Abstract
In September 1847, David John Thomas read a paper on etherisation at a monthly meeting of the Port Phillip Medical Association. Thomas’ paper is the earliest known presentation of a paper on etherisation in the Australian colonies. Almost half of Thomas’ 27-page manuscript was published in October 1847 in the Australian Medical Journal. The original manuscript was acquired at an unknown date by the Medical Society of Victoria. Although a full transcript of the manuscript was published in 1933, the original manuscript of Dr Thomas remained unknown to anaesthesia historians and is now held by the Medical History Museum, University of Melbourne.
Keywords
Melbourne surgeon David John Thomas (1813–1871) performed the first operation under ether in the Port Phillip District of New South Wales. Thomas’ patient James Egan had injured his left hand and forearm in a shooting accident five or six days before he arrived in Melbourne for treatment. Egan’s forearm was amputated on 2 August 1847. One month after the operation, Egan left Melbourne on horseback for his pastoral station ‘in good health and spirits’.1
On 7 September 1847, a few days after Egan had returned to his rural property, Thomas read a paper on etherisation at an ‘ordinary’ monthly meeting of the Port Phillip Medical Association.2 This is the earliest known, and quite likely the first, Australian paper on anaesthesia read before a medical society. There is no documentation of another comparable paper on etherisation in the Australian colonies in 1847. Earlier Australian reports of etherisation were typically brief case reports that were published in local newspapers and the Australian Medical Journal.
Nearly half of Dr Thomas’ manuscript was published in October 1847 in the Australian Medical Journal.3 Thereafter the earliest known citation of the extant manuscript was in January 1906.4 The manuscript was ‘rediscovered’ in 1931 and a full transcript was published in 1933.5,6
This article contains a brief account of the Port Phillip Medical Association, information regarding the monthly meeting of the association at which Thomas presented his paper on etherisation, and a discussion of the citations and provenance of the original manuscript. The title, Paper trails, alludes to the search for the original manuscript as well as its provenance and citations.
Port Phillip Medical Association
The Port Phillip Medical Association was established in May 1846 for ‘the promotion of Medical knowledge and a more free Professional intercourse’.2 It was active for five years, considerably longer than any association of doctors in the more established and larger towns in the Australian colonies.
Eleven of the 16 founder members attended the first meeting of the association at the Prince of Wales Hotel on 16 May 1846.2 Each member paid an annual subscription of two guineas to meet the ‘current expenses’ of the association and fund the formation of a medical library. Other objectives of the association were the introduction of a code of medical ethics, the reading of original papers on medical subjects and the formation of a medical museum. Members were expected to dine together twice a year in the months of January and July.
The first president of the association was Assistant Colonial Surgeon Patrick Cussen. He had been appointed 18 months earlier as the first president of the Port Phillip Medical Board.
The office-bearers of the Port Phillip Medical Association for 1846 were: President: Patrick Cussen (1792–1849) Vice-president: Godfrey Howitt (1800–1873) Secretary: David Elliot Wilkie (1815–1885) Treasurer: Thomas Black (d. 1894)
Thomas’ paper on etherisation
Thomas read his paper on etherisation on 7 September 1847 at the regular (‘ordinary’) monthly meeting of the Port Phillip Medical Association.2 The Australian colonies had received news of the discovery four months earlier, and it was three months to the day since the first trials of etherisation in Sydney and Launceston. Thomas could therefore have read overseas as well as Australian reports of etherisation. Moreover, he could reflect in his paper on his five-week experience in administering ether. His talk reveals a carefully considered approach to the new practice of producing insensibility for surgical operations—although it was nearly a year since the first public demonstration of etherisation in Boston, Massachusetts, on 16 October 1846.
