history of the cas

History of the CASHistory of the CAS• This section provides information about the This section provides information about the

origin of our Societyorigin of our Society

• Items include a photograph of the original Items include a photograph of the original gavel and case presented to the Society by gavel and case presented to the Society by the 1the 1stst President of the CAS President of the CAS

• Also included in this section are Also included in this section are photographs of the original seals of the photographs of the original seals of the Society and the crest and motto of the CAS Society and the crest and motto of the CAS and an oil paintingand an oil painting

Pharyngeal Bulb Gasway Pharyngeal Bulb Gasway c. c. 19351935• Dr. Beverly Leech, Regina SK, made Dr. Beverly Leech, Regina SK, made

wax casts of cadaver pharynxeswax casts of cadaver pharynxes

• His objective was to develop a His objective was to develop a pharyngeal airwaypharyngeal airway

• Detachable rubber bulb was Detachable rubber bulb was contoured to fit into the pharynx for contoured to fit into the pharynx for an air-tight seal. an air-tight seal.

• Lower end of metal core had a loop Lower end of metal core had a loop to prevent obstruction of aperture to prevent obstruction of aperture by epiglottis or other tissueby epiglottis or other tissue

1414

President’s Gavel in leather President’s Gavel in leather case case

c. Ante 1922c. Ante 1922• Presented to the Society by Presented to the Society by

the first President, Dr.Samuel the first President, Dr.Samuel Johnston in 1922 and this Johnston in 1922 and this gavel was used by all the CAS gavel was used by all the CAS Presidents between 1922 and Presidents between 1922 and 1929 and their names are 1929 and their names are engraved on the head of the engraved on the head of the gavel gavel

51 a-b51 a-b

CAS President’s Gavel CAS President’s Gavel c. Ante 1922c. Ante 1922

• A closer look at the gavel shows A closer look at the gavel shows that it is made of turned wood that it is made of turned wood and banded in silver on each and banded in silver on each end and in the middle; and the end and in the middle; and the names of the CAS Presidents names of the CAS Presidents from 1922-1929 are engraved on from 1922-1929 are engraved on one end.one end.

50 a50 a

The Original Seal of the CASThe Original Seal of the CAS c. 1943 c. 1943

• Used as an embosser or seal for Used as an embosser or seal for ceremonial purposes. It is made of cast ceremonial purposes. It is made of cast metal with a hinged polished handle that metal with a hinged polished handle that drives the spring mechanism to close two drives the spring mechanism to close two circular plates. The upper plate is circular plates. The upper plate is engraved and lower one embossedengraved and lower one embossed

5151

Plaque with original Seal and Plaque with original Seal and Motto Motto

c. unknownc. unknown• Shield shaped plaque with rounded Shield shaped plaque with rounded raised painted area showing the raised painted area showing the Greek figure Hypnos dripping liquid Greek figure Hypnos dripping liquid from cornucopia while holding a from cornucopia while holding a poppy in the left handpoppy in the left hand

• The motto of the CAS is written in The motto of the CAS is written in Greek under HYPNOS’ feet. In Greek under HYPNOS’ feet. In translation the motto says “We translation the motto says “We watch closely those who sleep”watch closely those who sleep”

• The emblem and motto were first The emblem and motto were first adopted in 1943 when the CAS was adopted in 1943 when the CAS was incorporated incorporated

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Plaque of Original Seal c. Plaque of Original Seal c. 19801980

• Two printed ceramic tiles set into Two printed ceramic tiles set into the plaque. The tile on the left the plaque. The tile on the left shows an image of the original shows an image of the original CAS sealCAS seal

• The tile on the right explains the The tile on the right explains the meaning and symbolism of the meaning and symbolism of the seal and the motto and provides seal and the motto and provides information about the artist information about the artist

5353

Painting of HYPNOS c. 1992Painting of HYPNOS c. 1992

• Painting of HYPNOS by the Painting of HYPNOS by the artist Linda Montgomeryartist Linda Montgomery

• Oil or acrylic on canvasOil or acrylic on canvas

• Gift from BOC Healthcare to Gift from BOC Healthcare to commemorate the 50commemorate the 50thth anniversary of the CAS anniversary of the CAS

6868

Ceremonial Seal c. 1993Ceremonial Seal c. 1993• A one piece metal hinge device that A one piece metal hinge device that

makes a circular mark, on paper, of makes a circular mark, on paper, of the Society’s new logo.the Society’s new logo.

