W. Bruce Fye Center For the History of Medicine: Celebrating 100 Years of Anesthesiology at Mayo Clinic

When Dr. William Worrall Mayo and his two sons, Dr. William J. Mayo and Dr. Charles H. Mayo, began practicing medicine in Rochester, Minnesota, techniques for administering anesthetic were crude and assistance was needed for this to be done properly. The hiring and training of nurse anesthetists was vital to properly and safely perform surgeries and procedures. Three nurse anesthetists who were essential in the early days of administering anesthetics were Edith Graham Mayo, Alice Magaw Kessel, and Florence Henderson.

Alice Magaw administering an anesthetic during a surgery, circa early 1900s

Edith Graham in nursing school, 1887

Edith Graham Mayo’s sister, Dinah F. Graham, was the first graduate nurse to give anesthetics at Saint Marys Hospital for Dr. Augustus W. Stinchfield. Edith soon took over for her sister in 1889 after returning to Rochester from receiving her training and degree in Nursing from the Women’s Hospital of Chicago, Illinois. Edith was trained by Dr. W.W. Mayo and was the sole anesthetist for the Mayos until 1893 when she married Dr. Charles H. Mayo.

Alice Magaw Kessel, undated

Alice Magaw Kessel graduated from a nursing course at the Women’s Hospital of Chicago, Illinois, in 1889 and began working as a nurse for the Mayos in 1892. She was trained in anesthesia by Edith Graham and took over the responsibilities of a nurse anesthetist from Edith in 1893. Later that year she was sent to Chicago by the Mayos for instruction in microscopy. Alice became known for her contributions to the methodology of anesthetics and was particularly noted for her skill and sensitivity. She married Dr. George Kessel on May 23, 1908, and worked at St. Joseph's Mercy Hospital in Cresco, Iowa. After the couple separated in 1919, Alice rejoined the staff of Saint Marys Hospital and remained until 1925.

Florence Henderson, circa early 1900s

Florence Henderson graduated from Bishop Clarkson Memorial Hospital Training School for Nurses in Omaha, Nebraska, and began working at Saint Marys Hospital in 1903. She began administering anesthetics in 1904 under the supervision of Alice Magaw and the Mayos. Like Alice, she became known for her skill and sensitivity. Florence resigned from Mayo Clinic in 1917 and moved with her mother to Los Angeles, California. She continued to work as a nurse anesthetist until her retirement in 1923.

Florence Henderson administering ether while Dr. Donald C. Balfour performs a thyroid surgery, circa early 1900s

Two wire-mesh masks used to help administer an anesthetic via the “open-drop” method, circa early 1900s

When the Mayos began practicing medicine in Rochester, techniques for administering anesthetics were crude compared to modern standards. Originally, patients received an anesthetic through a cloth saturated with chloroform or ether, which was then placed over their nose and mouth. The cloth was then tightly held which often caused patients to feel suffocated. To avoid this feeling of suffocation, the Mayos adopted the “open-drop” method, in which the anesthetic of choice was administered drop by drop onto several layers of gauze that was laid over a wire-mesh mask. The design for the mask evolved over time.

This is a quote from Dr. Albert Faulconer’s 1959 Annual Report of the Section of Anesthesiology to the Board of Governors of the Mayo Clinic. Dr. Faulconer was the head of the section from 1953 to 1970, and in his annual reports to the Board of Governors he often mentioned the importance of nurse anesthetists at Mayo Clinic.

In February 1924, Dr. William J. Mayo began his international trip to attend a conference of the British Medical Association taking place in Auckland, New Zealand. Dr. Will was asked to speak at the King’s County Medical Society meeting in Seattle, Washington, before departing. Dr. John S. Lundy was practicing anesthesia in Seattle and attended the same meeting. During that meeting the two met, and Dr. Will hired Dr. Lundy by the conclusion of the meeting. Dr. Lundy started working at Mayo Clinic on April 1, 1924. 

Left: Dr. John S. Lundy administering an anesthetic into the back of a patient, undated
Right: This excerpt is from an interview between Dr. Lundy and William Holmes (a Mayovox editor) from October 1959 regarding the initial meeting between Dr. Will and Dr. Lundy in Seattle, Washington.

During Dr. Lundy’s tenure as head of the section, it began to expand and grow quickly. Dr. Lundy and many of the new staff members didn’t just help the section expand, but several made advancements to the specialty.

Anesthesia Section staff listing from 1924-1927, from The Clinic Bulletin.

Photo montage of the founding members of the Anesthetist Travel Club in 1929.

Dr. Lundy wanted to organize a meeting of leading anesthetists in the United States and Canada to discuss problems pertaining to the speciality. The Anesthetists’ Travel Club was founded by Dr. Lundy in 1929. The first meeting was held December 16-21, 1929, in Rochester, Minnesota. In 1952, the last meeting was held in Rochester and was reorganized as the Academy of Anesthesiology. The inaugural meeting of the Academy of Anesthesiology was held in October 1954.

In 1933, Dr. Charles H. Mayo asked Dr. Lundy and the Section on Anesthesia to manage transfusions for children; the following year they expanded to adults. At the time, only fresh blood could be transfused into patients. While citrate and glucose were first used in 1914 to preserve blood for transfusion, there was not widespread use of citrated blood in the 1920s. In 1935, Dr. Lundy found that citrated blood stored in an ice box could be safely and effectively used for up to two weeks. Mayo Clinic was one of the first, if not the first, institutions in the United States to introduce blood preservation. Dr. Lundy and colleagues such as Dr. Charles Adams and Dr. T. Harry Seldon also established the country’s first blood bank.

Checking blood bank supplies, 1951

This photograph from 1951 shows Harriet Cronk, Noreen Robins, Dr. Lundy, Dr. Albert Faulconer, Jr., and Helene Romness checking supplies at Saint Marys Hospital before the Clinic Blood Bank moved to Mayo Clinic from Saint Marys Hospital.

During the testing of barbiturates to see what could be used as an intravenous anesthetic, Abbot Laboratories supplied Dr. Lundy with sodium pentothal for clinical trials in 1934. By 1935, Dr. Lundy proposed that the sodium pentothal was safe and the intravenous anesthetic agent of choice.

Syringe and needles used to administer sodium pentothal solution

Dr. Lundy’s rapid-infusing hand roller was used for rapid infusion or transfusion of fluids, blood, or plasma through large or small caliber needles.

Lundy-Lewisohn Needle with Obturator

Prior to the 1950s, giving intravenous fluid was challenging. Needles could become dislodged and couldn’t be used for extended periods of time. In 1950 a Mayo anesthesiology fellow named David Massa developed the predecessor of today’s intravenous angiocath. The “catheter over a needle” design was soon produced by the Rochester Products Company. This innovation made a massive impact in surgery and medicine.

Rochester Plastic Needles made by the Rochester Products Co.

This wax model shows how an anesthetic, like sodium pentothal, would be administered intravenously through the forearm of a patient.

Fluothane (halothane) was first used clinically in the 1950s, but at first its safety and efficacy was questioned. Eventually it became popular as a general anesthetic and replaced other anesthetics like ether. 

This device was made by the department’s very own Dr. Robert T. Patrick in collaboration with the Mayo Clinic Section of Engineering. The anesthetic was administered via syringe.

This bottle of Fluothane (halothane) was one of the first used at Mayo Clinic.