Thomas’ paper was documented in the minute book of the Port Phillip Medical Association.2 Only five doctors, including Thomas, were listed as present at the September 1847 meeting. Thomas read his paper on etherisation and exhibited the ether inhaler that was made for him in Melbourne. He was commended ‘for the zeal and industry displayed by him in the paper’ and advised to submit the paper for publication in the Australian Medical Journal. A transcription of the minute book was published in 2013 by AMA Victoria.2
The minutes of the September 1847 meeting of the Port Phillip Medical Association: Tuesday Evening 7th September The ordinary monthly meeting of the Association was held in Dr Wilkie’s house at 7. P.M. Present Dr Cussen Dr Black Mr Thomas Mr Greeves Dr Wilkie The Minutes of [the] last meeting having been read Mr Thomas read a very interesting paper on the inhalation of Ether[.] He also exhibited an inhaler which he had with considerable trouble got constructed in Melbourne according to the most improved principles[.] Mr Thomas also read some highly interesting cases in which he had used the Ether with success. The different members present complimented Mr Thomas for the zeal & industry displayed by him in the paper he had just read and expressed an opinion that it was desirable that the paper should be printed in the Australian Medical Journal[.] P. Cussen, M.D. President
‘On the inhalation of the vapour of Æther, with cases.’ Handwritten manuscript of a paper delivered by David J Thomas on 7 September 1847 at a meeting of the Port Phillip Medical Association, Melbourne. Original document in the Medical History Museum, University of Melbourne: accession number MHMA1137.1 (gift of AMA Victoria).
Covering letter, dated 17 September 1847, from David J Thomas to Isaac Aaron, editor of the Australian Medical Journal. Original document in the Medical History Museum, University of Melbourne: accession number MHMA1137.1 (gift of AMA Victoria).
Isaac Aaron (1804–1877), editor of the Australian Medical Journal, published a transcript of the first 12 pages and part of the 13th page of the manuscript in the October 1847 issue of the Australian Medical Journal.3 Aaron may have intended to publish Thomas’ manuscript in two or three parts but the journal ceased publication after the October 1847 issue. The only known copies of this series of the Australian Medical Journal (Sydney, NSW: August 1846 to October 1847) are two incomplete sets held by the Mitchell Library of the State Library of New South Wales (call numbers Q610.5/1 and Q610.5/A) that together comprise 14 of the 15 issues that were published. The missing issue is volume 1, no. 10 of May 1847 (the contents of this issue were published in The Sydney Morning Herald, 29 April 1847, p. 1). This series of the Australian Medical Journal can now be viewed online at the National Library of Australia (http://nla.gov.au/nla.obj-732251946).
History of the manuscript of Dr Thomas
Isaac Aaron may have returned the original manuscript to Thomas because it had been partially published in the October 1847 issue of the Australian Medical Journal.3 No documentation of the manuscript in the next six decades has been found. The earliest known citation of Thomas’ manuscript is in the first decade of the twentieth century, when the manuscript was in the Museum of the Medical Society of Victoria (the Medical Society of Victoria was formed in 1855 by the merger of the Victoria Medical Association and the Medico-Chirurgical Society of Victoria). Thomas was elected vice-president of the Medical Society of Victoria in 1863. A year later he was elected as the society’s president. The author could not ascertain whether Thomas donated his manuscript to the museum of the society or whether the manuscript was acquired by the society following the death of Thomas in 1871.
Of the 12 citations of the Thomas manuscript that were identified (Table 1),4–15 only two were made by Australian anaesthetists (E Gandevia, 19538 and G Wilson, 1995).15 Six authors were under the erroneous impression that the Thomas manuscript was not published in 1847.6–9,12,14 According to biographer David O’Sullivan, Thomas’ paper ‘was prepared for publication in the Australian Medical Journal, but it was not printed until 1934 [sic], for this journal ceased to be only six months after its inception in 1846’.9
Citations of the Thomas manuscript.
