To the Editor:—

I read with great interest the correspondence “Henry Isaiah Dorr Was the First Person to Hold the Title Professor of Anaesthesia.”1Lowenstein and Kitz state, “The earliest previously known appointment of a Professor of Anesthesia was that of T. S. Buchanan at the Flower School of Medicine in New York City in 1905.” During the past 2 yr, I have researched the beginnings of the anesthesia department at New York Medical College (Valhalla, NY), in particular the career of Thomas Drysdale Buchanan, M.D. I will explain the difference between the Dorr and Buchanan appointments and, in so doing, give credit to the many areas in which Buchanan contributed to the recognition of the specialty of anesthesiology.

Buchanan graduated from The New York Homeopathic Medical College and Hospital in 1897 (originally chartered in 1860 as The Homeopathic Medical College of the State of New York in New York City) and then interned at the Metropolitan, Post Graduate, and Flower Hospitals in New York City. He was appointed anesthetist at Flower Hospital in 1898 and director of anesthesia at the Fifth Avenue Hospital in 1902.

Quoting from a memorial to Buchanan (read by Ralph Waters, M.D., at the International Anesthesia Research Society meeting in 1940) written by Paul Wood, M.D., and published in Current Researches in Anesthesia and Analgesia , “In 1904 he (Buchanan) established a precedent, still in vogue, of having a department of anesthesia headed by a full time professor whose work was limited to the field of anesthesiology. Although others had taught officially in medical schools, they had not so limited their work, and to T. D. Buchanan goes the credit for being the first in this field.”2 

To New York Homeopathic Medical College (through a series of name changes, it became New York Medical College and Flower Hospital in 1936) goes the distinction of being the first medical college to have both a department dedicated to the specialty of anesthesia and a full-time professor of anesthesia. Here in lies the difference between Henry Isaiah Dorr, M.D., D.D.S., who was appointed Professor of the Practice of Dentistry, Anaesthetics and Anaesthesia at the Philadelphia College of Dentistry and Thomas Drysdale Buchanan, M.D., Professor of Anesthesia at the New York Homeopathic Medical College.

The Long Island Society of Anesthetists, established in 1905 by nine physician anesthetists, limited membership to physicians from Brooklyn (Long Island), New York. At the constant urging of colleagues from Manhattan, the nine founders reluctantly agreed to increase charter membership to no more than 50 physicians. Buchanan and J. T. Gwathmey, M.D., were admitted early on, with P. J. Flagg, M.D., becoming the final charter member. 3This organization became the New York Society in 1911, and with the urging of both Buchanan and Wood, the American Society of Anesthetists came into being in 1936, undergoing the last of its name changes, in 1945, to the American Society of Anesthesiologists. “He (Buchanan) was a Founder and Past President of the American Society of Anesthetists; and at the time of his death (1940) he was President of the American Board of Anesthesiology, both of which organizations his labors helped so materially to establish. The latter was one of the most difficult tasks, as not only was there the usual lack of interest, but in addition much active opposition on the part of the medical profession. His personality, persistence and good judgment finally overcame all opposition.”2Buchanan, who was the first President of the American Board of Anesthesiologists (written communication, Francis P. Hughes, Ph.D., American Board of Anesthesiologists Executive Vice President, Raleigh, NC, February, 2001), Wood, and Emery Rovenstine, M.D., were the examiners for the first board examination in 1939. Board certificate No. 1 was granted to Buchanan. 4,5,6,7 

Why my interest in Thomas Drysdale Buchanan? I graduated from New York Medical College, Flower and Fifth Avenue Hospitals in 1950, completing both my internship and anesthesia residency at the Flower and Fifth Avenue Hospitals. Donald E. Brace, M.D. (American Board of Anesthesiologists certificate No. 32), was Professor and Chair of the Department of Anesthesia. Brace was a close personal friend of Buchanan and had succeeded him as department head. Buchanan remained a member of the anesthesia department until his death in 1940. Don Brace, who referred to Buchanan as “Buck,” frequently spoke of him and the influence he had on our specialty. On one occasion, when meeting with the residents, he shared a letter he had earlier received from Buchanan, describing his training and introduction to the field of anesthesia—a letter from which Paul Wood quoted when memorializing Thomas Drysdale Buchanan. “I was a junior at the old Homeopathic College and at the time it was the practice to take on four seniors to administer the anesthetics for the clinics. Naturally, I was anxious to be selected as one of the four who were to anesthetize for old Dr. Helmuth’s clinic. In trying to obtain this experience, I finally importuned a junior surgeon and asked him if he would allow me to give an anesthetic and he said, ‘Yes indeed, you bring me a case for surgery and I will let you give the anesthetic.’ So I did. That was about the only instruction I had in anesthesia, more than most internes received at that time.”2 

In our society, we place a premium on being first. Of equal if not greater importance is the impact that those we anoint with the title of first have on future events. Each in their own way, Dorr and Buchanan played significant roles in the growth and development of the specialty of anesthesiology.

Lowenstein E, Kitz RJ: Henry Isaiah Dorr was the first person to hold the title of Professor of Anaesthesia (letter). A nesthesiology 2000; 93: 1160
Wood PM: Thomas Drysdale Buchanan Memorial. Current Researches in Anesthesia and Analgesia 1941; 20: 61–3
Betcher AM, Ciliberti BJ, Wood PM, Wright LH: The jubilee year of organized anesthesia. A nesthesiology 1956; 17: 226–64
American Board of Anesthesiology: Booklet of Information. Issue 1, July 1937
American Board of Anesthesiology: Booklet of Information. Issue 2, January 1939
Bacon DR, Lema MJ: To define a speciality: A brief history of the American Board of Anesthesiology’s first written examination. J Clin Anesth 1992; 4: 489–97
Smith BE: The genesis of the American Society of Anesthesiologists. ASA Newsletter 2000; 64: 5–7