No Laughing Matter. Historical aspects of anaesthesia

CHRISTOPHER LAWRENCE and GHISLAINE LAWRENCE, No Laughing Matter. Historical aspects of anaesthesia (Exhibition catalogue), London, Wellcome Institute for the History of Medicine, 1987, 4to, pp. 84, £5.00 paperback. The exhibition 'No Laughing Matter' coincided with the Second International Symposium on the History of Anaesthesia, which was held in London in July 1987. Both events underlined the increasing attention that the history ofanaesthesia now attracts, and both served to highlight the wealth of original material that still exists about the beginnings of anaesthesia itself, and of each epoch of its development. The history of anaesthesia is a notoriously difficult subject to describe or illustrate well, since it usually requires representations of both the printed word and mechanical artefacts. Furthermore, it is commonly assumed that little seminal material now exists. This catalogue gives the lie to that assumption and records episodes in the unique story and illustrates them by combining a careful selection of books and pamphlets (derived from the comprehensive printed collection in the Wellcome Institute) with similarly wide-ranging material, most of which is drawn from the Wellcome collection at London's Science Museum. Anaesthesia-of all aspects of medicine-provides an excellent opportunity for two such disparate sources to collaborate: 'No Laughing Matter' demonstrates how well such co-operation can be achieved, and also emphasizes its undoubted advantages. The two Dr Lawrences have avoided the pitfalls-the most abhorrent of which is superficiality-inherent in a sequential account of anaesthesia from its beginnings to the present day, for they have chosen to present an episodic, but nonetheless scholarly, review of their subject. A series of fifteen surprisingly general aspects of the history of anaesthesia has been selected and evaluated. They range from considerations of, precursors of, and priorities in the speciality through to anaesthesia and the World Wars, industry, technical solutions, and innovations. On the way, consideration is given to the public perceptions of anaesthesia, to various celebrations of the speciality, and its influence in Victorian times. More specific attention is given to anaesthesia and childbirth, and its relationship to cardiology. The prolonged debate over chloroform's safety is explored with ample reference to the Hyderabad Chloroform Commissions. This last is apposite, since the centenary of the Commissions is to be celebrated in Hyderabad in the near future. The Chloroform Commissions are at one and the same time the greatest paradoxes in the history of the speciality while remaining of enormous interest to those with an interest in clinical investigation in anaesthesia. The descriptions ofeach of the 280 exhibits are clear and informative (as are all but a few of the illustrations), and each of the fifteen sections is preceded by a stimulating introductory essay. Together, the essays and the catalogue's descriptions give a carefully appraised insight into their particular topics. Even though most of these topics appear to be-at first sight-unrelated to each other, it is important to note that, when viewed as a whole, the information presented amounts to far more than the sum of the individual or component parts. The authors have chosen and written well in order to ensure that those with only a superficial knowledge of the history of anaesthesia will find the text stimulating and rewarding, while those with more detailed knowledge-irrespective of their background-will also derive enormous benefit. Authoritative references abound, and the text points the way to the still available, but scarcely tapped, primary source material. Here is a wealth of information about an intriguing variety of aspects of the history of anaesthesia, each viewed with a previously overlooked perspective. It is seasoned by that much-prized, but rare consideration-namely historical insight. Accordingly, it serves not only as a valuable stimulus to further research into the history of anaesthesia, but also as an authoritative source book, and an example of what can be accomplished when discernment, erudition, and energy are simultaneously applied to the pursuit of historical enlightenment.