176 Indian J. Anaesth.

2003; 47 (3) : 176-177

INDIAN JOURNAL OF ANAESTHESIA, JUNE 2003 176

HISTORICAL FORUM

EARLY DEVICES FOR INHALATION OF ETHER AND CHLOROFORM

1850 1900 Col A. K. Bhargava
Devices for administering inhalational volatile anaesthetics have been an ongoing process. The early development of anaesthesia in the latter half of the 19th century saw a number of ingeniously designed devices. During this period both ether and chloroform rivaled each other for superiority. In India the first ether and chloroform administrations were performed on 22nd Mar 1847 and 12th Jan 1848 respectively at Calcutta within six months of their successful demonstrations in the west. In history we have known of Major Edward Lawrie as a great protagonist for chloroform and the person responsible for having the first and second Hyderabad commissions instituted in 1888 and 1889. It is not surprising therefore that the doctors / anaesthetists in the Indian Medical Service had easy access to the devices developed in Europe. Some exhibits in the museum at Armed Forces Medical College pertaining to this era are illustrated. Skinners inhaler Junkers inhaler FE Junker a German surgeon in London introduced this extremely popular device in 1867. It consists of double rubber bellows (one in a net), chloroform bottle (graduated to 16 drms) incorporating a safety ball valve, malleable rubber tube and celluloid face piece. Air is pumped by the distil bellow through a certain depth of chloroform contained in a bottle, and the vapour conveyed to the patient by means of the facemask. Excessive pressure build up in the system is vented via the ball valve in the bottle cap. Though an attempt was made in this inhaler to deliver a known percentage of the vapour it is in no way better than the open method of administration because the small quantity of high percentage vapour is diluted by a much larger quantity of air inspired from the general atmosphere. Nonetheless it could be well considered the forerunner of the plenum vaporizers in the decades to follow. Schimmelbusch mask

It is the oldest in the museum collection. Thos Skinner (1862) an obstetrician in Liverpool designed this domette covered wire framed mask that has since been imitated by others.

The inhaler designed by Carl Schimmelbusch of Berlin in 1890 had remained a popular device for both ether and chloroform and surprisingly in many of the third world countries it is still being used for the purpose of anaesthesia for the former agent. Mouth Gag Inhaler

MD, Professor of Anaesthesiology Armed Forces Medical College, Pune 411040

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Mason had invented a mouth gag in 1871. A mouth gag inhaler that has combined features of the Masons gag with an extended wire frame is one of the exhibits, which cannot be traced to its founder. It was probably a device to help in dental extraction or some form of oral surgery. Bellamy gardner mask and dropper

their distal end by a ring . Round these struts a towel was pinned. The device could be put on the Bellamy Gardner, Schimmelbusch or similar mask when in use. This technique converted the system into a somewhat semiopen method, which not only helped in attaining a higher concentration of ether with passage of time but was also economizing on the ether used. Hewitts inhaler

A wire frame device similar to the Scimmelbusch mask, which more closely fits the face, was that devised by Bellamy Gardner. An ether dropper, which too was designed by him, also goes by his name. The dropper is a rubber stopper adapted for an ordinary six ounce bottle; the long metal tube dips into the ether, the short one allows air to enter the bottle to replace the ether used. The present day ether bottles take this dropper easily; probably this is why the present manufacturers of ether have not changed their dispensing bottles. Ogston inhaler Joseph T Clover in 1877 when inventing his device cited these advantages for his inhaler: 1) valveless 2) quiet breathing due to gradual vapor supply 3) sleep within 2 minutes, 4) no intraoperative ether refilling 5) speedier recovery 6) warming not required 7) spongeless & feltless and 8) residual ether salvaged for next patient. Sir Fredrick Hewitt in 1891 described his wide bore ether inhaler which worked and looked similar to Clovers inhaler but differed in having less resistance during inspiration and expiration of air. The construction also slightly differed in that to turn on the ether instead of rotating the drum the indicator is moved. Ogston of Aberdeen around the same time designed a wireframe inhaler with several vertical struts, united at