The Lewis Wright Memorial Lectureship *

The Lewis Wright Memorial Lectureship *

F BULLETIN OF ANESTHESIA HISTORY The Lewis Wright Memorial Lectureship* �ists will �:oo ;ion Pa­ ted. 'um rial irst Jre­ BS, gist the to his his­ :h...

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F BULLETIN OF ANESTHESIA HISTORY

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by C.R. Stephen, MD, CM, FFARCS Professor Emeritus of Clinical Anesthesiology, Washington University School of Medicine, St. Louis, Missouri

There are not many left who had the privi­ lege of knowing Dr. Lewis H. Wright as the tall, quiet-talking man who always appeared to have time for a conversation regardless of the press of people at a busy meeting. But there we were, at the New York Postgraduate Assembly in 1947, discussing the place of d­ tubocurarine in the future practice of anes­ thesiology. What were the roots of this inno­ vator, Dr. Lewis H. Wright, and how did he play such a large part in the development of anesthesiology? He was born in North Dakota on July 9, 1894, the same year and in the same state as another of our founding fathers of anesthe­ sia, Dr. John S. Lundy. However, there is no evidence that these two men knew each other for a number of years: they soon left North Dakota and went their separate ways. Lew Wright was raised in Vermont and then at­ tended Cornell University where he was in­ terested in veterinary medicine. From there he went to the Agricultural and Mechanical College of Texas (Texas A. & M.) where he taught in the physiology and pharmacology laboratories. It was at the University of Ne­ vada in 1916 that he received his B.A. degree. By this time, he had decided that he wished to study medicine, and so he did at the Medi­ cal College of Georgia, receiving his M.D. degree in 1925. For the following five years he practiced obstetrics and anesthesia, the latter of which stirred his imagination. The peripatetic nature of his education, plus his interest in anesthesia, prompted him to join E.R. Squibb and Sons in 1930. This decision marked his lifelong interest in things pertain­ ing to anesthesia and allowed him to be a "roving ambassador of goodwill" to our pro­ fession. In his own way, and perhaps with forethought, he forged the close union that has developed between the pharmaceutical industry and anesthesiology through the years. He made it his task to attend medical con­ ventions in every state, to visit hospitals and get to know anesthesiologists in their own en­ vironment (an easy endeavor in the early years). He was in the forefront of the devel­ opment of cyclopropane and in 1940 con­ ceived the idea of curare possibly being a muscle relaxant for use in anesthesia. Squibb prepared a biologically standardized com­ pound known as Intocostrin and Wright was the man designated to sell it to the profes­ sion. He tried unsuccessfully with Drs. Stuart

�Presented at the Academy of Anesthesiology meet­ lUg, 1996.

Cullen and E.M. Papper, who found in the laboratory in animals that it was unsuitable, producing abundant salivation, bronchial spasm and respiratory depression. The skep­ tics were numerous as he approached them. But at the New York Postgraduate meeting he talked with his friend, Dr. Harold Griffith of Montreal, who thought the idea had merit and proceeded to use it cautiously in his daily practice as a supplement to cyclopropane. The result revolutionized the concept of an­ esthesia administration, as reported by Harold R. Griffith and G. Enid Johnson in Anesthesiology 3: 418-420, July, 1942, in an ar­ ticle titled, "The use of curare in general an­ esthesia." Dr. Wright's career was temporarily inter­ rupted by the Second World War in which he served in the U.S. Navy in the Pacific area from 1943 to 1946. Returning to the New York area, which was his home base, he was ap­ pointed Chief of Anesthesiology at the U.S. Naval Hospital, St. Albans, New York with the rank of Commander, U.S.N.R. On his return to civilian life he was appointed to the faculty of the New York Medical College. One of the many friends with whom Lew Wright formed a close association was Dr. Paul Wood, a New York anesthesiologist who had studied with people such as Dr. James Gwathmey. Both of these men had a least two interests in common. They were interested in organizational matters pertaining to anes­ thesia, and they were collectors, Wood of books and memorabilia associated with an­ esthesia, and Wright of bleeding bowls, scari­ fiers and anything pertaining to the history of anesthesia.Wood's collection accumulated to the point that it almost drove him out of house and home, so Wright arranged for it to be stored and catalogued in the Squibb build­ ing in New York as a gift from the Squibb P harmaceutical Company. This building was also the headquarters of the fledgling Ameri­ can Society of Anesthesiologists and the American Board of Anesthesiologists. It was Dr. Wright who promoted the idea that this historical collection should be perpetuated and named the Wood Library-Museum, and it was so incorporated under the laws of the State of New York. It was housed in various places in the city until, in 1949, the House of Delegates of the American Society of Anes­ thesiologists officially established a non­ profit corporation called the Wood Library­ Museum of Anesthesiology and designated it as the "repository for the archives and para­ phernalia pertaining to the field of anesthe-

