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The Worst of Evils: The Fight Against Pain.

The Worst of Evils: The Fight Against Pain. T. Dormandy. Yale University Press, PO Box 209040, New Haven, CT 06520-9040, U.S.A.; $69.95; 160 x 240 mm; pp. 547; ISBN 0-300-11322-6.

It is embarrassing to admit that the author of what is by far the best book yet written on the history of anaesthesia is a chemical pathologist.

As the title suggests, it ranges further than the subject of anaesthesia for surgery, but a substantial section of the book deals with "this Yankee dodge".

No-one has better summarised the murky circumstances surrounding the birth of anaesthesia in 1846 and subsequent events:

"Rarely has one of the great advances in medicine been accomplished by an unholier crew. Even more rarely has greed and paranoia played so dominant a part."

Maybe an anaesthetist would not have bagged the pioneers so comprehensively. But Dormandy gives generous credit where credit is due: Snow receives his unreserved admiration. The support of (some) surgeons is acknowledged, as is, of course, opposition by eminent practitioners who thought that pain was good for you.

International dissemination is meticulously documented, with extraordinary scholarship. Twenty-five pages of bibliography; a 20 page index which is faultless; and footnotes throughout the text which, far from being a distraction, are a welcome source of supplementary information. The latter range over a vast landscape, including the genetic legacy of Queen Victoria (haemophilia), and the carnival foundation of Samuel Colt's armament fortune which was grubstaked by his demonstrations of laughing gas, to name only two.

As the book moves into a more modern era, the contribution of John Bonica is acknowledged, but lest we forget, a share of that distinction is afforded to Nurse Dorothy Crowley and neurosurgeon Lowell White.

It concludes with a tribute to founders of the Hospice Movement, and the discipline of palliative care.

Reading this work is not only a pleasant and amusing experience for our membership, but an education in many other aspects of medicine and its history. Although Dormandy acknowledges the great advances in relief of suffering, he also does not let us forget how many times we got it wrong and how much further we have to go. In inculcating such a sense of humility he does us all a great service.

R. HOLLAND

Kurrajong, New South Wales
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Author:Holland, R.
Publication:Anaesthesia and Intensive Care
Article Type:Book review
Date:Jun 1, 2007
Words:382
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