Why does the Australian Society of Anaesthetists have a journal? Part I*

As the Journal approaches its 50th year, and as the society entrusts the Journal to a new publishing partnership with SAGE, this is a very pertinent question to consider. A simple answer might be found in the Journal’s instructions to authors: ¹ ‘Anaesthesia and Intensive Care is published by the Australian Society of Anaesthetists. It is an educational journal for those associated with anaesthesia, intensive care and pain management, and a means by which individuals may inform their colleagues of their research and experience’.

A more nuanced examination of the question, however, requires consideration from a number of related perspectives. Why did the Australian Society of Anaesthetists (ASA) establish a journal in the first place? Why does the ASA still have a journal? And will the ASA still have a journal in the future? The first question will be addressed here while the others will be considered in the next issue.

Why did the Society establish a journal?

As noted by Jeanette Thirlwell, ² early discoveries in anaesthesia were mainly published in the major general medical journals such as the Lancet (established in 1823) and the Boston Medical and Surgical Journal (later the New England Journal of Medicine, established in 1828). In 1838, the founder of the Lancet, Thomas Wakley, famously used his journal to describe Mesmerism as ‘humbug’. ² John Elliotson, a London practitioner and protagonist of Mesmerism with a large following, went on in 1843 to found The Zoist: Journal of Cerebral Physiology & Mesmerism, and Their Applications to Human Welfare, which was published internationally for 13 years. Thirlwell wondered if The Zoist might be considered the first anaesthesia journal, but went on to assign more convincing precedence to The Dental and Surgical Microcosm, ‘A quarterly magazine, devoted chiefly to the science of anaesthesia and anaesthetics’, founded by Pittsburgh dentist Samuel Hayes in 1891 and published by his company until his death in 1897.^2,3

Meanwhile, in the late 19th and early 20th centuries, societies of anaesthesia had started to appear. The Society of Anaesthetists (London) was established in 1893, ultimately evolving through several iterations into the Royal College of Anaesthetists a century later, having started publication of the British Journal of Anaesthesia in 1923. The Long Island Society of Anesthetists formed in 1905, becoming the New York Society in 1911, the American Society in 1936 then ultimately of Anesthesiologists in 1945; they started their journal Anesthesiology in 1930. Both of these were preceded, however, by what is generally agreed to be the first mainstream anaesthesia journal, Current Researches in Anesthesia and Analgesia (later shortened to Anesthesia and Analgesia) in 1922. Its publisher, the International Anesthesia Research Society, was formed in the same year and the first editor, Francis McMechan, wasted very little time establishing a journal, although it had been preceded by a quarterly ‘Anesthesia and Analgesia’ supplement in the American Journal of Surgery with which McMechan had been involved since 1914. ² McMechan was well known to Geoffrey Kaye and exerted considerable influence over subsequent events related to anaesthesia in Australia. ⁴

Over the next half-century or so, new anaesthesia society journals appeared on a reasonably regular basis. Examples include Minerva Anestesiologica (1934), Anaesthesia (1946), Revista Brasileira de Anestesiologia (1950), Der Anaesthesist (1952), Canadian Journal of Anesthesia (1954, originally Canadian Anaesthetists’ Society Journal), Masui (1954; the Japanese Society also started their English language Journal of Anesthesia in 1987), Acta Anaesthesiologica Scandinavica (1957), Korean Journal of Anesthesiology (1968) and the European Journal of Anaesthesiology (1984).

In 1934, and cognisant of developments in Europe and America, Geoffrey Kaye, Gilbert Brown, Gilbert Troup, Harry Daly, Ivor Hotton, G. Leonard Lillies and Cedric Duncombe met at Hadley’s Hotel during the British Medical Association Congress in Hobart, and there they established the Australian Society of Anaesthetists. ⁴ Facilitation of the exchange of ideas, encouragement of anaesthesia research, and publication of an anaesthesia supplement or entire issues of papers on anaesthesia in the Medical Journal of Australia were all documented objectives of the new society. In 1935, Kaye set about publishing regular society memoranda and newsletters containing some papers of a scientific nature. The intent, intimated in his first memorandum, seems fairly clear: this was to be the first step towards the establishment of a systematic mechanism for the local dissemination of anaesthesia research, but it was to take another 37 years before that aim could be fully realised in the form of a journal. This was not for the want of trying.