siology." The first recipient of the A.S.A. Dis­ tinguished Service Award in 1945 was Dr. Paul Wood, with the citation reading, among other things, "There is no one who . . . is more deserving of recognition by his fellow anesthesiologists . . ." The details of the organizational work which Paul Wood and Lew Wright performed in shaping our present anesthesia societies is lost to posterity in many respects, but they emerge from time to time in historical docu­ ments. For example, on February 13, 1936, at a meeting of the New York Society of Anes­ thetists, Paul Wood proposed to "make this Society, in name, as well as in fact, a national society in anesthesia." On December 10, 1936, the name was changed to the American Soci­ ety of Anesthetists, later Anesthesiology (A.S.A.). Lew Wright was the first New York Director to the confederation of component societies of the A.S.A. and was the first Vice­ President and later the second Vice-President of the A.S.A. for two terms. Moreover, he was a member of the A.S.A. Board of Directors for 15 years. An example of the way in which he exerted his influence within the A.S.A. was related by Dr. Ralph Knight during a video­ taped interview for the Living History series of the Wood Library-Museum. He recalls that, at the meeting of the A.S.A. in Wash­ ington in 1951, he met Lew Wright on a stair­ way, who informed him that an unofficial committee had concluded that it would like to have Ralph Knight nominated as Presi­ dent-Elect. And so it came to pass. Dr.Wright continued to play a prominent role in the development of anesthesiology as a specialty. He was heard to remark at one time, ''Anesthesiologists are never inferior, but it did take time for surgeons, internists and obstetricians to recognize it." He was a founding member of the Board of Trustees of the Wood Library-Museum and in later years served as its President-Emeritus. He was also a founder of the World Federation of Societ­ ies of Anesthesiologists in 1955, working in close collaboration with Dr. Harold Griffith, and was a delegate to its General Assembly in Toronto in 1960. He was honored by the A.S.A. in 1955 in receiving the Distinguished Service Award for recognition of his services to the specialty. The distinguished career of Dr. Wright ended on August 20, 1974. As stated in the memorial address, "He was dynamic, even when he envisioned a problem he could not resolve, but just thought of possible solutions. Continued on Page 6

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BULLETIN OF ANESTHESIA HISTORY

