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The Association of Anaesthetists of Great Britain and Ireland 1932 - 1992 and the Development of the Specialty of Anaesthesia. Sixty years of progress in the context of scientific, political and social change. Thomas B. Boulton The Association of Anaesthetists of Great Britain and Ireland, London, England. 1999. 789 pages. £30.00. ISBN 0-9536639-0-6

Vancouver, BC

None is better placed than Dr Thomas B. Boulton, the Association's archivist and a Laureate of the History of Anesthesia of the Wood Library Museum, Chicago, to write the history of The Association of Anaesthetists of Great Britain and Ireland. He was seven years old when the Association was founded in 1932 and practised in London and Reading, England, for much of its 60 yr history. Dr Boulton writes on "sixty years of progress in the context of scientific, political and social change" of the Association in ten chapters, arranged in chronological order through its formative years and progression to the present. Appendices cover a biography of the founding president, the Arms granted to the Association in 1945, lists of eponymous lecturers and recipients of honours and awards.

The Association's founder and first president was Dr Henry W. Featherstone, Honorary Anaesthetist, Birmingham, England, and President of the Section of Anaesthetics of the Royal Society of Medicine. He saw that anesthesia was poorly regarded and needed organization. Inequities in income arose as university departments of anesthesia were established and staffed by a mix of salaried personnel, unpaid visiting anesthetists and private practitioners, while general practitioners with varying abilities in the administration of anesthetics served outlying communities. Consequently, skilled anesthetists often earned less than unskilled practitioners. The importance of the Association's initiative in introducing the Diploma in Anaesthetics in 1934, became apparent in wartime and at the beginning of the UK National Health Service in 1948. Recognition of a standard of competence was to be pivotal in the organization of specialties. The Association advised on academic staffing and teaching in medical schools and negotiated contracts for newly recognized hospital consultant and trainee grades. Membership grew steadily to its present level of 6,000, although overseas representation has declined as physicians' migration has become restricted. The influence of the Association has continued, but its role has changed, with increasing emphasis on research and education. Successful financial planning culminated in the establishment of Research and Education Trusts and acquisition of property at Nine Bedford Square, London in1984 as the Association's present headquarters.

This book is superbly researched and serves as a resource, not only for the Association's achievements, but as an authoritative reference to our specialty's development and the evolution of Britain's Health Service. The index of names is meticulous, and many who owe much to the Association will find themselves mentioned. The relatively small amounts of support which were awarded to young investigators in the 1960s portended future academic careers: a deserving aspect of the Association's work which was not given full appreciation in the text.

From a Canadian anesthesiologist's perspective, Dr Boulton's closeness to the Association seems to prevent him from acknowledging international influences on the development of anesthesia. One could argue the relative merits of Dr Harold Griffith's contribution to the introduction of curare in 1942 and Gray and Halton's 1946 report of their experiences. Also, the founding of the World Federation of Societies of Anaesthesiologists should be shared rightfully by France, Britain and Canada, although the pivotal contributions of Dr Harold Griffith's leadership and the financial support of the International Anesthesia Research Society are not usually relegated to supporting roles.

Although this book must be regarded as a reference source, it is surprisingly easy to read. For those who have enjoyed the benefits of membership of the Association, it is essential reading.

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