The PioneersThe MilitaryReferences


The Modernisers

Dr August Karl Gustav Bier (1861–1949)

In 1897 the German surgeon, Dr August Bier administered the first spinal anaesthetic. 
August Bier subjected himself to a clinical experiment in which he observed the anaesthetic effect of a spinal; He had the local injected into himself so he could experience its anaesthetic effect.
August Bier is known as the father the spinal anaesthesia and intravenous regional neural blockade. He was however a surgeon although described as unorthodox. It took him only two years to become a senior lecturer in surgery his mentor being the surgeon Friedrich von Esmarch. (Of Esmarch bandage fame)
Bier had a tremendous impact on surgery and anaesthesia. He was the co-author of a surgical textbook,
Chirurgische Operationslehre (Operative Surgery).

He was also responsible for the invention the M1916 army helmet used by the Germans during the First World War, this familiar shaped helmet was the design the Germans kept and gave them the nickname "square heads"
In 1908, he pioneered the use of intravenous procaine analgesia. The term
“Biers Block” is commonly used by some anaesthetists when they perform a regional block on a limb. The substance used nowadays would be Prilocaine, however, this particular block is not very widespread in today’s hospitals.
Bier was renowned for his humorous comments such as

"A professor is a gentleman with a different point of view.”



Treves and Rampley

In 1879 Mr. Frederick Treves (who eventually received G.C.V.O., C.B., Serjeant-Surgeon to His Majesty the King)
was appointed Assistant Surgeon. Always there with him was the "Grand Old Man of the London Hospital" Josiah Rampley.

Rampleys Instrument is still widely used world wide. In 1902 New Operating Theatre Floor and five Theatres built at cost of 13,000 pounds.

His Majesty King Edward VII.'s appendix was removed just before the day fixed for the Coronation. This was only made possible by Lord Listers advise and the statement by Treves after the King had said he would be crowned in his present condition and Treves replied "Then sire you will go as a corpse"
Sir Frederick Treves operated and a Dr. Frederick Hewitt gave the anaesthetic.

History shows that the King survived and months later was crowned.

He was operated on with an anaesthetic, a different story as nearly 170 years earlier Queen Caroline who was the wife of King George II, died as a result of a strangulated umbilical hernia, which is quite a common straightforward procedure today. She was however obese and there was no anaesthetic.


Leonard Corning

There are several writers who say that Leonard Corning performed the first spinal anaesthetic in 1885. It is said he was experimenting with the action of 2% cocaine solution between two inferior dorsal vertebrae of a dog, causing paralysis of the hindquarters, and hence inadvertently performed the first spinal anaesthetic.

It is disputed though as no CSF was seen, so most academics suggest he performed an epidural. What ever the dispute it is considered that Bier performed the first planned Spinal anaesthesia.



Quote 84


“Medical scientists are nice people, but you should not let them treat you.” 137



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