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Kochsalzinfusionen auf die Chloroformwirkung wahrend und nach der Narkose; nach experimentellen und klinische Beobachtungen. Arch ldin Chir 75: 11791196, 1905. 9. Burkhardt L. U ber Chloroform - und Athernarkose durch intravenose Injektion. Arch exper Path Pharmakol 61: 323-342, 1909. 10. Burkhardt L. Die intravenose Narkose mit Aether und Chloroform. MUnch med Wochenschr 46: 2365-2369, 1909. 11. Burkhardt L. Zur Frage del' intravenosen Narkose. Bemerkungen zu dem gleichnamigen Artikel des Herrn Dr. Peter Janssen in No. 3. dieser Wochenschrift. Miinch med Wochenschr 7: 361-362, 1910. 12. Burkhardt L. Ueber intravenose Narkose. Miinch med Wochenschr 15: 778-782, 1911. 13. Jenkins MT. History of Fluid Administration During Anesthesia and Operation. In: Anesthesia -Es­ says on Its History. Ed J Ruprecht,M J van Lieburg,J A Lee,W Erdmann. Springer Verlag,Berlin Heidelberg, 1985. 14. Lexer E. Lehrbuch der Chirurgie 1904. Enke Verlag,Stuttgart. 15. SchneiderlinE.Eine neue Narkose. Aerztliche Mitteilungen aus und fUr Bden 10:101-103, 1900. 16. Goerig M, K Ayisis. Twilight Sleep. Anesthe­ sia History Association,Spring Meeting, 1993. 17. Straub W. Ein Apparat zur Infusion von Fliissigkeiten unter konstanter Geschwindgkeit. MUnch med Wochenschr 28: 1514-1515, 1911. 18. Kiimmell M. (Kiel) Personal communication about Hermann KUmmell,Summer 1990. 19. Bier A. Hermann Kiimmell. Zbl f Chir 21: 1252-1253, 1932. 20. Howat D. Paul Sudeck - his contribution to anaesthesia. Anaesthesia 44: 847-850,1989. 21. Goerig M. Helmut Schmidt - a German Pio­ neer of Anesthesia. (in preparation) 22. Kiimmell H. Uber die Wirksamkeit und die Gefahren der intraarteriellen Infusion alkalischer Kochsalzlosung bei akuter Anamie. Cbl f Chir 19: 305308, 1882. 23. Kiimmell H. Ueber intravenose Aethernarkose. Arch f ldin Chir 40: 1-15,1911. 24. Kiimmell H. Weitere Erfahrungen Uber intravenose Aethernarkose. Bruns Beitr z klin Chir 92: 27-36, 1914. 25. KUmmell H. IntravenousEther Anesthesia. Surg Gynec Obstet 19: 334-339, 1914. 26. Schmitz-Peiffer W. Zur Frage der intravenosen Aethernarkose. Bruns Beitr z klin Chir 69: 832-841,1910. 27. Schmitz-Peiffer G. (Hamburg) Personal com­ munication about W ilhelm Schmitz-Peiffer,April,1991. 28. Graef \VI, Bericht iiber Erfahrungen mit den intravenosen Aether und Isopral-Aethernarkosen. Bruns Beitr z klin Chir 83: 173-211,1913. 29. Schlimpert H. Versuche mit intravenoser Narkose. Zbl f Gyn 25: 833-839,1911. 30. Honan \VF, Hasseler J\V, Intravenous Anes­ thesia. Ann of Surg 58: 900-916,1913. 31. Anonymus Obituary. Memorial Service. W ill­ iam Francis Honan. Am Inst Homeopathy 28: 708-709, 1935. 32. Dreser H. Uber ein neuartiges Hypnotikum aus der Reihe del' Urthane. MUnch med Wochenschr 40: 1310, 1899. 33. Kissin I, Wright AJ. The introduction of Hedonal: A Russian vontribution to Inlravenous Anes­ thesia. Anesthesiology 69: 242-245, 1988. 34. Killian H,Weese H. Die Narkose. Ein Lehr und Handbuch. Thieme Verlag Stuttgart 1954,870. 35. Wendel W. Bericht zur intravenosen­ Athernarkosetechnik. In Verhandlungsbericht zum 40. Congress del' Deutschen Gesellschaft fUr Chirurgie Arch f kl Chir 95: 235,1911. 36. Rood R Infusion anesthesia: The use of nor­ mal saline infusion as a means of administering ether. Br Med J 974-977,1911. 37. Wepfer A. Die intravenose Isopral-

Aethernarkose in der Kriegschirurgie. Bruns Beitr z klin Chir 97: 1-6, 1915. 38. Dieterich \V, Ueber intravenose Isopral-Aether­ Kochsalz-Narkosen. MUnch med Wochenschr 30: 11031104, 1916. Dyroff R. Eine verwendungsbereite 39. Infusionslosung fUr den Praktiker. Dtsch med Wochenschr 44: 1851-1853, 1926. 40. Lehmbecher A. Erfahrungen an 850 intravenosen Narkosen. Arch klin Chir 122: 317-319, 1923. 41. Kreuter E, Streichele H. 1000 intravenose Isopral-Athernarkosen ohne Todesfall. Bruns Beitr z klin Chir 137: 454-464,1926. 42. Borchardt M,Crahn H. Erfahrungen mit der intravenosen Isopral-Athernarkose nach Burkhardt.

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Bruns Beitr z klin Chir 141: 380-388, 1926. 4 3 . Bumm R. Intravenose Narkosen m i t Barbitursaurederivaten. Klin Wochenschr 6 : 725-728, 1927. 44. Bumm K (Kassel): Personal communication about Rudolf Bumm,Summer 1990. 45. Kirchner M. Eine psycheschonende und steuerbare Form der Allgemeinbetaubung. Chirurg 15: 673-684, 1929. 46. Weese H, Scharpff \VI, Evipan, ein neuartiges Einschlafmittel. Dtsch med Wochenschr 58: 1205,1932. 47. LundyJS. Intravenous anesthesia: preliminary report of the use of two new thiobarbiturates. Prac Mayo Clin 10: 534, 1934. 48. Kingreen O. Chirurgische Operationslehre. Urban & Schwarzenberg Verlag,MUnchen,IBerlin 1952.