• The logo now consists of a circle The logo now consists of a circle surrounded by the words Canadian surrounded by the words Canadian Anesthesiologists’ Society in both Anesthesiologists’ Society in both English and French. The centerpiece English and French. The centerpiece is a maple leaf with Caduceus.is a maple leaf with Caduceus.

• This new logo replaced the original This new logo replaced the original logo in 1993logo in 1993

• The motto of the CAS was also The motto of the CAS was also changed in 1993 and now consists of changed in 1993 and now consists of three wordsthree words

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SCIENCE

VIGILANCE

COMPASSION

Volatiles: Volatiles: • On October 16, 1846, dentist William On October 16, 1846, dentist William

Thomas Green Morton, invited to the Thomas Green Morton, invited to the Massachusetts General Hospital, Massachusetts General Hospital, performed the first public performed the first public demonstration of diethyl ether (then demonstration of diethyl ether (then called sulfuric ether) as an anesthetic called sulfuric ether) as an anesthetic agent, for a patient (Edward Gilbert agent, for a patient (Edward Gilbert Abbott) undergoing an excision of a Abbott) undergoing an excision of a vascular tumor from his neck.vascular tumor from his neck.

• In a letter to Morton shortly thereafter, In a letter to Morton shortly thereafter, Oliver Wendell Holmes, Sr. proposed Oliver Wendell Holmes, Sr. proposed naming the procedure naming the procedure anæsthesiaanæsthesia..

• Despite Morton's efforts to keep "his" Despite Morton's efforts to keep "his" compound a secret, which he named compound a secret, which he named ""LetheonLetheon" and for which he received a " and for which he received a US patent, the news of the discovery US patent, the news of the discovery and the nature of the compound and the nature of the compound spread very quickly to Europe in late spread very quickly to Europe in late 1846.1846.

Volatiles: Trichloroethylene

• Manufactured in 1945Manufactured in 1945• Imperial Chemical Ltd.Imperial Chemical Ltd.• Manchester, EnglandManchester, England• For use with pocket type inhaler For use with pocket type inhaler

for “auto-analgesia”for “auto-analgesia”• Used in Surgery, Obstetrics and Used in Surgery, Obstetrics and

Dentistry.Dentistry.

1616

Volatiles: ChloroformVolatiles: Chloroform

• 19161916• Made by Wellcome Chemical Made by Wellcome Chemical

Works, EnglandWorks, England• Amber coloured glass designed Amber coloured glass designed

to exclude light and thus prevent to exclude light and thus prevent drug degradationdrug degradation

44

Chloroform: CHClChloroform: CHCl33

• Chloroform, the name given to trichloromethane, because of its Chloroform, the name given to trichloromethane, because of its supposed relation to formic acid. supposed relation to formic acid.

• Chloroform has a heavy, etherlike odor and a burning sweetness of taste, Chloroform has a heavy, etherlike odor and a burning sweetness of taste, being about 40 times as sweet as cane sugar. being about 40 times as sweet as cane sugar.

• Chloroform may be prepared by the chlorination of ethyl alcohol or of Chloroform may be prepared by the chlorination of ethyl alcohol or of methane, or by the action of iron and acid on carbon tetrachloride. methane, or by the action of iron and acid on carbon tetrachloride.

• Chloroform was developed in 1831 and was first used to induce narcosis Chloroform was developed in 1831 and was first used to induce narcosis in self-experimentation by James Young Simpson (1847).in self-experimentation by James Young Simpson (1847).

• In the presence of light, however, it tends to decompose, yielding the In the presence of light, however, it tends to decompose, yielding the highly poisonous compound phosgenehighly poisonous compound phosgene. .

• The first fatality was a 15-year-old girl called Hannah Greener, who died The first fatality was a 15-year-old girl called Hannah Greener, who died on January 28, 1848.on January 28, 1848.

The Inhalers: Ether Parties The Inhalers: Ether Parties (1802)(1802)

“ “ Breathing a gas may make you high, but it won’t make you fart”Breathing a gas may make you high, but it won’t make you fart” By Caricaturist GillrayBy Caricaturist Gillray

The Snow Ether InhalerThe Snow Ether Inhaler

• This replica of John Snow’s inhaler This replica of John Snow’s inhaler of 1847 was made by John Henry of 1847 was made by John Henry Hawkes in 1950Hawkes in 1950

• The mask has 2 valves for intake The mask has 2 valves for intake and output, and a chamois cover and output, and a chamois cover lead rim to fit around the hose and lead rim to fit around the hose and mouthmouth

