Dr August Karl Gustav Bier (1861–1949)
In 1897 the German
surgeon, Dr August Bier administered the
first spinal anaesthetic.
August Bier subjected himself to a
clinical experiment in which he observed the
anaesthetic effect of a spinal; He had the
local injected into himself so he could
experience its anaesthetic effect.
August Bier is known as the father the
spinal anaesthesia and intravenous regional
neural blockade. He was however a surgeon
although described as unorthodox. It took him
only two years to become a senior lecturer in
surgery his mentor being the surgeon Friedrich
von Esmarch. (Of Esmarch bandage fame)
Bier had a tremendous impact on surgery and
anaesthesia. He was the co-author of a surgical
textbook, Chirurgische Operationslehre
He was also responsible
for the invention the M1916 army helmet
used by the Germans during the First World War,
this familiar shaped helmet was the design the
Germans kept and gave them the nickname
In 1908, he pioneered the use of intravenous
procaine analgesia. The term
is commonly used by
some anaesthetists when they perform a regional
block on a limb. The substance used
nowadays would be Prilocaine, however, this
particular block is not very widespread in
Bier was renowned for
his humorous comments such as
Treves and Rampley
In 1879 Mr. Frederick Treves (who eventually
received G.C.V.O., C.B., Serjeant-Surgeon to
His Majesty the King)
was appointed Assistant Surgeon. Always there
with him was the "Grand
Old Man of the London Hospital" Josiah
Rampleys Instrument is
still widely used world wide.
In 1902 New Operating
Theatre Floor and five Theatres built at cost
of 13,000 pounds.
His Majesty King Edward
VII.'s appendix was removed just before the day
fixed for the Coronation. This was only made
possible by Lord Listers advise and the
statement by Treves after the King had said he
would be crowned in his present condition and
Treves replied "Then sire you will go as a
Sir Frederick Treves operated and a Dr.
Frederick Hewitt gave the anaesthetic.
History shows that the King survived and
months later was crowned.
He was operated on with an anaesthetic, a
different story as nearly 170 years earlier
Queen Caroline who was the wife of King George
II, died as a result of a strangulated
umbilical hernia, which is quite a common
straightforward procedure today. She was
however obese and there was no anaesthetic.
There are several writers who say that Leonard
Corning performed the first spinal
anaesthetic in 1885. It is said he was
experimenting with the action of 2% cocaine
solution between two inferior dorsal vertebrae
of a dog, causing paralysis of the
hindquarters, and hence inadvertently performed
the first spinal anaesthetic.
It is disputed though as no CSF was seen, so
most academics suggest he performed an
epidural. What ever the dispute it is
considered that Bier performed the first
planned Spinal anaesthesia.