September 2008


In September 30, 1846 William Morton used ether to assist extracting a tooth from a patient in his dental office. Two weeks later he repeated the technique in front of an audience of his peers at Massachusetts General Hospital. The success of the ether demonstration ushered in a new era in surgical anesthesia.

Over forty years later, the use of ether and nitrous oxide were prevalent in surgical operations but still poorly adopted by many for dental procedures. The 1889-1890 Catalogue for the newly created College of Dentistry listed instruction in the administration of ether and nitrous oxide as a part of the curriculum. According to Mellor Holland’s A History of the University of Minnesota School of Dentistry: 1888-1988, cocaine was the primary local anesthetic available at the time. The clinical instruction and opportunity to administer the gases to patients at the infirmary offered dental students an opportunity to learn practical skills that exceeded common practice.

Rules and regulations

Rule #1: Keep your Friday lunch open.

That is rule number one in the nineteen point Rules and Regulations of the University of Minnesota Hospitals approved October 11, 1961.

The Rules, approved by Dean Robert Howard and Ray Amberg, Director of University Hospitals, represent a carefully worded outline of expectations and duties for faculty physicians on staff at the University Hospitals.

The Rules, however, were not formulated without some criticism and changes.

After reviewing a draft version in the spring of 1961, Dr. John McKelvey, Head of Obstetrics and Gynecology, objected to the provision in item number 2 that all patients seen at the University of Minnesota Medical Center be referred by a private physician. He noted that most staff and students’ wives are seen in Obstetrics without such a referral. His suggested substitution was accepted as added language to the rule allowing “Obstetrical patients without a referring physician.”

After the Rules were distributed, Dr. Richard DeWall submitted a complaint regarding item number 15 and the need for all staff to secure autopsies. Dr. DeWall responded by expressing his concern that the effort to secure autopsies would surpass their usefulness and that house staff, not the attending physician, could complete the task.

Also, note an early version of HIPAA in rule number eighteen.

Read the Rules and Regulations below and see you at noon on Friday.