2222

The Analgizer InhalerThe Analgizer Inhaler

• Made by Abbott Laboratories, Made by Abbott Laboratories, ChicagoChicago

• Methoxyflurane inhalerMethoxyflurane inhaler

• Used to relieve pain on demand Used to relieve pain on demand by the patientby the patient

• The inhaler is fastened to the The inhaler is fastened to the patient’s wrist using the patient’s wrist using the attached twill tapeattached twill tape

33

The “Duke” InhalerThe “Duke” Inhaler

• 1950’s1950’s

• Dental inhalerDental inhaler

• Made in MontrealMade in Montreal

• Adult and Pediatric masksAdult and Pediatric masks

• Trichloroethylene used with Trichloroethylene used with this devicethis device

1818

The Oxford Vinethene The Oxford Vinethene InhalerInhaler

• Dental inhalerDental inhaler

• Invented in 1940Invented in 1940

• Made by Medical & Industrial Made by Medical & Industrial Equipment Ltd., EnglandEquipment Ltd., England

• Used for inhalation anesthesia of Used for inhalation anesthesia of Trilene (Trichloroethylene) and Trilene (Trichloroethylene) and Vinethene (Divinyl ether)Vinethene (Divinyl ether)

• Central chamber contains piece of Central chamber contains piece of sea-sponge and meshsea-sponge and mesh

1212

Stratford-Cookson Somnoform Stratford-Cookson Somnoform InhalerInhaler

• Introduced by Georges Rolland of Introduced by Georges Rolland of Bordeaux in 1901Bordeaux in 1901

• Made in Pennsylvania, USAMade in Pennsylvania, USA

• Used to administer mixture of Used to administer mixture of ethylchloride,methylchloride, and ethylchloride,methylchloride, and ethylbromide in proportions 60:35:5 ethylbromide in proportions 60:35:5

• Controversial and no longer used Controversial and no longer used after 1931.after 1931.

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Clover’s Portable Regulating Clover’s Portable Regulating Ether InhalerEther Inhaler

• Made in 1900 by Down Brothers, Made in 1900 by Down Brothers, EnglandEngland

• Based on Joseph Clover’s Based on Joseph Clover’s design design

• Allows for ether to be warmed in Allows for ether to be warmed in a water batha water bath

2121

Drager InhalerDrager Inhaler

• 19551955

• Drager, USADrager, USA

• TrichloroethyleneTrichloroethylene

• Hand held inhaler with chain Hand held inhaler with chain for attachment to patient’s for attachment to patient’s bed?bed?

1313

The “Telephone” InhalerThe “Telephone” Inhaler

• 19481948

• Made by Northern Electric Made by Northern Electric Company Ltd., CanadaCompany Ltd., Canada

• Metal connector for Metal connector for attachment to anaesthesia attachment to anaesthesia equipmentequipment

99

The Oro-Nasal InhalerThe Oro-Nasal Inhaler

• Made by Ohio Chemical and Made by Ohio Chemical and Manufacturing Company, USAManufacturing Company, USA

• For nitrous oxide / oxygen For nitrous oxide / oxygen anaesthesiaanaesthesia

• Consists of face-piece with 2 Consists of face-piece with 2 valves, one expiratory and one for valves, one expiratory and one for airair

121121

The Trilite InhalerThe Trilite Inhaler

• Made in 1947 by Trilite Ltd., Made in 1947 by Trilite Ltd., EnglandEngland

• Metal rod-shaped Metal rod-shaped

• Filled with trilene Filled with trilene (trichloroethylene)(trichloroethylene)

• Developed for pain control during Developed for pain control during war timeswar times

• Patient controlled devicePatient controlled device

132132

The Cyprane InhalerThe Cyprane Inhaler

• 19551955

• Made by Cyprane Ltd, EnglandMade by Cyprane Ltd, England

• TrichloroethyleneTrichloroethylene

• Used in ObstetricsUsed in Obstetrics

8989

Anesthetic MasksAnesthetic Masks• Essential part of delivering volatile anestheticsEssential part of delivering volatile anesthetics

• Covers the mouth and noseCovers the mouth and nose

• Evolved from simple cotton gauze to a gauze covered wire Evolved from simple cotton gauze to a gauze covered wire cage (e.g. Heidbrink mask), to a metal mask as part of an cage (e.g. Heidbrink mask), to a metal mask as part of an inhaler (e.g. Ombredanne inhaler), to a rubber or synthetic inhaler (e.g. Ombredanne inhaler), to a rubber or synthetic mask mask

• Most recently combined with an airway (e.g. laryngeal mask Most recently combined with an airway (e.g. laryngeal mask airway)airway)

Yankauer Mask c. 1910

• The coiled wire holds the gauze in place.The coiled wire holds the gauze in place.

