The chemistry of anesthesia

Since that time it has hecome a medical specialty partly because of scientific advances and partly through the efforts of a relatively few professiona...
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THE CHEMISTRY OF ANESTHESIA

John Adriani, M.D., Charity Hospital01Louisiana at NewOlleans, and Clinical Assistant Professor of Surgery, Louisiana State University School of Medicine. Charles C. Thomas, Springfield, Illinois, 1946. x 536 pp. 45 figs. 28 tables. 15 X 23 om. $7.00.

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administrative official realize the need for recognizrrlp, anesthesiology as s medical specialty. From the standpoint of chemical educntion the book is valunble in that it shows clearly t h e practival relatiomhip of chemistry to a medical xpecinlty and demonstrates how the single property of uarcotization with its variables of intensity and side actions can be traced from the simple gaseous hydrocarbons to the structurally complicated solid analgesic amnt,s. ----~~--In passing, the reviewer noted errors in tvooeraohv -. . " and stvle illust&d by the followingexamples. In the second line on page 108 the ward "pharmaoaloaists" is missoelled. and in the last line of the first paragraph of the summary an page 327 "in questionable" should doubtless be "is questionable." The fourth sentence of the second paragraph, page 107, would he improved by rearranging to read, "Atropine is not prepared synthetically because of the complexities involved even though its structure is h o w n and it has been synthesized."

T m nrscomm of successful &cal anesthesia, made during the years between 1842 and 1847, was a contrihution to the advancement of medicine that is distinctly American. It is curious that in the century that hss elapsed knce that epochal event, anesthesiology has been more an art than a science. Prior to World War I the administration of an anesthetic was largely the application of technical skills. Since that time it has hecome a medical specialty partly because of scientific advances and partly through the efforts of a relatively few professional anesthesioloaists. - It seems somehow fitting that in the country where'anesthesia was discovered there exists some of the best anesthesiolom in the world. However, it is unfortunate that such is not the case where the specialty is neither encouraged nor recognized. If anesthesiology is to change completely from an art to a science, it must rest firmly on the fundamental sciences of chemistry, physiology, and pharmacology. With respect to the fist of 0 ORGANIC PREPARATIONS' these, it can he,said that Dr. Adriani has adequately fulfilled the purpose of summarizing the fundamental chemistry essential to Conrad Weygmd, University of Leipzig. Interscience Pubthe science of anesthesiology and pointing out the gaps where lishers, Inc., New York, 1945. dii 534 pp. 12 figs. 15 X 23 cm. $6.00. additional research is reauired. The author has logically divided the hook into three parts. FORSTUDENTS of organic chemistry and for laboratory workers Part I is concerned with the inorganic chemistry pertinent to engaged in syntheses in that field, this little volume neatly s u p anesthesia and is therefore primarily a review of the chemistxy of plements Houbeu-Weyl and Lamar-Cohn. Whereas the former inorganic gases and of carhon dioxide absorption. Since it is is organized about functional groups and the latter about redi6icult to separate the chemistry of gases from their physical be- agents, Weygand's book is based on the production, and the behavior, the author has wisely included the physics of gases. havior, of bonds between two atoms or groups. By presenting Differences in rates of diiusion of gases must be appreciated he- mterial most excellently from another point of view, this book is fore the anesthetist can understand the role they play in anes- hound to he stimulating and idea-provoking. It is splendidly thesia. The four chapters of Part I deal with the physical he- documented. The translators refer to "Organic Syntheses" rehavior of gases, the clinical application of the physical laws of peatedly rather than quote from that valuable set. This practice gases, the chemistry of inorganic gsses, and the chemical absorp made the book unusually small but is commendable since it may tion of carbon dioxide in rebreathing appliances. safely be presumed that the collective volumes of "Organic Part I1 covers the organic chemistry related to anesthesia and Syntheses" are available to all organic researchers in this country. consists of 16 chapters which emphasize the relationship of chemiWhile it is a real pleasure whole-heartedly to praise this book, cal structure to pharmacological action and anesthetic efficiency. it is only fair to say that it is not perfect. There are occasional The subject is developed interestingly and systematically from misprints and some obvious errors. The illustrator (see the the simple gaseous hydrocarbons to the structurally complicated cover and page 11) did not follow accepted usage in dmwing the barbiturates, alkaloids, sympathetic and pamympathetic agents, diagrams. It is regrettable that "saponified" is given so broad a and analepties. meaning. That tenn has a definite and egpecial signi6oance. In ~ a r G 1 1 the biochemistry related to anesthesiais considered. whereas "hydrolysis" is the term of broader scope. Without deTwelve chapters are devoted to an appraisal of the effects of anes- veloping too extensively a specialized jargon, scientists'can exthetic agents on the biochemistry ofthe living organism, starting press themselves more accurately, and hence more clearly, by a with a review of the chemical basis for the various proposed more careful choice of worda. The translators, or the author, mechanisms of narcosis. Consideration is given to the effects of failed to distinguish "clear" from "colorless." There is a differanesthesia upon the composition of body fluids, liver function, "-"" formation and composition of urine, and upon lipoid and nervous ~h~ better a book is, the more its seem. tiasue. The author calls attention to the paucity of data in this ~ h foregoing , remrb should not damn thiswork. Weygand,s whole important field, especially the effectsw o n enzymes, vitaa fine book and be in every organic library, mins, and hormones. lh. Adrinni's book should be valuable not only to the student W ~ B L Z T I IU N I V L B . I ~ ~ and practitioner of anesthesiology, but should hclp the responsible ~ m o ~ a r o a~r o. a n ~ c n e m

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