The earliest known reference to the extant manuscript of Dr Thomas is a statement made in January 1906 by Dr A. Jeffreys Wood (1861–1937) in his presidential address at the annual meeting of the Medical Society of Victoria. A transcript of the talk was published later that month in the Intercolonial Medical Journal of Australasia,4 and reproduced in the February 1906 issue of The Australasian Medical Gazette. Wood observed that the society had completed its jubilee year during his year as president and he used his address to recount the history of some of the medical societies of Victoria. With regard to the meetings of the Port Phillip Medical Association, Wood stated that the ‘first paper of any importance read before this Association was one read by Dr. D. J. Thomas. The manuscript of this paper is in the possession of the Society, and should be carefully preserved, dealing, as it does, with the introduction of ether as a general anæsthetic into Melbourne.’4
The manuscript was ‘rediscovered’ in 1931 by George Thomas Howard (1857–1934), most likely while he and a group of doctors appointed by the Victorian Branch of the British Medical Association were conducting research on the early history of the medical profession in Victoria. According to a handwritten note made by Howard, the manuscript was ‘rediscovered’ on 21 April 1931 (Figure 3). Howard did not state where the discovery was made. Two years later, Howard wrote a newspaper article in which he described the manuscript as ‘recently unexpectedly rediscovered’ and again omitted information on the discovery and location of the manuscript.5
Dr GT Howard’s inscription on the manuscript of Dr Thomas. Original document in the Medical History Museum, University of Melbourne: accession number MHMA1137.1 (gift of AMA Victoria).
In December 1933, a complete transcript was published in The Melbourne Hospital Clinical Reports; the introductory comments, which might have been written by the journal’s editor, do not reveal where the manuscript was found or who was responsible for transcribing the manuscript.6
In 1938, three photographs of the handwritten manuscript were published in an article entitled ‘Anæsthetics in Australia in the early days’.7 The author WL Potter believed that the manuscript had not been published in 1847: ‘It appears that Dr. Thomas’s paper was never printed because the Australian Medical Journal ceased publication during the month following its reading’. Potter cited the original manuscript as ‘D. J. Thomas: Unpublished paper read before the Port Phillip Medical Association on September 7, 1847, the manuscript of which is held by the Victorian Branch of the British Medical Association’.7
The first anaesthetist known to have remarked on the Thomas manuscript was Eric Gandevia (1891–1958). In April 1953, Gandevia, who was the retiring president of the Australian Society of Anaesthetists, read a paper entitled ‘Observations upon the early days of anæsthesia in Australia’ at the society’s annual meeting in Adelaide, South Australia.8 Gandevia began his talk by observing that ‘Very little has been published on the history of anæsthesia in this country, and none of it, to my knowledge, has been written by an anæsthetist’.8 Later in the talk, he made brief remarks on Dr Thomas and his paper on etherisation: ‘He was Dr. D. J. Thomas, who on August 2, 1847, performed the first surgical operation under ether at Port Phillip. He also had the distinction of reading the first scientific paper before a medical society in Victoria, the title being “On the Inhalation of the Vapour of Æther, with Cases”. This paper was rediscovered by Dr. G. T. Howard. The Australian Medical Journal became extinct before the paper was published, but the manuscript is in the library of the British Medical Association in Melbourne and was reprinted in full in the Royal Melbourne Hospital Clinical Reports in 1933.’8
David M O’Sullivan, author of the most detailed biography of Thomas, wrote that Thomas’ paper had not been published in 1847.9 Although O’Sullivan was clearly aware of the transcript published in 1933, he does not comment on the location of the original manuscript, which he almost certainly would have seen during his research for the biography of Thomas.
In 1957, respiratory physician and medical historian Bryan Gandevia (1925–2006; son of Dr Eric Gandevia), reported that ‘Thomas read one of the first scientific papers to be presented in Victoria to the recently formed Port Phillip Medical Association, and the manuscript of this is still extant (“On the Inhalation of the Vapour of Æther, with Cases”).’10
The Thomas manuscript was cited in 1962 by Ann Tovell and Bryan Gandevia in an article entitled ‘Early Australian Medical Associations’.11 In the discussion of the Port Phillip Medical Association, Tovell and Gandevia wrote that ‘members who attended the meeting in September, 1847, heard D. J. Thomas read his paper on the first use of ether in the colony; the manuscript is preserved in the Museum of the Medical Society of Victoria.’11