• The volatile anesthetic, e.g. ether, was The volatile anesthetic, e.g. ether, was dripped on to the gauze with the mask dripped on to the gauze with the mask held over the mouth and nose.held over the mouth and nose.

• Vaporization of the ether often resulted Vaporization of the ether often resulted in “frost-bite” to the hand of the in “frost-bite” to the hand of the anesthesiologist. anesthesiologist.

11

Ombredanne Inhaler Showing Ombredanne Inhaler Showing Metal Mask c. 1908Metal Mask c. 1908

• The volatile anesthetic agent was in the The volatile anesthetic agent was in the body of this inhaler. The metal mask body of this inhaler. The metal mask (often copper) was placed over the (often copper) was placed over the patient’s mouth and nose.patient’s mouth and nose.

19 a-b19 a-b

Rubber Mask c. 1940-Rubber Mask c. 1940-19601960

• This mask is similar to the ones This mask is similar to the ones currently in use. It is molded to fit currently in use. It is molded to fit tightly over the mouth and nose. tightly over the mouth and nose.

• The part in touch with the face is The part in touch with the face is inflatable for greater patient comfort.inflatable for greater patient comfort.

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Synthetic Mask with Inflatable Synthetic Mask with Inflatable Rubber Cushion c. 1950Rubber Cushion c. 1950

• Synthetic masks became more Synthetic masks became more popular in the 1990s because of popular in the 1990s because of concerns about latex allergy.concerns about latex allergy.

• However, this photo demonstrates However, this photo demonstrates that they are not a recent innovation.that they are not a recent innovation.

8080

Clear synthetic Mask with Clear synthetic Mask with Attachment for Strap c. 1960sAttachment for Strap c. 1960s

• In order to free the anesthesiologist’s hands a mechanism for attaching a head strap became popular in the last century.

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Miscellaneous Archive Miscellaneous Archive Items:Items:

• 1940’s item1940’s item

• Glass syringe and needle setGlass syringe and needle set

• Used for intravenous or spinal Used for intravenous or spinal anesthesiaanesthesia

• Ouch!!!!!Ouch!!!!!

110110

Miscellaneous cont.Miscellaneous cont.

• 1930’s item1930’s item• Ohio chemical and manufacturing Ohio chemical and manufacturing

companycompany• CO2 canisters filled with soda limeCO2 canisters filled with soda lime• Notice the color change????Notice the color change????

109109


• 1940’s Horton Intercoupler1940’s Horton Intercoupler• Small resistors to connect to gas Small resistors to connect to gas

machinemachine• Woven metal brackets to ground Woven metal brackets to ground

anaesthetist and patientanaesthetist and patient• Electrical storm beware!Electrical storm beware!• Dr. H.M. SlaterDr. H.M. Slater

111111


• 1960’s item1960’s item• Pediatric “ Toy Telephone Pediatric “ Toy Telephone

“inhaler device“inhaler device• Montreal Children’s HospitalMontreal Children’s Hospital• Hello! Can you hear me now?Hello! Can you hear me now?

88

Miscellaneous cont.Miscellaneous cont.• 1900-19301900-1930• Mayer and Phelps of London, Mayer and Phelps of London,

EnglandEngland• Brass bronchoscope with built in Brass bronchoscope with built in

light sourcelight source

8787


• 19681968• Research Laboratory in Research Laboratory in

TorontoToronto• Electric timerElectric timer• Multiple usesMultiple uses• Used up until 2007?Used up until 2007?

8888

Anesthetic MachinesAnesthetic Machines• Anesthetic machines began appearing at the end of the 19Anesthetic machines began appearing at the end of the 19thth century century

• Early anesthetic machines were utilized in dental anesthesia for Early anesthetic machines were utilized in dental anesthesia for administration of administration of NN22O and OO and O22

• Initial machines were either:Initial machines were either:

• Continuous flow – continuous flow throughout inspiration and Continuous flow – continuous flow throughout inspiration and expiration (eg. Heidbrink, Foregger, Boyle)expiration (eg. Heidbrink, Foregger, Boyle)

• Intermittent flow – flow of gas during inspiration only (eg. Intermittent flow – flow of gas during inspiration only (eg. McKesson)McKesson)

