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By R. Miller

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Example text

This transition was succeeded in the late 1930s by the discovery of effective new drugs, initially the sulfonamides and then the antibiotics, for the treatment of infection. Inevitably, anesthesia would be caught up in the succeeding therapeutic and scientific ferment, as were all the specialties of medicine. The first change in direction was the initial use during anesthesia of a curare product by Griffith and Johnson of Montreal in 1942. The muscle-paralyzing properties of the alkaloid derived from several preparations of South American plants had been known for centuries, and the site of action at the neuromuscular junction was graphically demonstrated by Claude Bernard.

As noted in the introduction to this chapter, for more than 2,000 years disease was considered to be the result of a disturbed balance of the cardinal humors of the body, which enjoyed health when in balance but showed symptoms of disease when upset. Then, in the 18th and 19th centuries, with Morgagni describing the results of large numbers of autopsies, it was learned that organic lesions were responsible for disease. It seemed, then, that if an organ were abnormal, its function would also be abnormal.

Lundy of Rochester coined the term "balanced anesthesia" to describe his use of these agents in conjunction with general or regional anesthesia. These practices were further advanced when, during the French-Indo-Chinese warfare of the late 1940s, Laborit and Huguenard of France used a "lytic cocktail" to prevent development of circulatory shock in the wounded. The resulting "artificial hibernation" induced by simultaneous injection of a barbiturate; an analgesic, meperidine; and the tranquilizer chloropromazine (L'Argactil), was typified by a state of stress-free suspended animation.

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