Bryan Gandevia remarked again on the Thomas manuscript in 1967. In a biography of Thomas for the Australian Dictionary of Biography, Gandevia wrote, ‘The manuscript of this paper, the third presented to the association, was prepared for publication in the Australian Medical Journal, but as this journal became defunct it remained unpublished until 1934 [sic] when the manuscript was brought to light.’12
Sir Edward Ford, in an article published in 1972 on early Australian medical publications, noted that the original manuscript was ‘in the Library of the Australian Medical Association in Melbourne’.13 (The Australian Medical Association was established as a federal entity in 1962 by the state branches of the British Medical Association. The Victorian Branch of the British Medical Association became known as the Victorian Branch of the Australian Medical Association and is now known as AMA Victoria.) According to Ford, the manuscript was ‘printed in full in the Royal Melbourne Hospital Clinical Reports [sic] by the editor Dr. S. O. Cowen’.13
In 1993, J Lewis, in a presentation at a meeting of the History of Anaesthesia Society at Llangollen, Wales, stated that the Thomas manuscript was ‘prepared for publication in the Australian Medical Journal, but was not printed until 1933 … for the journal ceased to be only six months after its inception in 1846. The paper was rediscovered by Dr Howard, Consultant Physician to the Melbourne Hospital in 1933.’14
Anaesthetist and historian Gwen Wilson (1916–1998), in One Grand Chain: The History of Anaesthesia in Australia, reported that the manuscript of Dr Thomas was discovered in 1933 at the Royal Melbourne Hospital.15 In fact, the hospital would only be renamed The Royal Melbourne Hospital in 1935. Wilson might have been misled by the date of publication of the full transcript (1933) and the name of the journal in which the transcript was published (The Melbourne Hospital Clinical Reports). Wilson, who quoted the case report of Mr Egan from the published transcript, did not divulge whether she had examined or searched for this historically significant manuscript.
Wilson, however, did not mention the extant Thomas manuscript in two earlier publications.16,17 In 1972, citing O’Sullivan, Wilson stated that Thomas’ paper was not published in 1847—Wilson’s article on the history of anaesthesia in Australia had the distinction of being published as the first article in the inaugural issue of Anaesthesia and Intensive Care.16 Wilson was then the honorary historian of the Faculty of Anaesthetists, Royal Australasian College of Surgeons. By 1987, Wilson was able to report that Thomas’ ‘remarkable’ paper was indeed published in October 1847 in the final issue of the Australian Medical Journal, although she did not remark on an extant manuscript.17
The author commenced a search for the original handwritten manuscript in April 2017. After establishing that the manuscript was not held by the Australian and New Zealand College of Anaesthetists, Melbourne, other possible locations were considered. The information received from AMA Victoria was that the historical archive of AMA Victoria had been transferred on loan to the University of Melbourne in 1994 (the archive was donated to the Medical History Museum, University of Melbourne, in 2011). Fortunately, each page of the original manuscript had been photographed in the 1930s. The author received scanned images of photographs of the manuscript, but the librarians at the Brownless Biomedical Library were not aware of the location of the original manuscript. In July 2019, the author received additional information regarding the manuscript. It had been exhibited in the Medical History Museum from October 2014 to February 2015 (‘Boisterous Beginnings: Doctors in the Port Phillip District’). Thereafter, it had been stored separately from the AMA Victoria archive. The author first examined the original manuscript (accession number MHMA1137.1) on 30 July 2019 at the Brownless Biomedical Library, University of Melbourne.
Conclusion
Dr David John Thomas read a paper on etherisation at the September 1847 meeting of the Port Phillip Medical Association.2 Thomas’ paper was submitted to the Australian Medical Journal and nearly half of the manuscript was published in October 1847.3 The original handwritten manuscript was acquired at an unknown date by the Medical Society of Victoria. It was cited in 1906 by A Jeffreys Wood, retiring president of the Medical Society of Victoria.4 The manuscript was ‘rediscovered’ in 1931 and a transcript of the manuscript was published 1933.6 The manuscript is now held by the Medical History Museum, the University of Melbourne. The author will be publishing a monograph, Paper Trails: History and Transcript of the First Australian Paper on Ether Anaesthesia, which will include an annotated transcript of the manuscript of Dr Thomas.
Footnotes
Acknowledgements
The author(s) would like to acknowledge the assistance provided by librarians and curators of the Brownless Biomedical Library and Medical History Museum at the University of Melbourne, the State Library of Victoria, the State Library of New South Wales, the Fisher Library at the University of Sydney, the Richard Bailey Library at the Australian Society of Anaesthetists, and the History of Medicine Library at the Royal Australasian College of Physicians.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
