Barrell of Lunatics: Places Associated with the First Public Demonstration of Ether Anesthesia.  By David C. Lai, M.D. Park Ridge, Illinois, Wood Library-Museum of Anesthesiology, 2003. Pages: 30. Price: $20.00.

No event in the history of anesthesia is of greater importance than the discovery and first use of diethyl ether for anesthesia. Although opiates and plant derivatives have been used as analgesics for thousands of years, the first truly effective anesthetic agent, ether, was put to surgical use in the Northeastern United States in October 1846. In 1972, the Wood Library-Museum of Anesthesiology (Park Ridge, Illinois) published An Historical Guide to New England Pertaining to the Discovery of Anesthesia  to recognize the historic landmarks and activities of key figures associated with the first demonstration of ether anesthesia. This guide, complete with walking and driving directions to relevant New England landmarks, was published primarily as a tour guide for attendees of the annual meeting of the American Society of Anesthesiologists held in Boston that year. The guide was then republished in 1996 to mark the 150th anniversary of William T. G. Morton’s first public demonstration at the Massachusetts General Hospital (Boston, Massachusetts).

Now, a third pamphlet, Barrell of Lunatics: Places Associated with the First Public Demonstration of Ether Anesthesia  by David Lai, M.D. (Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts), introduces a complementary and additional perspective to its two predecessors. This companion explores the shared history of anesthesia, surgery, and psychiatry, revealed through an interesting collection of photographs, poems, illustrations, and watercolors of key historical sites in New England. The title, Barrell of Lunatics , derives from the Joseph Barrell House (Somerville, Massachusetts), which later became the McLean Asylum and home of Dr. Charles T. Jackson after his failed claims to gain credit for the discovery supposedly drove him insane. The historic connection featured in this new work is the influence of Charles Bulfinch (American architect, 1763–1844), designer of not only the Joseph Barrell House but also the Massachusetts General Hospital, which included the famous “ether dome” where surgeon John Collins Warren (1778–1856) completed the first surgery with inhalational anesthesia. Of interest, Dr. Leroy D. Vandam (Professor of Anesthesia Emeritus, Harvard Medical School, Boston, Massachusetts), a central contributor to the original historic guide published in 1972, has painted the watercolors of William T. G. Morton’s homes included in this new work.

In addition to the architectural montage of William T. G. Morton’s professional and personal dwellings, Lai includes a series of fascinating photographs and epitaphs from the Mt. Auburn Cemetery, where several monuments commemorate Morton. Epitaphs such as “BEFORE WHOM in all time Surgery was Agony” and “SINCE WHOM Science has Control of Pain” lend cultural commentary on Morton’s contribution to medicine.

Although Barrell of Lunatics  draws on a thematically related collection of photos, facts, and verse, it lacks a clear historical sketch of the first demonstration of ether and will be most appreciated by those already intimately familiar with the events, primarily historians and serious students of anesthesia’s past. Nevertheless, this work successfully underscores the impact anesthesia has made on the practice of medicine and is a portal to a unique component of New England’s architectural and medical history.

Mayo Clinic, Rochester, Minnesota.