As represented by the Italian poet Dante, the plutonic rivers Lethe, Styx, Acheron, and Cocytus can be interpreted as supplying amnesia, hypnosis, analgesia, and akinesia, respectively—later regarded as properties of general anesthesia. However, of the five great streams of the Greco-Roman underworld, only the molten river Pyriphlegethon (Greek for “fire-flaming”) boils the souls of the most violent offenders. Indeed, egregious and impulsive behaviors of tyrants, murderers, and other violent offenders melt away in the lava-like Pyriphlegethon. By flowing over and engulfing the violent, the river stabilizes the previously unstable. Perhaps this stabilizing effect of Pyriphlegethon reflects one final property of general anesthesia, cardiovascular and autonomic stability. (Copyright © the American Society of Anesthesiologists’ Wood Library-Museum of Anesthesiology.)

As represented by the Italian poet Dante, the plutonic rivers Lethe, Styx, Acheron, and Cocytus can be interpreted as supplying amnesia, hypnosis, analgesia, and akinesia, respectively—later regarded as properties of general anesthesia. However, of the five great streams of the Greco-Roman underworld, only the molten river Pyriphlegethon (Greek for “fire-flaming”) boils the souls of the most violent offenders. Indeed, egregious and impulsive behaviors of tyrants, murderers, and other violent offenders melt away in the lava-like Pyriphlegethon. By flowing over and engulfing the violent, the river stabilizes the previously unstable. Perhaps this stabilizing effect of Pyriphlegethon reflects one final property of general anesthesia, cardiovascular and autonomic stability. (Copyright © the American Society of Anesthesiologists’ Wood Library-Museum of Anesthesiology.)

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