By the 1950s, Australian anaesthesia researchers were finding it more difficult to have their work published and the Medical Journal of Australia did not provide for editorial comment. ⁴ At a federal executive meeting, preceding the annual general meeting (AGM) in Perth during April of 1954, President Elect James McCulloch, having researched the likely costs, contributions and revenue, proposed the foundation of a Society journal. This proposal was supported by the retiring president, Mary Burnell of South Australia, along with the executive members present, predominantly from New South Wales (NSW). Several Victorian members of the executive were notably absent. ⁴ After considerable discussion, a motion to institute a journal of anaesthesia was then carried at the AGM, with McCulloch now president. During a second executive meeting a few days later, McCulloch was proposed as editor, with Stuart Marshall (also from NSW) as assistant and an editorial committee comprised of representatives to be appointed by each state. Simmering tensions between the Victorian and NSW sections over a variety of matters came to a head, however, when news of the proposed journal reached the former. More detailed discussion of events can be found elsewhere,^4,5 but vigorous debate regarding financial liability and the likely quality of the journal took place and a referendum on the matter ensued, the result being that the proposal for a journal was abandoned at the AGM of 1955, replaced by another proposal to seek the support of the Australian and New Zealand Journal of Surgery for the publication of Australian anaesthesia research papers instead.

The idea of a journal floundered for the next decade, possibly because the Society no longer had a permanent home after termination in 1954 of the agreement with Kaye regarding use of the property in Mathoura Road, Melbourne, and because the newsletter still served the purpose reasonably well. ⁴ By the mid-1960s, however, the newsletter was becoming increasingly unsuitable while, on the other hand and especially towards the end of the decade, conditions became more favourable for the journal proposal to be revisited.

The practice based at 86 Elizabeth Bay Road, Sydney, founded by Harry Daly, was one very important factor. Stuart Marshall and James McCulloch, instigators of the failed attempt in 1954, were both practice members, as was Ben Barry. Barry and a number of other important characters in the journal’s history, including Brian Horan, the second chief editor of the journal, were encouraged into careers in anaesthesia by another prime motivator, Brian Dwyer. ⁶ Dwyer recognised the importance of the ‘fringes of anaesthesia’: care of the critically ill (or intensive care), pain relief, education and administration. ⁷ He founded some of the earliest departments for these specialties in Australia. As the director of the department at St Vincent’s Hospital in Sydney, he further encouraged his protégés towards involvement with the Society and ultimately the Journal.^4,6–8 By 1969 Barry was federal secretary of the Society, which then with his influence found both a home and secretariat at the Elizabeth Bay Road practice. With the membership having grown from approximately 200 in 1954 to 800 in 1970, the financial liability concerns were substantially reduced. ⁵

In September 1970 Barry convinced the executive to support a motion that ‘This society supports in principle the establishment of an Australian Journal of Anaesthesia’. The motion, moved by Dwyer and Maurice Sando at the subsequent AGM in Canberra, was carried. ⁴ Sando, Director of Anaesthesia at Royal Adelaide Hospital and with a very strong interest in intensive care, is also credited by Kester Brown with suggesting the Journal’s chosen name. ⁹ Over the following year Barry was appointed the first Editor and a committee was established to progress the establishment of the Journal, ultimately evolving into the first editorial board. Along with Barry, the members of the board included Noel Cass (who remained a board member for 43 years), Kester Brown (for 23 years), Graham Fisk, Allan Bond, Tess Brophy (later Cramond), Brian Dwyer, Millar Forbes, G.A. Don Harrison, Douglas Joseph, Jim Loughman, John Mainland and Maurice Sando;^4,9 many ‘household’ names for their extraordinary contributions to and leadership in the clinical and academic spheres of anaesthesia, pain and intensive care medicine, both in our region and the wider world. The active contemporaneous involvement of several members in the Faculty of Anaesthetists, Royal Australian College of Surgeons (FARACS), also helped achieve the support of both the Faculty and the College for the foundation of the Journal.

Volume 1, issue 1 was ultimately published in August of 1972, with an introductory editorial by Ben Barry, forewords by W.D. Refshauge, Director General of Health, Commonwealth of Australia, and M.C. Newland, President, Australian Society of Anaesthetists, as well as commendations by Kevin McCaul, Dean, FARACS, and John Loewenthal, President, RACS. It contained a note in the front matter: ‘annual subscription (non-members) $A12.00, payable in advance. … All enquiries regarding subscriptions should be directed to the editor’. The current Editor is very pleased subscription arrangements have since changed!

A great deal of water has passed under the bridge since 1972. After 47 years we have reached a point where we need to embark on a new and exciting chapter in the Journal’s history, in partnership with SAGE. The reasons for this undertaking, along with some of the events of the intervening years, will be considered in the next issue of the journal.