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He was a cool diplomat and very persuasive. He never stepped on the sensitive toes of his colleagues, but infused them with his enthu­ siasm, optimism, and ability to meet the chal­ lenge with a friendly-shaped policy." One of his memos reflects his attitude toward life, "Egotism is the anesthetic provided by na­ ture to dull the pain of being a damn fool." The Board of Trustees of the Wood LibralY­ Museum inaugurated a series of historical lec­ tures at the annual A.S.A. meeting in 1967, and in 1975 began to name them the Lewis H.Wright Memorial Lectures. As the following list indi­ cates, they have included a panorama of what is best in our historical heritage. (1 am indebted to Dr.Jolm W.Pender, Dr. Hany Seldon and others for infonnation included above.)

1967: *Chauncey D. Leake, Ph.D., Prac­ tical Aspects of the History of Anesthesia. 1968: *Thomas E. Keys, D.Sc. (h.c.), Early Pneumatic Chemists and Physicians: Their Influence on the Development of Surgical Anesthesia. 1969: *John S. Lundy, M.D., The Intro­ duction of Sodium Pentothal. 1970: *David M. Little, Jr., M.D., In the Beginning (On Horace Wells). 1971: James Harvey Young, P h.D., Crawford W. Long, M.D. - A Georgian In­ novator. 1972: Leroy D. Vandam, M.D., Early American Anesthetists. 1973: *Peter D. Olch, M.D., William S. Halsted and Local Anesthesia: Contributions and Complications. 1974: Charles C. Tandy, M.D., Treasures of the Wood Library-Museum. 1975: Albert M. Betcher, M.D., The Civi­ lizing of Curare. 1976: J. Englebert Dunphy, M.D., The Contributions of Anesthesiology to Surgery. 1977: R.A. Gordon, M.D., A Ca psule His­ tory of Anaesthesia in Canada. 1978: W.D.A. Smith, M.D., Henry Hill Hickman: Quack or Anti-Quack? 1979: *K. Garth Huston, Sr., M.D., Gardner Q. Colton: Itinerant Chemist, 49'er,

Proponent of Anesthesia. 1980: John W. Pender, M.D., Contempo­ raries of Lewis Wright. 1981: William B. Bean, M D., The Dan­ gers of Precocious DiscovelY: Anesthesia and the Civil War. 1982: Betty J. Bamforth, M.D., The Evo­ lution of Modern Anesthesiology Residency. 1983: *Roderick K. Calverley, M.D., Arthur Guedel: The Life and Times of an Extraordinary Man. 1984: B. Raymond Fink, M.D., Leaves and Needles: The DiscovelY of Local Anesthesia. 1985: *Richard H. Ellis, MD., Early Ether Anesthesia: The Anglo-American Connec­ tions. 1986: Richard J. Wolfe, The First Opera­ tion Under Anesthesia: Robert C. Hinkley's Interpretation. 1987: Selma H. Calmes, M.D., Dr. Virginia Apgar: A Woman P hysician's Career in a Developing Specialty. 1988: John W. Severinghaus, M.D., Moni­ tors, The Patent Medicine of Anesthesia. 1989: Nicholas M. Greene, M.D., They Also Served: Contributions by Non-anesthe­ tists to the Development of Anesthesia. 1990: Thomas B. Boulton, M.B., Chir.B., F.F.A.R.C.S., T.D., Balancing the Anaesthetic. 1991: C. Ronald Stephen,MD., The Great Triumvirate. 1992: Francis F. Foldes, M.D., Impact of Muscle Relaxants on the Development of Anesthesia and SurgelY: The Role of Lewis H. Wright 1993: *M. T. "Pepper" Jenkins, M.D., Epochs in Intravenous Fluid Therapy: From the Goose Quill and Pig Bladder to Balanced Salt Solutions. 1994: James E. Eckenhoff, M.D., The Growth of Anesthesiology as Viewed by Art­ ists and Photographers. 1995: E.S. Sikel, M.D., A.nesthesia Safety- . An Evolution. 1996: Joseph F. Artusio, Jr., M.D., From Symmetrical to Asymmetrical. *Deceased