DEVLOPMENT OF ANESTHESIOLOGY IN CZECHOSLOVAKIA

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83-00423R001300980001-9
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 4
• Document Creation Date: November 9, 2016
• Document Release Date: October 21, 1998
• Sequence Number: 1
• Publication Date: January 13, 1954
• Content Type: REPORT

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COUNTRY: Czechoslovakia CIA
SUBJECT: Development of Anesthesiology in Czechoslovakia
DATE ACQUIRED: 19+7
INFORMATION: 19+7 and earlier S/?3a4
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DATE-/,? January /9`"S
DATE OF ? .
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1. Dr Emil Schulz of Prague delivered a very interesting paper, "Development
of Anesthesiology in Czechoslovakia," at the Twenty-Second Annual Congress
of Anesthetists. This was arjoint session of the International Anesthesia
Research Society and the International College of Anesthetists, held in
New York on September 8-11, 19117.
2. Excerpts from Dr Schulz's report are as follows:
3. "I accepted with great pleasure the invitation to address the Twenty-
Second International Congress of Anesthetists on the occasion ofl Dr Francis
Hoeffer McMechan Memorial and I regard it my special duty to c with
affection and appreciation the close association of the name of Dr McMechan
with the history of modern anesthesia in Czechoslovakia, since 1924.
1i. "In Czechoslovakia as in France, Augtria, Germany and other European
countries anesthesia was practiced only as an appendiosugr anesthesia
was assigned regularly to nurses. The young physicians regarded
a nuisance and were never enthusiastic about its administration. The follow-
ing were the routine procedures: open mask or Ombredanne's or Schimmelbusch's
mask, or by Roth-Draeger apparatus; spinal anesthesia after premedication
with ephedrine was given for abdominal operations. Local anesthesia with
novocain-adrenalin gave excellent results in abdominal and thoracic surgery
in preference to spinal and general anesthesia. Evipan was used intravenous-
ly and avertin as a basal anesthetic was employed intrarectally.
5. "My first contact with US anesthesia was established in 192+ and 1925 when
I visited the United States and Canada to study modern dentistry, and at
the same time to observe methods of inhalation anesthesia. This type of
anesthesia was of especial interest to me because of my previous work in
plastic surgery. I studied the administration of nitrous oxide and
ethylene with the leading men like Dr McKesson and Dr Heidbrink, and at
the clinics of Dr Crile and Dr Mayo.
~. "Returning to Czechoslovakia I became a pioneer of modern anesthesia in our
country and introduced the gas anesthesia for all operations in general
surgery, gynecology, obstetrics, nose and throat surgery, and dentistry.
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T. ."I introduced gas anesthesia at the Surgical Clinic of Professor Dr A Jirasek,
Charles University of Prague. The State Plastic Institute of Professor
F Burian used this method of anesthesia for plastic surgery, and the Gyne-
cological Clinic of Professor F Ostrcil employed it for gynecological
operations.
8. "About this time Dr McMechan visited me in Prague and I was the only
member of the International Anesthesia Research Society in our country.
He advised me to see Dr Schmidt in Hamburg, who experimented with acetylene,
called narcylene, and urged me to visit also Dr de Caux of London who
administered gas anesthesia in London in the Middlesex Hospital by the
intratracheal and intranasal routes. I followed his advice, and studied
anesthesia in Hamburg and London. Later I conducted an experimental pharma-
cologic research on anoxemia due to low percentage of oxygen in nitrous
oxide anesthesia, and read a paper on 'Nitrous Oxide in General Surgery'
at the Surgical Congress in Prague. In 1930 the Surgical Society invited
the anesthetist Dr de Caux and his surgeon Dr F Abel of London to operate
at the Congress in Prague using nitrous oxide anesthesia.
9. "At this time gas anesthesia was used with great enthusiasm at different
hospitals like Jicin and Beroun. The dental profession accepted enthusiastical-
ly the new method and in a short time about 40 gas machines were imported
from the US. By 1937 nitrous oxide was manufactured in Czechoslovakia. I
also introduced ethylene and continued to use it until the outbreak of the
war.
10. "As a direct result of the enthusiastic encouragement of Dr McMechan, the
new anesthesia spread so rapidly in our country that probably nowhere on
the European continent was gas anesthesia used as much as in Czechoslovakia.
