The Evolution of Anaesthesia in the British Isles

  • Cedric Prys-Roberts


In 1800, Davy suggested that nitrous oxide might be used to relieve pain during surgery, but no one acted on his suggestion. Morton’s 16 Oct 1846 discovery led to ether anaesthesia in Scotland and London on 19 Dec 1846. Liston proclaimed “This Yankee dodge beats mesmerism hollow”. Simpson discovered and popularized chloroform anaesthesia in 1847. In the late 1840s, Snow developed an anaesthetic vaporiser and correlated anaesthetic dose and effect. In 1904, the General Medical Council (GMC), added anaesthetics as the 16th subject that every medical course and examination should contain.The British Journal of Anaesthesia, andAnaesthesia began publishing in 1923 and 1946, respectively. Magill helped found the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in 1932, and in 1935, the Anaesthetic Section of the Royal Society of Medicine awarded the Diploma in Anaesthesia. Lord Nuffield underwrote the Nuffield Department of Anaesthetics (NDA) at Oxford in 1937. Universities at Bristol (1946), Newcastle-upon-Tyne (1949), Cardiff (Welsh National School of Medicine; 1952) and Liverpool (1959) created Departments of Anaesthesia. In 1948, the Royal College of Surgeons established a Faculty of Anaesthetists, soon to introduce a Fellowship by examination (FFARCS). Parallel developments led to the Irish Faculty of Anaesthetists in 1959. Between 1960 and 1971, 15 new university departments headed by chairs of anaesthesia emerged in the UK.


History of anesthesia in the British Isles Evolution of anesthesia in the British Isles Development of anesthesia in the British Isles History of anesthesia in England and Ireland Evolution of anesthesia in England and Ireland Development of anesthesia in England and Ireland 


