Morphine to methadone,and beyond

In August 1972, the Australian Society of Anaesthetists published the first issue of its new journal, Anaesthesia and Intensive Care. The somewhat fraught history of how this eventually came about, nearly 40 years after the foundation of the Society, has been discussed in detail elsewhere. ¹ But come about it did, and with considerable success, thanks in large part to the efforts of the first Editor-in-Chief, Benedict (Ben) Barry. ² It was the suggestion of Maurice Sando, a founding Editorial Board member, that won the vote for the new journal’s title. ³ The journal would also need a cover design, however, and this was also given much consideration by the committee entrusted with the responsibility of bringing the journal into being. ⁴ David Gibb, a colleague of Ben Barry at St Vincent’s Hospital in Sydney and later to become an Editorial Board member himself, asked his friend, artist and author Bill Bottomley, to draft some samples with relevance to anaesthesia, one of which was selected for the cover (Figure 1). ⁴

Figure 1.

The original cover design of Anaesthesia and Intensive Care.

The chosen design features a stylised representation of morphine, the phenanthrene core of which is seen in white, on a green background and surrounded by black dots. The black of the dots represents pain, the contrasting white representing relief from that pain, with anaesthesia depicted by the green background. ⁴ For this Editor, in the research for this editorial, the discovery of these layers of significance in the original cover design is a new revelation, and there is little wonder the first Editor and his committee found the very meaningful design highly suitable for the cover of the Society’s journal.

The cover evolved when the Editorial Board eventually decided to replace that design initially with paintings, engravings and photographs of a colonial nature accompanied by descriptions provided by Gwen Wilson. ⁵ In 1984, the 50th anniversary of the foundation of the Society, Dr Wilson was instead asked to write a cover note to accompany a photo of its first President, Gilbert Brown. This was the first of the Historical Cover Notes, a unique and ongoing feature of Anaesthesia and Intensive Care, and we are grateful to Rod Westhorpe, Chris Ball and Peter Featherstone for continuing the contributions Gwen Wilson started. ⁶

Barry envisaged the journal would include a yearly ‘educational number’ (symposium or themed issue) ⁷ and the first of these (Volume 1, No. 6, 1973) was on the theme of paediatric anaesthesia. Those educational numbers have not been a consistent feature of the journal, particularly in the later years, but with this special issue we continue Barry’s vision.

The cover may also have changed in many ways over the years, but the green background continues to this day and with the title in white we have still, perhaps without some of us even realising, retained Bottomley’s original colour representations of anaesthesia along with pain relief from morphine, the archetypical opioid receptor agonist.

It is, therefore, particularly fitting that this special issue, the milestone first issue of Volume 50 of Anaesthesia and Intensive Care, be an ‘educational number’ devoted to opioids. The issue has been ably coordinated and edited by Meredith Craigie to whom, along with all the contributing authors, reviewers and editors, we owe many thanks.

In the nearly 50 years of Anaesthesia and Intensive Care, Journal of the Australian Society of Anaesthetists, the covers have made their way from morphine to methadone, with so, so much in between and, hopefully, with so much more to come.