History of the Scottish Society of Anaesthetists

This Story has been told, at least in part, before. The Editor he flattered me by suggesting that I might write down what I knew, but if you respond to that you soon discover that you don’t know as much as you thought. Thus, late for the deadline, here is what I know now.

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The key character is Dr. Francis Hoeffner McMechan (1879-1993) who was born and practised in Cincinnati, Ohio. He was married in 1909. Eighteen months later he became the victim of a crippling arthritis which forced him to cease practise. Supported by his seemingly formidable wife Laurette, a descendant of Baron Larrey (Napoleon’s Surgeon General, pioneer of the field ambulance, snow induced regional hypothermia for amputation of a limb, and Henry Hill Hickman’s champion before Charles X of France in 1828). McMechan set about regular correspondence with the leading anaesthetists in the western world. The ultimate objective was to encourage the formation of national and eventually international organisations of anaesthetists. He had considerable talent as a writer and had persuaded the American Journal of Surgery to launch, in 1914, a Quarterly Supplement on anaesthesia and analgesia. The Scottish Society was established in the same year – the world’s first national society of anaesthetists. McMechan soon embraced them with the quarterly supplement as their official organ, sharing that distinction with the American Association of Anaesthetists, a product of his strategy but not quite a national society as there were regional competitors, notably from New York and the Pacific states.

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The Quarterly Supplement soon listed several distinguished British names as Associate Editors. Dudley Buxton and H.E.G. Boyle are probably the best remembered, but Torrance Thomson from Edinburgh is denoted as ‘Associate Editor for Scotland’. Perusal of the pages for 1914-19 suggests little copy from Scotland, although the period spanned the Great War. There was, however, a half column obituary of Dr. D.C. McAllum, the first president of SSA, who had died at Edinburgh in February 1915. The obituary is lukewarm, in my opinion and perhaps not just mine. In the SSA proceedings of 29 November, 1919 Torrance Thomson reports that the American “arrangements” were not working satisfactorily and that his report to the Supplement had been altered by McMechan without reference to him. The Secretary was instructed by the meeting to terminate the “special connection”.

 

The SSA continued to flourish; so also did McMechan. His campaign for international entente may have received short shrift from the Scots but he was including more American regional societies within his fold and had extended to involve the Canadians. He published the first Yearbook of Anaesthesia and Analgesia and was the major influence in setting up the National Anaesthesia Research Society which soon became the International Research Society. He was Permanent Secretary-General of both. The Research Society published its own journal, Current Researches in Anaesthesia and Analgesia in 1922 with McMechan as editor.

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The rift between SSA and McMechan appears to have healed by 1926. The last issue of the Quarterly Supplement, in 1925, drew attention to the 1926 meeting of the BMA in Nottingham. McMechan had secured an invitation from the secretary of the BMA to a party of North American anaesthesiologists to visit the meeting for joint symposia with the BMA section on Anaesthetics. The McMechans led a party to Nottingham via France, Germany and Scotland. The BJA (founded 1923) had become the vehicle for SSA reports. The July 1926 issue tells the story fully and quaintly:

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The Americans in Scotland

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The Scottish Society of Anaesthetists, on hearing early in the year that there was a probability of a visit from a party of anaesthetists from the USA and Canada, decided to postpone their Annual Meeting until July in order to leave open the opportunity of having those prospective visitors at the meeting. This turned out to be a wise decision, and led to a most interesting and enjoyable meeting on 6 July, the day of the visitors’ arrival in Glasgow….. The morning was given up to visits to the Royal Infirmary and the Royal Hospital for Sick Children where demonstrations had been arranged by Dr. Fairlie and Dr. Ross McKenzie, the latter prefacing the demonstration of gas oxygen anaesthesia combined with CO2 administration with a short paper illustrated by lantern slides.

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In the afternoon the venue of the meeting was the Royal Faculty of Physicians and Surgeons’ premises where a room had kindly been provided. The President of the Scottish Society occupied the chair and delivered an address dealing with many of the problems with which the anaesthetist is faced, special emphasis being given to the teaching of anaesthetics.

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The address was singularly instructive and inspiring and left its hearers with a feeling of deep regret that anaesthesia was about to lose the services of Dr. [J. Stuart] Ross. The paper was followed by a discussion in which some of the overseas visitors took part. A paper was then read by Dr. Wesley Bourne of Montreal on “Some Impurities of Ether”. This was very much appreciated as the participants in the ensuing discussion indicated.

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The customary dinner following the Annual Meeting was held in the Central Hotel when the Scottish Society had the privilege of entertaining the party of visitors. A most enjoyable evening was spent. A novel feature of this dinner was the presence of ladies. By a happy chance the first appearance of lady members of the Scottish Society coincided with the presence of several lady members of the overseas party…..

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The BJA Board also met at Nottingham. McMechan was “unanimously elected Honorary Associate Editor in token of the highly valuable work he has done and continues to do for anaesthesia generally.” It is interesting to note that of eleven Board members, three were Scots: Torrance Thomson, H.P. Fairlie (Glasgow) and John Johnston (Aberdeen). All were founder members of the Scottish Society. In 1927 the IARS presented a scroll to the BJA Board. Is it significant that the Scottish Society did not receive one? I have no difficulty in seeing the Hand of McMechan. What might have happened to the Society had it been  allowed to come closer?

I am grateful to Dr. A.H.B. Masson, Dr. A.G. Macdonald, Dr. A.G. McKenzie and Professor J.A.W. Wildsmith for their help. Dr. I.D. Levack discovered the last known copy of the IARS scroll (probably Dr. John Johnston’s copy). It is now in the Royal College of Anaesthetists.