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The first spinal anesthesia. Who deserves the laurels?
1Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York.
Regional Anesthesia
|November 1, 1994
Summary
Corning's early attempt at spinal anesthesia was likely an extradural block, not a true spinal anesthetic. August Bier is credited with the first authentic spinal anesthesia, using cocaine.
Area of Science:
- Anesthesiology
- Neurology
- Medical History
Background:
- Investigating the historical debate surrounding James Leonard Corning's 1885 cocaine injection.
- Comparing Corning's procedure with early authentic spinal anesthesia techniques by Bier and Tuffier.
Discussion:
- Corning's injection details, including dose, onset, and sensory level, suggest an extradural rather than a spinal block.
- Corning's proposed mechanism of action differed significantly from established understanding of spinal anesthesia.
Key Insights:
- Corning's cocaine injection did not involve cerebrospinal fluid, unlike authentic spinal anesthesia.
- Corning used a higher dose of cocaine with slower onset and lower sensory level compared to Bier and Tuffier.
- Corning theorized venous absorption for cocaine's effect, contrasting with direct spinal cord action.
Outlook:
- Re-evaluating historical contributions to spinal anesthesia.
- Clarifying the distinction between extradural and spinal anesthesia in early practices.
- Highlighting August Bier's definitive contribution to spinal anesthesia.
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