Historical development of the anesthetic machine: from Morton to the integration of the mechanical ventilator.

The first anesthetic machines appeared following their public demonstration by Morton in 1846. These initial devices were simple inhalers based on the evaporation of the anesthetic agent. Their main problem was the loss of effectiveness with cooling. More complex inhalers were subsequently developed, in which the main difference was the possibility to provide more than one agent. Moreover, the concentration of the inhaled anesthetic was regulated for greater efficiency. At the beginning of the twentieth century, gas machines emerged, allowing the application of an anesthetic flow independent of the patient's inspiratory effort. These machines incorporated technological advances such as flow meters, carbon dioxide absorption systems and fine adjustment vaporizers. In this period, in the field of thoracic surgery, intraoperative artificial ventilation began to be employed, which helped overcome the problem of pneumothorax associated with open pleura by applying positive pressure. From the 1930s, the gas machines were fitted with a ventilator, and by the 1950s this had become a basic component of the anesthesia system. Later still, in the 1980s, alarm and monitoring systems were incorporated, giving rise to the current generation of workstations.

Gimbernat's stay in Cadiz and his discovery of the human anatomy

The dates on which Antonio Gimbernat studied at the Navy Royal College of Surgery in Cadiz (Real Colegio de Cirugía de la Armada, RCCA) show some discrepancies between different authors. A detailed reading of the Royal College archives, especially the books of enrollments kept in the Department of History of Medicine at the University of Cadiz, allows us to clarify this issue. In this contribution we present the academic records of Gimbernat in Cadiz, as well as annotations on his participation in college life, where his remarkable vocation for anatomy is reflected. On the other hand, we will see aspects that have had influence on his curriculum during the short but productive and notable period of studies in the Royal College. Moreover, we will analyze the contents of the academic curriculum followed by Gimbernat, which was designed by Virgili, although some other aspects of the academic life of the RCCA were not supported by our honoree surgeon. Finally, through generic documents on the customs and habits of the Navy Royal College of Surgery in Cadiz we outline how Gimbernat’s life and habits were during his time as college member (AU)

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