  1. 1.
    Fulton JF. History of medical education. BMJ. 1953;ii:457–61.Google Scholar
  2. 2.
    Clark G. A history of the Royal College of Physicians vol 1. London: Royal College of Physicians; 1964.Google Scholar
  3. 3.
  4. 4.
  5. 5.
  6. 6.
    Davy H. Researches, chemical and philosophical; Chiefly Concerning Nitrous Oxide. London: J.Johnson; 1800. (also facsimile reproduction, Butterworths, London, 1972).Google Scholar
  7. 7.
    Smith WDA. A history of nitrous oxide and oxygen anaesthesia. Part II: Davy’s researches in relation to inhalation anaesthesia. Br J Anaesth. 1965;37:871–82.PubMedCrossRefGoogle Scholar
  8. 8.
    Smith WDA. A history of nitrous oxide and oxygen anaesthesia. Part IV: Hickman and the “introduction of certain gases into the lungs”. Br J Anaesth. 1966;38:58–72.PubMedCrossRefGoogle Scholar
  9. 9.
    Henry Hill Hickman by W.D.A. Smith.: A. Padfield, E. N. Armitage, F. E. Bennetts and P. M. E. Drury (editors). History of Anaesthesia Society, Sheffield, 2005.Google Scholar
  10. 10.
    Baillie TW. The first European trial of anaesthetic ether: the Dumfries Claim. Br J Anaesth. 1965;37:952–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Robinson J. A treatise on the inhalation of the vapour of ether. London: Webster; 1847. (Facsimile edition: Eastbourne, Baillière Tindall, 1983).Google Scholar
  12. 12.
    Rushman GB, Davies NJH, Atkinson RS. A short history of anaesthesia’the first 150 years. Oxford: Butterworth Heinemann; 1996. pp. 16, 26, 27, 96.Google Scholar
  13. 13.
    Shepard DAE. John Snow, anaesthetist to a queen and epidemiologist to a nation. A biography. Cornwall: York Point; 1995.Google Scholar
  14. 14.
    Snow J. On the inhalation of the vapour of ether in surgical operations. Reprinted in Br J Anaesth. 1953;25:53–67, 162–9, 253–67, 349–82.Google Scholar
  15. 15.
    Snow J. On chloroform and other anaesthetics. London: John Churchill; 1858.Google Scholar
  16. 16.
    Snow J. On the mode of communication of cholera. 2nd ed. London: John Churchill; 1855.Google Scholar
  17. 17.
    Silk JFW. Anaesthetics a necessary part of the curriculum. Lancet. 1892:1178–80.Google Scholar
  18. 18.
    Buxton DW. Anesthetics: their uses and administration. London: HK Lewis; 1888.Google Scholar
  19. 19.
    Buxton DW. On the advisability of the inclusion of the study of anaesthetics as compulsory subject in the medical curriculum. BMJ. 1901; i:1007–9.Google Scholar
  20. 20.
    Prys-Roberts C, Cooper GM, Hutton P. Anaesthesia in the undergraduate curriculum. Br J Anaesth. 1988;60:355–7.Google Scholar
  21. 21.
    Barker AE. A report on clinical experiences with spinal analgesia in 100 cases. BMJ. 1907;i:665–74.Google Scholar
  22. 22.
    Beinart J. A history of the Nuffield Department of Anaesthetics, Oxford 1937–1987. Oxford: Oxford University Press; 1987. pp. 24, 30, 35, 51, 52–4.Google Scholar
  23. 23.
    Buzzard EF. ‘And the Future’. BMJ. 1936;ii:163–6.Google Scholar
  24. 24.
    Epstein HG, Macintosh R. An anaesthetic inhaler with automatic thermocompensation. Anaesthesia. 1956;11:83–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Godber G. ‘The Domesday Book of British hospitals’. Bull Soc Hist Med. 1983;32:4–13.Google Scholar
  26. 26.
    Gray TC, Rees GJ. The role of apnoea in anaesthesia for major surgery BMJ. 1952;ii:891–2.Google Scholar
  27. 27.
    Shafer SL. From d-tubocurarine to sugammadex: the contribution of T. Cecil Gray to modern anaesthetic practice. Br J Anaesth. 2011;107:97–102.PubMedCrossRefGoogle Scholar
  28. 28.
    Gillies J. Anaesthesia for the surgical treatment of hypertension. Proc Roy Soc Med. 1949;42:295–8.PubMedGoogle Scholar
  29. 29.
    Enderby GEH. Historical review of the practice of deliberate hypotension, Hypotensive anaesthesia. Enderby GEH, editor. London:Churchill Livingstone; 1985.Google Scholar
  30. 30.
    Goodenough W. Report of the Inter-departmental Committee on medical schools. London: HMSO; 1944.Google Scholar
  31. 31.
    Spens W. Report of inter-departmental committee on the remuneration of consultants and specialists. London: HMSO; 1948. (also BMJ 1948; i: 1146).Google Scholar
  32. 32.
    Nunn JF. The first meeting of the Anaesthetic Research Society. Br J Anaesth. 1988;61:639–41.PubMedCrossRefGoogle Scholar
  33. 33.
    Suckling CW. Some chemical and physical factors in the development of fluothane. Br J Anaesth. 1957;29:466–72.PubMedCrossRefGoogle Scholar
  34. 34.
    Raventós J. The action of fluothane; a new volatile anaesthetic. Br J Pharmacol. 1956;11:394–410.Google Scholar
  35. 35.
    Bryce-Smith R, O’Brien HD. Fluothane: a non-explosive volatile anaesthetic agent. BMJ. 1956;ii:969–72.Google Scholar
  36. 36.
    Johnstone M. The human cardiovascular response to fluothane anaesthesia. Br J Anaesth. 1956;28:392–410.PubMedCrossRefGoogle Scholar
  37. 37.
    Prys-Roberts C, Gersh BJ, Baker AB, Reuben SR. The effects of halothane on the interaction between myocardial contractility, aortic impedance and left ventricular performance. I. Theoretical consideration and results. Br J Anaesth. 1972;44:634–49.Google Scholar
  38. 38.
    Prys-Roberts C, Lloyd JW, Fisher A, Kerr JH, Patterson TJS. Deliberate profound hypotension induced with halothane: studies of haemodynamics and pulmonary gas exchange. Br J Anaesth. 1974;46:105–16.Google Scholar
  39. 39.
    Tunstall ME. Obstetric analgesia. The use of a fixed nitrous oxide and oxygen mixture from one cylinder. Lancet. 1961;2:964. (single page article).Google Scholar