11. "However, the war destroyed this promising start of modern anesthesia in
our country. The German invaded Czechoslovakia in 1939; the universities
and medical schools were closed; hospitals and clinics were used only for
the Germans; and Czech patients were crowded into temporary shelters and
barracks where no advanced medicine could be performed. At the end of the
war we were confronted with the situation that all better anesthetic equip-
ment like the McKesson and Heidbrink gas machines were stolen by the Germans,
and during the great fighting with the Germans at the time of the revolution
in Prague, in May 1945, not even the simplest anesthetic agent like ether was
at hand. We were unable to perform any transfusion, glucose infusion or
intravenous anesthesia due to the lack of material and equipment; surgery
was performed without anesthesia; no alcohol, opiates, penicillin, or sulpho-
namides were available.
12. "This lamentable picture prevailed at the time of our liberation in 191+5.
But relatively soon the immense amount of medical and hospital supplies of
UNRRA, tremendously helped at the most critical time. With these supplies
came some anesthetic gas apparatus, but in some places the young physicians
were not familiar with their use and no gas cylinders were supplied, so that
the gas apparatus stood idle. The modest amount of literature on anesthesia
received with the supplies gave the first stimulus to young physicians to
attack the problem of anesthesia.
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13. "The Czech and Slovak people are deeply grateful to the US for these vast
donations of UNRRA, because without this help our patients would have
lacked indefinitely the blessings of modern medicine.
14+. "Thus was again established a close contact with US anesthesiology. The
Unitarian Medical Mission to Czechoslovakia, called 'American Faculty on
Wheels,' consisting of 11i outstanding US medical and dental specialists,
came to Czechoslovakia in 1946, bringing to the medical and dental professions
fresh knowledge and inspiration from new methods, technical and surgical pro-
cedures, and drugs. The anesthetist on the staff was Dr E A Rovenstine of
New York University who administered spectacular anesthesia in a case of
pneumonectomy and resection of carcinoma of esophagus performed by Dr A
Brunschwig of the University of Chicago.
15. "The success of this difficult anesthesia was so electrifying for the medical
profession that young physicians immediately attacked the problem of anesthesia
and of modern anesthesiology as a subject of medical teaching.
16. "The first remarkable result of this US influence was the decision of
Dr Rapant, head of the Surgical Clinic in Olomouc, Moravia, to establish
the first special department of anesthesia in our country. Furthermore,
the Ministry of Education sent a young physician, Dr Zdenek Sery, to the
Middlesex County Hospital in London to study modern methods of anesthesia.
17. "All available literature by such authors as Lundy, McIntosh, Bannister,
Hewett, Mackenzie and others, was studied. With ,a US apparatus intratracheal
anesthesia was started, in abdominal and thoracic cases pentotal with nitrous
oxide-ether was used and intocostrin and tubarine were introduced. Premedica-
tion and postoperative treatment was practiced, while during operations trans-
fusions of blood and human and animal plasma were given, blood pressure was
measured and proper oxygenation was practiced. In cases of pulmonary in-
fections only pentothal and curare were used.
18. "The reports of the State Plastic Institute of Dr F Burrian and of the
Surgical Clinic of the University of Olomouc, emphasized that in general,
difficulties are encountered in obtaining new apparatus such as the Oxford
Vaporizer, Boyle's anesthesia. Even our ether is sometimes not absolutely
pure. We lack human plasma, protein hydrolysates, aminoacids for cancer .
patients. There is the greatest need for literature on anesthesia, journals,
both new and old, dating even as far back as 10 years.
19. "The Czech and Slovak medical profession would appreciate gratefully any
suggestions or advice which could help us during this critical time of
rehabilitation. So far as we can with our limited means, and with the
handicaps resulting from the wax, we are anxious to follow the US example
of progress in anesthesiology and we hope that the first endeavor to teach
anesthesia and establish it as an independent subject of study will be
followed by similar action in other universities in Czechoslovakia. It
is essential in Czechoslovakia to establish for the future the specialty
of anesthesia,
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20, "There is one more reason why anesthesiology should be established:
In impoverished Europe the former dominant centers of medical teaching
in Germany and Austria, for many years at least, are no longer active.
Their functions could be undertaken by Czechoslovakia for Southeastern
Europe, Now more and more of our physicians are trained in the US and
UK instead of in France, Germany, and Austria, Therefore, Czechoslovakia
could easily become a teaching center in anesthesiology and a connecting
scientific link between East and West,
21, "In closing I want to express the deep gratitude I owe to the late Dr
McMechan for advice and encouragement, and to all the other US anesthetists
who have contributed to the advancement of our anesthesia since 1924.
Furthermore, we gratefully acknolwedge our debt to UNRRA for material
help and to the Unitarian Medical Mission for inspiration which resulted
in a new interest in the specialty of anesthesia in Czechoslovakia."
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