Flemish artist Maerten de Vos’ watercraft-seated Phlegmaticus (1583) reminds us that a patient of phlegmatic temperament flows with the cold, wet “phlegm” humor linked by ancient Greeks with elemental water. By 1893 at Chicago’s Post-Graduate School of Anaesthesia (PGSA), professors were tutoring future “Master of the Science of Anaesthesia” candidates to anticipate that a phlegmatic patient’s anesthesia might comprise—what today’s anesthesiologists would characterize as—(1) a swift induction, (2) a risk for heart-depressing anesthetic overdosage (termed “concussion” by the PGSA), and (3) a smooth emergence. PGSA Professor James M. Clyde, D.D.S., M.S.A., taught that phlegmatic patients might not only resist preanesthetic calming but also be vulnerable to an anesthetically “over-charged atmosphere … [which could] paralyze the medulla and cause death” from cardiac “concussion.” (Copyright © the American Society of Anesthesiologists, Inc.)

Flemish artist Maerten de Vos’ watercraft-seated Phlegmaticus (1583) reminds us that a patient of phlegmatic temperament flows with the cold, wet “phlegm” humor linked by ancient Greeks with elemental water. By 1893 at Chicago’s Post-Graduate School of Anaesthesia (PGSA), professors were tutoring future “Master of the Science of Anaesthesia” candidates to anticipate that a phlegmatic patient’s anesthesia might comprise—what today’s anesthesiologists would characterize as—(1) a swift induction, (2) a risk for heart-depressing anesthetic overdosage (termed “concussion” by the PGSA), and (3) a smooth emergence. PGSA Professor James M. Clyde, D.D.S., M.S.A., taught that phlegmatic patients might not only resist preanesthetic calming but also be vulnerable to an anesthetically “over-charged atmosphere … [which could] paralyze the medulla and cause death” from cardiac “concussion.” (Copyright © the American Society of Anesthesiologists, Inc.)

George S. Bause, M.D., M.P.H., Honorary Curator, ASA’s Wood Library-Museum of Anesthesiology, Schaumburg, Illinois, and Clinical Associate Professor, Case Western Reserve University, Cleveland, Ohio. UJYC@aol.com.