, and anaesthetists were only recognised as such from 1953. 1 It was in 1992 that anaesthetists could proudly be elected by examination (Fellowship of the Royal College of Anaesthetists) at their own Royal College.
As far as replacement of a surgeon by a robot goes, I would argue the anaesthetist has been using a robot called a Boyles machine since the 1920s!
This of course hinges on the definition of a robot. Dr Pither may be thinking of Hal from 2001: A Space Odyssey but today’s surgical robot is a large and expensive surgical instrument. A sentient surgeon has to guide the machine in real time. The anaesthetic ventilator, invented in 1917, is a mechanical aid that allows The Times crossword puzzle to be addressed while keeping the patient safely asleep.