Two sides to every story: Reappraising the early history of liver transplantation at Addenbrooke's Hospital, Cambridge.

Over the course of the past six decades, liver transplantation has evolved to become the treatment of choice for chronic end-stage liver disease and some cases of acute hepatic failure. Currently, more than 34,000 liver transplants are conducted worldwide per annum, and overall one year survival rates exceed 90%. However, the early years of human liver transplantation were beset by failure. Eyewitness reports from this period make for tragic, yet compelling reading. Volume 12 of The History of Anaesthesia Society Proceedings contains one such account, written by Dr Elizabeth Gibbs. This outlined the experience of single-handedly anaesthetising the recipient of the first liver transplant to be undertaken at Addenbrooke's Hospital, Cambridge, UK, in June 1967. Despite the best efforts of the team, the patient died from uncontrollable haemorrhage 19 hours after the start of the procedure. While this tragic outcome might have been expected in the early days of liver transplantation, Gibbs included an unsettling postscript in her paper. This stated that all of the patient's records had apparently been 'lost', and the date of the first Cambridge liver transplant was publicly reported as 2 May 1968, some 11 months after the events described. This article outlines the results of research aimed at critically appraising this postscript. In doing so a number of unexpected discoveries were made. These highlight some important lessons for medical historians and demonstrate that if you look hard enough, there really are two sides to every story.

John Henry Evans, MD: Founding Chairman of the Board of Governors of the International Anesthesia Research Society, and a Forgotten Pioneer of Oxygen Therapy.

The theoretical and practical foundations of modern oxygen therapy were established during the first half of the 20th century. John Henry Evans, MD, inaugural chairman of the Board of Governors of the International Anesthesia Research Society (IARS), was an early pioneer in this field. Challenging the conventional wisdom that high concentrations of oxygen were harmful when inspired over long periods, Evans advocated the continuous and extended administration of 100% oxygen in a wide range of conditions, using special apparatus developed by the Toledo Technical Appliance Company (later, the McKesson Appliance Company), which incorporated a tight-fitting facemask or nasal inhaler. In doing so, Evans became embroiled in a conflict with Alvan Barach of Columbia University College of Physicians and Surgeons, which would take nearly a decade to resolve. Additionally, Evans experimented with the subcutaneous injection and intravenous infusion of oxygen, reporting significant benefits of the former in several acute inflammatory conditions, as well as a variety of chronic ailments. While these contributions have largely been forgotten, Evans expanded the remit of anesthesiology beyond the operating theater and the original charter of the IARS and helped lay the foundations for the rational use of oxygen as a therapeutic agent in all areas of medicine.