The historical significance of anaesthesia events at Pearl Harbor.

Up to the end of World War II, less than 10% of the general anaesthetics administered was with intravenous barbiturates. The remaining 90% of anaesthetics given in the USA were with diethyl ether. In the United Kingdom and elsewhere, chloroform was also popular. Diethyl ether administration was a relatively safe and simple procedure, often delegated to nurses or junior doctors with little or no specific training in anaesthesia. During the Japanese attack on the US bases at Pearl Harbor, with reduced stocks of diethyl ether available, intravenous Sodium Pentothal(®), a most 'sophisticated and complex' drug, was used with devastating effects in many of those hypovolaemic, anaemic and septic patients. The hazards of spinal anaesthesia too were realised very quickly. These effects were compounded by the dearth of trained anaesthetists. This paper presents the significance of the anaesthesia tragedies at Pearl Harbor, and the discovery in the next few years of many other superior drugs that caused medical and other health professionals to realise that anaesthesia needed to be a specialist medical discipline in its own right. Specialist recognition, aided by the foundation of the National Health Service in the UK, the establishment of Faculties of Anaesthesia and appropriate training in pharmacology, physiology and other sciences soon followed. Modern anaesthesiology, as we understand it today, was born and a century or more of ether anaesthesia finally ceased.

[Helmut Weese--an attempt at an appreciation of his importance for German-language anesthesia]. / Hellmut Weese--der Versuch einer Würdigung seiner Bedeutung für die deutschsprachige Anästhesie.

In addition to the two surgeons Hans Killian and Helmut Schmidt the pharmacologist Hellmut Weese was elected honorary member of the German Association of Anaesthesiology at the organisation's founding congress in 1953. Especially the younger colleagues are quite unfamiliar with his name, although a "Hellmut Weese commemorative" lecture is annually held at our national association's gathering. While it is widely known that his name is intimately connected with the introduction of evipan anaesthesia during the early thirties, only few people know about his extensive research on the therapy of shock that lead to the development of the plasma-expanding substance "Periston"". Moreover, his pharmacological investigations on sympathomimetic amines and long-term studies on cardiac glycosides which he published in a well recognised monograph in 1936 have fallen into oblivion. Since he had not collaborated with Nazi regime he was able to start teaching at the University of Cologne again in the fall of 1945. One year later he became head of the Department of Pharmacology at the Medical Academy of Düsseldorf. There he started--together with colleagues of similar ideas and opinions--holding lectures on clinical anaesthesia at the beginning of the winter term 1948/49. People who attended his lectures later claimed that these were the "best lesson ever". At the same time the call for specialists for anaesthesiology that was commonly heard in Anglo-American countries could not be ignored in Germany any longer. Weese, who was already an honorary member of the International Anesthesia Research Society at the Association's congress in New York in 1938, realised the lack of trained physicians. Thus he fought enthusiastically for the idea of producing specialists and as a member of a committee for questions concerning anaesthesia played in important part in founding the "Deutsche Arbeitsgemeinschaft für Anästhesiologie". He lived to see the association's name being changed to "Deutsche Gesellschaft für Anaesthesiologie" in 1953 but died before the textbook of anaesthesia (Die Narkose) he had written together with Hans Killian was published in 1954. The following text reports on Weese's medical career and on some of his most important contributions to the knowledge of anaesthesia.