Into the Ether
Old-time movie villains used chloroform-soaked rags to subdue their victims, which knocked them out in seconds. In reality, physicians once used chloroform and ether as surgical anesthesia, delivering them with the help of a mask held to a patient’s face for several minutes.
The Schimmelbusch mask, invented in 1890 and named for its German creator, introduced a portable, hygienic way to put someone under for surgery. A physician or assistant would wrap the wire-frame mask in gauze, place it over a patient’s nose and mouth, and slowly drip a liquid sleep agent onto the fabric. The outwardly curved “gutters” along the mask’s rim collected excess anesthetic to avoid it trickling onto and irritating the patient’s skin. The tool collapsed flat so it was easy to carry in doctors’ bags. Because of its ease of use, it saw military action during World Wars I and II, and it is still used today in some developing countries.
Anesthesiologists today employ intravenous medications or gases delivered via a less frightful-looking mask. After inducing anesthesia, a physician — guided by a viewing tool called a laryngoscope — inserts a breathing tube into the patient’s trachea. The tube then is attached to a ventilator that blows air and more anesthetic into the lungs.
Cedars-Sinai is studying new laryngoscopes that aim to improve the physician’s view into the throat and hasten the intubation process. One test scope is equipped with vacuum-like suction that allows physicians to do with one tool what previously required two or three. Expedient intubation is crucial: Since general anesthesia with relaxation effectively paralyzes the body, the ventilator must take over breathing immediately. Investigators believe the study’s results will lead to more efficient procedures.
The Schimmelbusch mask pictured here resides with a collection of medical artifacts in Cedars-Sinai’s Historical Conservancy.