"Named" lectures are not permanent. Once there was an Arthur Guedel lecture. The first Guedel lecture was given by William W. Mushin (Anesthesiology 19:131, 1958). In that lecture he proposed that a distinguished anesthesiologist must have excellent technical skills (image).

Harold Dodd (1899-1964) was a prominent British surgeon who operated within the abdomen by infiltrating procaine. His innovation was to place indigocarmine into the procaine solution. If the tissue was blue, cutting it was not painful. If not blue, it was (BMJ:2:345, 1940).

From Daniel Moore's book on regional anesthesia (1961): Withdraw before changing needle direction.

Capsaicin is the active ingredient of the chili pepper (Capsicum annum - image). The Incas burned the chili plant to blind the invading Spaniards (1532-1572). They also rubbed it onto the gums to relieve the pain of a toothache. Today capsaicin is widely used as an analgesic.

Lewis Thomas (1913-1993) was president of Sloan Kettering and Dean at Yale Medical School. He wrote essays for the NEJM in which he promoted the value of science. In 1960 (see text) he predicted that scientists would solve the problems of cancer and drug addiction. Waiting.

Timely placement of an epidural involves an educated thumb that can detect when the Tuohy needle is in four different locations: SQ tissue (yellow), muscle (pink), ligamentum flavin (yellow) or epidural space (white with blue ovals). See image from David L. Brown, 1992.

We all know about the pupillary light reflex. What about the pupillary dark reflex? In this scan a 1 sec dark interval is positioned between 1.5 and 2.5 sec. The pupil dilates because it is in the dark. But why does it constrict below baseline when the light comes back on?

For 40 years a "caudal" was preferred for OB analgesia. But even if you were highly skilled at the technique, you would have failures. Here Minnet (1948) shows 2 of the variations that prevented success. Not shown was the completely calcified hiatus. Hence lumbar epidural.

Grand Rounds are not the same as they were 50 years ago. Then the responsible physician for a complication was known to the audience. Remarkably, UCSF actually published their complications in a book (image - from Wilkinson, Ham, Miller - Mosby, 1980).

Nero was a narcissistic, self indulgent Roman emperor who died by suicide in AD 68 (age 31). But one of his army physicians was the first to develop the idea of pain free surgery. Dioscorides (AD 40-90) used opium and other herbs and coined the word "anesthesia".

As an anesthesiologist it is risky to think that you are better than your peers. Or that you will never have a complication. Why? Because patients are unpredictable. Eventually some dumb thing will happen. (Schwartzman - 2014: 6,400 cases, 175 complications - Brazil).

71 years ago John J. Bonica, MD wrote his magnum opus on management of pain. Not included: Neuraxial opioids, ultrasound, gate theory, pain services, infusion pumps, neuromodulation. Included: Icepick lobotomy, alcohol infusions, topectomy. The 5th edition was published in 2023.

Epinephrine was obtained from the adrenal glands which are on top of the kidney. Thus the word epinephrine: "epi" (Greek: above) and "nephros" (Greek: kidney). John J Bonica (Management of Pain, 1953) thought "peridural" was a more appropriate word than "epidural".

Morris Fishbein, MD was editor of JAMA for 26 years. His classic book "Medical Writing" was developed from his experience of reviewing manuscripts. An except from his book explains the reasons for rejections. "Fancies" refers to a paper that is long on theory but short on facts.

If you have witnessed the moment of death, then you know the validity (if you looked at the eyes) of what Dogliotti described (image) in his 1939 book "Anesthesia" (Also see: search.app/b1T8728pokwg9N…)

Neuraxial blocks interfere with sympathetic, sensory and motor function. Those nerve fibers pass through the ventral and dorsal roots. But the autonomic ganglia lie outside of the vertebral canal (right). So, one can block the sympathetics and not interrupt somatic function.

The idea of an epidural for labor analgesia was introduced in 1909 by Walter Stoeckel (1871-1961)...but his idea was ignored. 100 years ago, 17% of mothers died during childbirth (image)!! Epidural methods were revived in the 1940s and today maternal mortality is 0.0002%.

When palpating for deep bony landmarks, Daniel C. Moore (1961) advised using 2 hands. The dominant hand pressed down on the hand in contact with the patient. "When the one hand method is used, the delicate tactile sensitivity of the fingertips is dulled".

Ever give an anesthesia "badly" as described by John Snow over 150 years ago? Text from his book "On Chloroform and other Anesthetics" (1858).

Halothane was one of the most successful anesthetic drugs ever introduced (1958). This 1961 classic book stated that it was not metabolized. It was (later) learned that metabolism of halothane did occur and caused "halothane hepatitis" in rare cases.