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The term "gum elastic bougie" has been recurring in anaesthetic literature ever since Professor Robert Macintosh was apparently experimenting with the development of the right-angled Oxford endotracheal tube and wrote a short, illustrated article in the British Medical Journal on January 1, 1949 (1). In Mackintosh's day the device was indeed gum, elastic and a bougie. Today the devices we use to facilitate difficult endotracheal intubations cannot accurately be classified with any of these words. An elegant plea for abandoning the term in the correspondence columns of Anesthesiology (2) in 2004 has gone unheeded, despite pointing out that a device such as the Eschmann Tracheal Tube Introducer is neither gum, elastic nor a bougie.

The problem is, what should it be called? The device is very different from the malleable airway stylet also commonly found in anaesthesia practice. Common usage seems to accept bougie, but that is inadequate. Airway bougie or plastic airway bougie both seem appropriate and unlikely to cause confusion in critical situations--even if not quite correct. I suggest that in journal articles, either the manufacturer's catalogue name be used or authors describe it generically as a plastic airway bougie.

Footnote: The term bougie was probably used first for urethral and oesophageal dilators, taking this name from a slender wax candle arising from the trade of wax in the Algerian town of Bijiyah (3). From this, the French used the word bouge as a verb meaning to swell out (4) and from thence evolved the word 'bougie' as a surgical device to swell out a stricture.


(1.) Macintosh RR. An aid to oral intubation. BMJ 1949; 1:28.

(2.) El-Orbany MI, Salem MR, Joseph NJ. The Eschmann Tracheal Tube Introducer is not gum, elastic or a bougie. Anesthesiology 2004; 101:1240.

(3.) The Concise Oxford Dictionary, 5th ed. Fowler HW, Le Mesurier HG (eds), Oxford University Press 1934; p. 128.

(4.) Samuel Johnson. Dictionary of the English Language, 8th ed. Longman, Paternoster Row, London, 1799; printers folio mark 2E2.

A. Bacon

Berwick, Victoria
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Article Details
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Title Annotation:Correspondence; endotracheal intubations
Author:Bacon, A.
Publication:Anaesthesia and Intensive Care
Article Type:Letter to the editor
Geographic Code:8AUST
Date:May 1, 2009
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