Anesthesiology:
doi: 10.1097/ALN.0b013e31823c9d8f
Correspondence

In Reply

Riegels, Nicholas M.D.; Richards, Michael J. B.M., F.R.C.A.*

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Haridas rejects our assertion1 that Humphry Davy might be considered the first anesthesiologist. Curiously, Haridas avoids any mention of Davy's groundbreaking experimental results, not only as they pertain to nitrous oxide, but also in the realm of respiratory physiology. He instead mounts an ad hominem attack on Davy for his youth and recklessness. If youth truly deserves our censure in connection with scientific discovery, then Haridas must broaden his denouncement. With respect to self-experimentation, undertaken, as Haridas observes, at considerable peril, Davy would doubtless hold himself guilty as charged; to Davy, science was exploration, and incidental threats to his personal safety were of little consequence. In this regard, we may perhaps compare Davy's experiments to those of August Bier and August Hildebrant in spinal anesthesia,2 or of William Halstead in local anesthesia.3 Halstead, as a consequence of his studies, struggled with and ultimately overcame cocaine addiction,4 and Haridas, in turn, invites us to speculate whether Davy may have been addicted to nitrous oxide. Although Davy's pattern of daily nitrous oxide use during his time at the Bristol Pneumatic Institute suggests, at a minimum, a maladaptive pattern of behavior, there is no indication either from Davy's exhaustive notes, or from the many accounts of friends and colleagues, that Davy would have met modern criteria for substance dependence. There is, furthermore, no record of Davy having consumed nitrous oxide following his tenure in Bristol. Inexplicably, Haridas equates Davy's work with nitrous oxide to Charles Thomas Jackson's claims of priority with ether anesthesia, before abruptly conceding that Jackson never published experimental results pertaining to the anesthetic properties of ether.5
Haridas' critique ultimately appears to crystallize into one of pragmatism: Davy, he asserts, was a failure because he did not put nitrous oxide into practical use as an anesthetic. Haridas asks us to believe that Davy's body of work at the Pneumatic Institute has no intrinsic value: No matter that Davy conducted and published an unprecedented series of experiments on nitrous oxide and other inhaled gases, he did not “follow up.” Haridas will have us stop there, but many, ourselves included, will continue to wonder why not only Davy, but also the innumerable readers of his work, did not follow up, or why not even Horace Wells' failed attempt to demonstrate nitrous oxide anesthesia did not provoke greater interest in the technique. Science does not exist in a vacuum, nor do its results always succeed, in the near term, on their merits; rather it is, and always has been, vulnerable to cultural context and a socially determined sense of possibility. Haridas chooses to evaluate Davy's work on strictly utilitarian grounds and concludes that it was a failure on this basis, in that it did not lead directly to the development of nitrous oxide anesthesia. We instead see in Davy's experiments the first systematic approach to the evaluation of several gases of immense practical significance to anesthesiology; it is this approach which, to our minds, defines the first practice of anesthesiology as a science, whereby we call Davy the first anesthesiologist.
Nicholas Riegels, M.D., Michael J. Richards, B.M., F.R.C.A.* *University of Washington and Seattle Children's Hospital, Seattle, Washington. michael.richards@seattlechildrens.org
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References

1. Riegels N, Richards MJ: Humphry Davy: His life, works, and contribution to anesthesiology. ANESTHESIOLOGY 2011; 114:1282–8

2. Bier A: Versuche uber Cocainisirung des Ruckenmarkes. (Experiments on the cocainization of the spinal cord) Deutsche Zeitschrift fur Chirurgie 1899; 51:361–9

3. Halstead WS: Practical comments on the use and abuse of cocaine, suggested by its invariably successful employment in more than a thousand minor surgical operations. NY State J Med 1885; 42:294–5

4. MacCallum WG: William Stewart Halsted, Surgeon. Baltimore: The Johns Hopkins Press; 1930

5. Fenster J: Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. New York: Harper Collins; 2001

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