• Machines evolved to incorporate reducing valves, flow meters, Machines evolved to incorporate reducing valves, flow meters, vaporizers and circuits with carbon dioxide absorptionvaporizers and circuits with carbon dioxide absorption

Boyle Anesthesia ApparatusBoyle Anesthesia Apparatus c. c. 19201920• Modification of original machine developed Modification of original machine developed

by Dr. Henry Boyle in 1917by Dr. Henry Boyle in 1917

• Coxeter dry flow meter allowed Coxeter dry flow meter allowed proportioning of Oproportioning of O22, CO, CO22 & N & N22OO

• Two glass vaporizing bottles Two glass vaporizing bottles

• Bottom illustrations:Bottom illustrations:

– Case with accessoriesCase with accessories

– Machine stand with four cylinder yokes Machine stand with four cylinder yokes (2 each for N(2 each for N22O and OO and O22) + carrying handle) + carrying handle

116a, 117116a, 117

Foregger Metric Gas MachineForegger Metric Gas Machine Montreal Model Montreal Model c. 1924c. 1924

• Modification of Richard von Foregger’s Modification of Richard von Foregger’s original metric gas machine for use with original metric gas machine for use with cyclopropane cyclopropane

• Eliminated reserve gas tanks, with Eliminated reserve gas tanks, with exception of Oexception of O22, because of the increased , because of the increased use of COuse of CO22 absorbers absorbers

• ““Wet flowmeters” used water displacement Wet flowmeters” used water displacement to provide accurate measurement while to provide accurate measurement while introducing humidity to reduce the risks of introducing humidity to reduce the risks of interior staticinterior static

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Water’s CannistersWater’s Cannisters(Waters “to and fro”) (Waters “to and fro”) c. 1930c. 1930

• Ralph M Waters began experiments with CORalph M Waters began experiments with CO22 absorption in 1915absorption in 1915

• Developed “to and fro” system through Developed “to and fro” system through which inspired and expired gases were which inspired and expired gases were directeddirected

• Metal cylinder was packed with absorbent Metal cylinder was packed with absorbent alkaline granules resulting in economy of alkaline granules resulting in economy of gas use along with heat and moisture gas use along with heat and moisture conservationconservation

109 a-c109 a-c

McKesson Nargraf MachineMcKesson Nargraf Machine(Model H)(Model H) c. 1920c. 1920

• Modification of Dr. E I McKesson’s Model A Modification of Dr. E I McKesson’s Model A machine of 1910machine of 1910

• Reducing valves admit NReducing valves admit N22O and OO and O22 into two into two bags enclosed in metal drums at equal bags enclosed in metal drums at equal pressurespressures

• Gases pass to percentage mixing chamber Gases pass to percentage mixing chamber with proportion controlled by dialwith proportion controlled by dial

• Intermittent flow is dependant upon Intermittent flow is dependant upon patients inspiration patients inspiration

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McKesson Nargraf MachineMcKesson Nargraf Machine(Model L)(Model L) c. 1940c. 1940

• Further modification of Further modification of Dr. E I Dr. E I McKesson’s original 1910 machineMcKesson’s original 1910 machine

• Incorporates flow meters for Incorporates flow meters for NN22O and O and OO22 along with stand for anesthetic along with stand for anesthetic recordrecord

120120

Heidbrink ApparatusHeidbrink Apparatus (mixing head only) c. 1930(mixing head only) c. 1930

• Modification of Dentist Jay Modification of Dentist Jay Heidbrink’s original apparatus Heidbrink’s original apparatus introduced in 1912 for administration introduced in 1912 for administration of of NN22O and OO and O22 primarily for dental primarily for dental anaesthesiaanaesthesia

• Proportioning device and valves Proportioning device and valves reduced cylinder pressure of tank reduced cylinder pressure of tank gases to working pressuresgases to working pressures

143143

Midget Kinet-O-Meter Midget Kinet-O-Meter c. c. 19401940

• Modification of Dr. Heidbrink’s earlier Modification of Dr. Heidbrink’s earlier apparatus to administer Napparatus to administer N22O / OO / O22 for for dental anesthesia dental anesthesia

• Flow meter panel calibrated for oxygen, Flow meter panel calibrated for oxygen, nitrous oxide and cyclopropane along nitrous oxide and cyclopropane along with four cylinder yokes (two each for Owith four cylinder yokes (two each for O22 and Nand N22O)O)

• Mounted on a pole to which chart stand Mounted on a pole to which chart stand support is attached support is attached

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history of the cas

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