Barnett R. "A horse named 'Twilight Sleep': the language of obstetric anaesthesia in 20th century Britain " International Journal of Obstetric Anesthesia 14(4):310-315, October 2005.

[Eugene Garfield]

This is a  fascinating study and I think readers of SIG-Metrics will find
it interesting.  Since I cannot reproduce tables/figures  here, I have
listed the captions only.

E-mail Address:

Richard Barnett :  ucgarba at ucl.ac.uk


Title: A horse named 'Twilight Sleep': the language of obstetric
anaesthesia in 20th century Britain

Author(s): Barnett R

Source: INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA 14 (4): 310-315 OCT
2005

Document Type: Editorial Material
Language: English
Cited References: 26      Times Cited: 0

Abstract: Historians of medicine frequently marginalize or completely
ignore the importance of linguistics in the development and dissemination
of medical theories and clinical techniques, both in professional culture
and in society at large. This is particularly true in the history of pain
relief in labour, despite the significant role played by popular attitudes
to birth and pain relief in the development of clinical services. This
paper uses a simple form of citation analysis to examine shifts in the
usage of terms related to regional nerve block techniques in The Lancet and
The Times from 1900 to 1999. Graphical representations of these data are
used to relate changes in the incidence of citations to key events in the 20
(th) century history of obstetric anaesthesia in Britain. A study of the
rise and fall of 'twilight sleep' in the early part of the century is used
to demonstrate the advantages and disadvantages associated with this
approach to medical history. Conclusions from this analysis are used to
suggest (tentative) models for the acceptance and diffusion of medical
words in professional and popular vocabularies. (c) 2005 Elsevier Ltd. All
rights reserved.


Addresses: Barnett R (reprint author), Univ Coll London, Wellcome Trust Ctr
Hist Med, 210 Euston Rd, London, NW1 2B3 England
Univ Coll London, Wellcome Trust Ctr Hist Med, London, NW1 2B3 England
E-mail Addresses: ucgarba at ucl.ac.uk
Publisher: CHURCHILL LIVINGSTONE, JOURNAL PRODUCTION DEPT, ROBERT STEVENSON
HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN,
SCOTLAND
Subject Category: ANESTHESIOLOGY; OBSTETRICS & GYNECOLOGY
IDS Number: 978LF
ISSN: 0959-289X

CAPTIONS OF FIGURES / TABLES:
Figure 1: Citation relating to regional pain relief in The Times and The
Lancet, 1900-1999.  Search terms: “epidural,” ‘epidurals’, ‘epidural
analgesia’, ‘spinal anaesthesia’, and ‘spinal analgesia’.

Figure 2: ‘Epidural’ and ‘spinal’ in The Lancet, 1900-1999.  Search
terms: ‘epidural’, ‘epidurals’, ‘epidural analgesia’, ‘caydak
anakgesua’, ‘caudal anaesthesia’, ‘spinal analgesia,’ ‘spinal anaesthesia’,
and ‘spinal anaesthetic’.

Figure 3: ‘Twilight sleep’ and ‘Dammerschlaf’ in The Times and The Lancet,
1900-1999.  Search terms : ‘twilight sleep’ and ‘Dammerschlaf’

EXCERPT :
“Discussion:
What conclusions can we draw from this limited historical survey?  Taking
first the example of regional nerve block techniques, I suggest that what
has been observed here may be one model for the acceptance and
dissemination of medical terms within the professional and public
consciousness.  In the early part of the period a majority of references to
the techniques are found in professional publications: the idea is vague,
still under development, and so the term is poorly understood and rarely
used.  Only when the technique is more widely accepted in the professional
world does the word begin to enter the public vocabulary, at firs through
high-profile events such as criminal trials and litigation, and then
through a more general process in which the technique’s place in medical
practice is negotiated by both the profession and the public.  In the case
of twilight sleep, however, this model must be extended to include the exit
of a term from the medical vocabulary as the technique falls out of use,
and the renegotiations of its usage and meaning in the popular
consciousness – the horse named Twilight Sleep.

An extension of this survey to include 1850 to 1900, the inclusion of a
wider range of periodicals and the extension of the survey into an
international context, or a breakdown of The Lancet and Times citations by
authorship or article type, would provide  an opportunity to flesh out this
description (in particular the details of the process of negotiation) and
to work out more fully its implications for the history of anaesthesia.

In writing the history of medicine, words are often neglected in favour of
more concrete subjects for study: techniques, equipment, individuals or
organizations.  This insular approach ignores the central role of language
in definition, communication, education and dissemination of knowledge.  It
is also one-sided: medical words may be created by medical practitioners,
but their usage and acceptance is determined by the interaction not only of
clinicians but also of patients, journalists, legislators and many other
groups.  Words are not simply vectors, carrying information from one mind
to another.  They can themselves transform our thoughts, our understanding
and our practices.”



CITED REFERENCES:
LANCET 303 : 968 1974
 TIMES LOND 0329 : 22 1967
 TIMES LOND 0507 : 8 1964
 TIMES LOND 0720 : 4 1925
 TIMES LOND 0808 : 3 1913
 TIMES LOND 0920 : 4 1935
 TIMES LOND 1004 : 2 1984
 BIER A
DTSCH Z CHIR 51 : 361 1899
 CATON D
WHAT BLESSING SHE HA : 26 1994
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NY MED J 42 : 483 1885
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P 5 INT S HIST AN SA : 2002
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FDN OBSTET ANAESTHES : 1 1987
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P OBST AN ASS KINGST : 1972
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TIMES LOND 1222 : 1 1981
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CITATION INDEXING IT : 1 1983
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MED KLIN 2 : 136 1906
 HINGSON RA
Continuous caudal analgesia in obstetrics
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 121 : 225 1943
 HOWAT DDC
LANCET 259 : 81 1952
 KREIS O
On spinal narcosis during labour
INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA 9 : 174 2000
 LANCASTER CG
TIMES LOND 1021 : 5 1944
 MANDABACH M
P 5 INT S HIST AN SA : 163 2002
 MUGGERIDGE M
TIMES LOND 1216 : 9 1968
 PARMLEY R
SADDLE BLOCK ANESTHESIA WITH NUPERCAINE IN OBSTETRICS
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 52 : 636 1946
 SANDELOWSKI M
PAIN PLEASURE AM CHI : 1984
 TUOHY EB
CONTINUOUS SPINAL ANESTHESIA - A NEW METHOD UTILIZING A URETERAL CATHETER
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