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1. -Dr Nisar Ahmed Arain
-Assistant Professor
-Anesthesia/Critical care/ER
-HISTORY OF
ANESTHESIA

2. -A-GENERAL ANESTHESIA
-ANESTHESIA HISTORY
-An ancient times (Pharos)-
--Imhotep (lived about 2600 BC)
--He was an ancient Egyptian priest, Officer, and builder who was credited as the architect
of the earliest of all Egyptian pyramids and the first Physician in the world
--He is considered to be “The Father of Medicine”, He diagnosed and treated over 200
diseases.
--Imhotep treated Tuberculosis, Gall stones, Appendicitis, Gout, Arthritis
--He also performed surgery and practiced Dentistry
--He would extract Medicines from Plants
--He also knew the position and function of vital organs and circulation of the blood system
He was familiar with the pulse
--The Encyclopedia Britannica says “The evidence offered by Egyptian and Greek texts
support the view That Imhotep's reputation was very respected in early times – His
prestige increased with the lapse of Centuries and his temples in Greek times were the
centers of medical teaching

3. -ANESTHESIA HISTORY contd.
--1-The ancient EGYPTIANS used the combination of opium poppy
(Morphine) and Hyoscyamus (Hyoscyamine and scopolamine) a
similar combination, Morphine and Scopolamine, is still used
parenterally for premedication
--2-Skull Trepanning was one of the first surgical procedures
performed in the ancient Egypt. It was performed on live patients
to relieve intracranial pressure and to treat Fractured skull
--B-REGIONAL ANESTHESIA
--In ancient times, it consisted of compression of nerve trunks
(Nerve Ischemia) or the Application of coldness (Cryo analgesia)

4. -HISTORY in
Greek and Roman
Medicine
--In 23 to 79 AD they used decoction of Mandrake in
alcohol
--The juice of Mandrake was administered in doses
proportional to the strength of patient
--The juice had Narcotic effect. It was given before
incisions or punctures were made in the body
to ensure insensibility of pain.
--By time, opium (of ancient Egypt) and Mandrake
(of Roman) fell Into the neglect of history

5. -ANESTHESIA PRACTICE IN ARABIC
ISLAMIC MEDICINE
---Arabic translations of the Greek Medicine help to make Islamic physicians supreme
in the middle ages.
--AL ZAWARI, IBNE-SINA, AL NAFEES, AVICINA, and AL KOFF were the most famous
surgeons in Arabic ages
--AL ZAHRAWI described many surgeries and pictured many surgical instruments,
which were recently Produced on Tunisia and held in a surgical museum
--In his writing AVICINA indicated that a patient who wanted to have an amputation of
one of his limbs Must have a drink prepared from a mixture of “MANDRAGORA and
other sleeping drugs.
--Both Mandrake plant and opium plant were written in many Arabic medical
manuscripts.
--IBNAL KOFF (1232 TO 1286 AD) wrote a complete chapter on Pain relief in his book
“AL- OMDAH FI- SINAAET AL JERAHA”
--He differentiated between true and non true pain relief considering non true pain
relief the “Anesthetic” Which the surgeon may use for treatment of pain, or to be
able to institute the surgical treatment

6. -ARABIC
ANESTHETISTS
PREPARING
TO USE THE
SOPORIFIC
SPONGE

7. -ARABIC
ANESTHETISTS
PREPARING
TO SUE THE
SOPORIFIC SPONGE
-The technique of use of “Soporific sponge” was purely Arabic
and was not known before. The “soporific sponge” was put
in the juice of Hashish, papaver, and Hyoscyamine, and then
dried under the sun. --When called upon for use, it was
humidified again, and placed at the patients nose; so that
the mucus membrane absorbs it (It is presumed to cause
deep sleep and relief of surgical pains)
--The discovery was introduced into Europe and was practiced
until the 18th century when modern inhalational anesthetics
were introduced in the 40s of the 19th century
--The Major books, which were followed in the medical and
surgical practice, were
-Avicenna's Al – Canon
-Al-Razi’s Al-Hawi
-Ali Ibn Al Abbas's Al-Kamel
-Al Zahrani's Al Tasreef and
-Ibn Al Koff”s Al Omdah fi Sinaaet Al Jareha

8. William Thomas Green Morton (Britisher)
--He used Diethyl Ether vapour to produce anesthesia for
excision of a neck tumor
--His details were published in 1846
John Snow (1813 to 1858) Britisher
--1-He is generally considered as a Father of Anesthesia
--2-He made an art of Anesthesia a science
--3-He was the first physician to be Full time Anesthetist
--4-He was interested in Ether
--5-He described the physiology of General anesthesia and
mentioned four stages of Anesthesia
--6-In 1847 he published his first book on General Anesthesia
on the inhalation of Ether
--7-In 1853 he acted as an Anesthetist at the birth of Queen
Victoria’s eighth child and again in 1857 by using chloroform
--8-In 1858 he published his second book on Chloroform and
other Anesthetics
-THE MODERN HISTORY

9. Joseph T Clover (1825 to 1882)
--He took Snow place after Snow’s Death
--He emphasized continuously on monitoring
the patients pulse during Anesthesia
---He was the First Physician to use the
“Jaw Thrust Maneuver” for the remedy of
airway obstruction and a cricothyroid
cannula for complete airway obstruction
--Sir Frederick Hewitt (1857 to 1916)
Britisher
--He had many inventions including the first
practical machine for giving “Nitrous Oxide
and Oxygen” in a fixed proportions (1887)
and the use of Oral airway (1908)
--He wrote the first True Text book of Anesthesia
in 1893
-THE MODERN HISTORY contd.
-- Joseph T Clover

10. -THE MODERN HISTORY contd
Heinrich Friedrich Wilhelm Braun (1862 to 1934) German
He is also called (Remembered) the Father of local anesthesia
BECAUSE
--In 1902 he was the first to add epinephrine to prolong the action of
local anesthetics
--In 1905 he was the first to use Procaine as a local anesthetic and he
published the first edition of his book “LOCAL ANESTHESIA”
Arthur E Guedel (1883 to 1956) American
--He was the first to elaborate on the signs of General Anesthesia after
Snow’s original description
--He made an earlier description of self administration of Nitrous oxide
and air for obstetric cases and minor surgeries
--He advocated cuffed endotracheal tubes
--He introduced artificial respiration during Ether Anesthesia in 1934

11. -TERM ANESTHESIA
--The Greek Philosopher “Dioscorides” (40 to 90 BC)
is said to have first used
--The term Anesthesia in the first century AD to describe
the Narcotic – like effects of the plant Mandragora
(An = no, Asthesia = sensation)
--The present use of the term to denote the sleep like
state that makes possible Painless surgery is
credited to “Oliver Wendell Holmes” in 1846.
He suggested this Term to William Morton