by Dr. Peter Gordon (Honorary Curator, Emeritus Professor, UCT)
The Nagin Parbhoo History of Anaesthesia Museum is housed in the University of Cape Town’s Department of Anaesthesia and Perioperative Medicine situated in the New Groote Schuur Hospital in Observatory. Artefacts in the museum reveal the long and often painful change in anaesthesia from an art in the early 1900s to a science in the post Second World War era.
Visitors are introduced to the museum by a large high-resolution copy of the painting Surgery by Dorothy Kay depicting a female patient undergoing surgery in Port Elizabeth in 1937. In the absence of monitoring equipment prevalent in a modern operating theatre the onlooker is captivated by the central figure of the anaesthetist using his senses to monitor the state of the patient. The patient is being anaesthetised by chloroform or ether via a Shipway apparatus and a Schimmelbusch mask covered by cloth.
Early history of anaesthesia
The public demonstration by Boston dentist WJG Morton in October 1846 that ether could annul the pain of surgery was a turning point in medicine. The news spread rapidly around the world. In April 1847 ether was being used in Cape Town for dental extractions and in June 1847 Dr William Guybon Atherstone, manufactured ether, designed a inhaler, and administered ether for the mid-thigh amputation of a patient’s leg in Grahamstown. World Anaesthesia Day is celebrated annually on the 16th October. Facsimiles of both Morton’s and Atherstone’s inhaler are displayed in the museum.
Early South African anaesthetists travelled overseas for training and brought back a variety of anaesthetic equipment much of which survived and is on display in the museum. Early artifacts include a variety of wire masks that were covered with gauze over which ether or chloroform was dropped to provide anaesthesia, a Clover’s portable regulating ether inhaler manufactured in 1877, and an Esmarch’s chloroform inhaler designed in 1867 for use on the battlefield, and was that was still used during the Second World War.
The University of Cape Town’s Medical School, South Africa’s first, started teaching anaesthesia to medical students in their fourth year of study at the New Somerset Hospital in 1921. United Kingdom trained Dr G.W. Bampfylde Daniell was appointed as the Universities first lecturer in anaesthetics. Several items belonging to Daniell are owned by the museum. As in the United Kingdom, the majority of doctors practicing anesthesia in state hospitals at that time were employed as honorary anesthetists receiving remuneration from the surgeon employing them in private practice.
Anaesthetics at UCT
In 1921 New Zealand born and Edinburgh trained, Dr Royden Muir emigrated to Cape Town and joined Dr Daniell in practice and as a part-time lecturer in anaesthesia. He brought with him the so-called Pinson “ether bomb” and a rare, portable Boyles anaesthetic machine designed in 1917 by English anaesthetist Dr Henry Boyle. Both items are on display. The collection traces the development of subsequent Boyles machines that gradually allowed more accurate control of gas flows and pressure from the gas cylinders.
A Rapidly Expanding Field
In the 1930s, several South African anaesthetists including Muir travelled to the UK and USA to learn from leaders in the rapidly expanding field. They brought back new ideas on the training of anaesthetists, as well as modern equipment, that included apparatus to administer the new, explosive anaesthetic, agent cyclopropane. Several items from this era are on display. They include the “Muir Midget”, commissioned by Muir in the USA to meet the needs of SA anaesthetists in private practice who at that time had to carry equipment from nursing home to nursing home.
Origins of the Dr Nagin Parbhoo Museum
The collection was started in earnest by the UCT Head of Anaesthesia, Dr C.S. (Buck) Jones in November 1956 after the donation by Dr Lindsay van der Spuy of equipment to the UCT Department of valuable early equipment that had belonged to Royden Muir. Initially housed in the office of the HoD at the UCT Medical School the collection moved to the New Groote Schuur Hospital building after it opened in 1989. The museum is named after Dr Nagin Parbhoo the honorary curator of the museum who had sourced many artefacts from hospitals in the Western Cape and commissioned eight oak and glass display oak and glass display cabinets.
Advances in Ventilation
Until the 1960s patients requiring ventilation during anaesthesia were ventilated manually by squeezing a rubber bag containing anaesthetic gases.
The collection possesses a wide range of ventilators ranging from the tiny Minivent designed by Johannesburg anaesthetist Dr Anthony Cohen in 1965 in an era when private anaesthetists had to carry equipment from hospital to hospital, to the huge Dräger Iron Lung weighing 620kg that was used in Cape Town during the polio epidemics of the 1950s.
When Red Cross War Memorial Children’s Hospital opened in 1956 there was no equipment for measuring blood pressure in tiny neonates undergoing surgery. Dr Tom Voss solved the problem by cannulating an artery and measuring the blood pressure by the height of a column of water attached to the catheter.
This technique was adopted by Groote Schuur Hospital and Tygerberg Hospital for measuring patient’s blood pressure in the ICU after surgery. The technique became obsolete with the introduction of electronic manometers.
Remembering South African Innovations
A section of the museum is dedicated to anaesthetic equipment invented by South African anaesthetists. It includes the Taurus blood warmer developed in a collaborative project between the UCT Departments of Anaesthesia and Electronic Engineering. Named after UCT’s Professor Arthur Bull it became an essential piece of equipment to avoid hypothermia and possible cardiac arrest when rapid transfusion of cold refrigerated blood was required. A bronze bust of Professor Bull commissioned by the Cape Western Branch of the SA Society of Anaesthetists and presented to Bull on his retirement was subsequently donated to the museum.
A section of the museum is devoted to the South African Society of Anaesthetists (SASA), the world’s 9th oldest national society of anaesthesia when it was formed with 26 members in 1943. Currently membership stands at over 2000 in 2019. The display includes photographs, SASA Guidelines for Anaesthesia, and posters advertising the 2008 World Congress of Anaesthesiologists organised by the SASA and held in Cape Town.
The UCT Department of Anaesthesia has evolved from an ancillary department of Surgery in 1921 run by part-time anaesthetists to a world respected Department of Anaesthesia and Perioperative Medicine. The department’s history is remembered by photographs of previous heads of department, boards honouring members of the department who have been awarded medals in the College of Anaesthetists examinations, recent publications, and posters commemorating the pioneering roles played by Dr Joseph Ozinsky in establishing the successful heart transplant programme initiated by Professor Christian Barnard, and Professor Gaisford Harrison’s role in documenting and reducing anaesthetic mortality at Groote Schuur Hospital over 30 years. He also established the porcine model of the fatal condition Malignant Hyperthermia and then discovered that the drug Dantrolene could terminate the syndrome.
The museum aims to preserve the history of the department and anaesthesia in South Africa. Artefacts in the Collection provide a valuable resource for both researchers. and for those involved with teaching medical students and registrars in training.
Visit the museum
The museum forms part of an active department and visitors wishing to do so are welcome. Appointments can be made by e-mailing Peter Gordon, the Honorary Curator at email@example.com, or Dr Robert Nieuwveld (Assistant Honorary Curator) at firstname.lastname@example.org or by telephoning the Department Secretary Mrs. C Wyngaard at +27 21 404 5004.