  40. 40.
    Edmonds-Seal J, Prys-Roberts C. The pharmacology of drugs used in neuroleptanalgesia. Br J Anaesth. 1970;42:207–16.PubMedCrossRefGoogle Scholar
  41. 41.
    Sear JW, Prys-Roberts C. Plasma concentrations of alphaxolone during continuous infusion of Althesin. Br J Anaesth. 1979;51:861–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Sear JW, Prys-Roberts C. Dose-related haemodynamic effects of continuous infusions of Althesin in man. Br J Anaesth. 1979;51:867–73.PubMedCrossRefGoogle Scholar
  43. 43.
    Watkins J, Appleyard TN, Thornton JA. Immune mediated reactions to Althesin (alphaxolone). Br J Anaesth. 1976;48:881–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Aveling W, Sear JW, Fitch W, Chang H, Waters A, Cooper GM, Simpson P, Savege TM, Prys-Roberts C, Campbell D. Early clinical evaluation of minaxolone; a new intravenous steroid anaesthetic agent. Lancet. 1979;ii:71–3.Google Scholar
  45. 45.
    Glen JB. Animal pharmacology of ICI 35,868, a new i.v. anaesthetics agent. Br J Anaesth. 1980;52:230P. (single page article).Google Scholar
  46. 46.
    Glen JB, Davies GE, Thomson DS et al. An animal model for the investigation of adverse responses to I.V. anaesthetic agents and their solvents. Br J Anaesth. 1979;51:819–27.PubMedCrossRefGoogle Scholar
  47. 47.
    Glen JB, Hunter SC. Pharmacology of an emulsion formulation of ICI 35,868. Br J Anaesth. 1984;56:617–26.PubMedCrossRefGoogle Scholar
  48. 48.
    Baird WLM, Reid AM. The neuromuscular blocking properties of a new steroid compound, pancuronium bromide. Br J Anaesth. 1967;39:775–80.PubMedCrossRefGoogle Scholar
  49. 49.
    Hughes R, Chappell DJ. The pharmacology of atracurium: a new competitive neuromuscular blocking agent. Br J Anaesth. 1981;53:31–44.PubMedCrossRefGoogle Scholar
  50. 50.
    Payne JP, Hughes R. Evaluation of atracurium in anaesthetized man. Br J Anaesth. 1981;53:45–54.PubMedCrossRefGoogle Scholar
  51. 51.
    Brain AIJ. The laryngeal mask’a new concept in airway management. Br J Anaesth. 1983;55:801–5.PubMedCrossRefGoogle Scholar
  52. 52.
    Baskett PJF, Parr MJA, Nolan JP. The intubating laryngeal mask. Results of a multicentre trial with experience of 500 cases. Anaesthesia. 1998;53:1174–9.PubMedCrossRefGoogle Scholar
  53. 53.
    Lunn JN, Mushin WW. Mortality associated with anaesthesia. Oxford: Nuffield Provincial Hospitals Trust; 1982.Google Scholar
  54. 54.
    Buck N, Devlin HB, Lunn JN. The report of a confidential enquiry into perioperative deaths. London: The Nuffield Provincial Hospitals Trust and Kings Fund; 1987.Google Scholar
  55. 55.
    Cooper GM. Editorial II. Confidential enquiries into anaesthetic deaths. Br J Anaesth. 2007;99:606–8.PubMedCrossRefGoogle Scholar
  56. 56.
    National Confidential Enquiry into Patient Outcome and Death. Knowing the Risk: a Review of the Perioperative Care of Surgical Patients. London, NCEPOD, 2011.Google Scholar
  57. 57.
    Wong DJN, Wickham AJ. The UK needs more critical care investment in order to improve peri-operative outcomes. Anaesthesia. 2012;67:541.PubMedCrossRefGoogle Scholar
  58. 58.
    Goldhill DR, Waldmann CS, Soni N. ‘The future ain’t what it used to be’’reflections on the future of anaesthesia. Anaesthesia. 2012;67:470–3.PubMedCrossRefGoogle Scholar
  59. 59.
    Jarratt A. Report of the steering committee for efficiency studies. London: CVCP; 1985.Google Scholar
  60. 60.
    McNay I. From the collegial academy to corporate enterprise: the changing cultures of universities, The Changing University. Schuller T, editor. Buckingham:Open University Press; 1995.Google Scholar
  61. 61.
    Tapper T, Palfreyman D: Oxford and the Decline of the Collegiate Tradition. London: Woburn; 2000.Google Scholar
  62. 62.
    Randle K, Brady N. Managerialism and professionalism in the ‘Cinderella Service’. J Vocat Edu Train. 1997;49:121–39.Google Scholar
  63. 63.
    Nightingale P. Development of the faculty of intensive care medicine. Br J Anaesth. 2011;107:5–7.PubMedCrossRefGoogle Scholar
  64. 64.
  65. 65.
  66. 66.
    Temple J. Time for training. A review of the impact of the European working time directive on the quality of training. London: HMSO; 2010.Google Scholar
  67. 67.
    Paul RG, Bunker N, Fauvel NJ, Cox M. The effect of the European working time directive on anaesthetic working patterns and training. Anaesthesia. 2012;67:951–6.PubMedCrossRefGoogle Scholar
  68. 68.
    Nunn JF. Development of academic anaesthesia in the UK up to the end of 1998. Br J Anaesth. 1999;83:916–32.Google Scholar
  69. 69.
  70. 70.
  71. 71.
  72. 72. Scholar
  73. 73. Scholar
  74. 74.
    Academy of Medical Sciences. Clinical academic medicine in jeopardy: recommendations for change. London: Academy of Medical Sciences; 2002.Google Scholar
  75. 75.
    Pandit JJ. A national strategy for academic anaesthesia. London: Royal College of Anaesthetists; 2005.Google Scholar
  76. 76. Scholar
  77. 77.
    Feneck RO, Natarajan N, Sebastian R, Naughton C. Decline in research publications from the United Kingdom in anaesthesia journals from 1997 to 2006. Anaesthesia. 2008;63:270–5.PubMedCrossRefGoogle Scholar
  78. 78.
    Moppett IK, Hardman JG. Bibliometrics of anaesthesia researchers in the UK. Br J Anaesth. 2011;107:351–6.PubMedCrossRefGoogle Scholar

Copyright information

© Edmond I Eger, MD 2014

Authors and Affiliations

  1. 1.Past President, Royal College of AnaesthetistsEmeritus Professor, University of BristolCleeve, BristolUK

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