Why did these outstanding discoveries miss out? Medical historians from the Department for History, Theory and Ethics of Medicine of Dusseldorf University Hospital, together with a colleague from Paracelsus Medical University Nuremberg, have uncovered the reasons: At the time when four anesthesiology pioneers were nominated for the Nobel Prize, their discoveries were already too old and they were controversially discussed by experts in the field. The research of the medical historians is published in the US journal “Anesthesiology”.
“No Silver Medal of the highest scientific award”
At least one of the four anesthesiology Nobel Prize candidates has been a runner up to the prize. “In contrast to the Olympic Games there is no silver medal of the highest scientific award”, says Dr. Nils Hansson, medical historian from Duesseldorf University. His research in the Stockholm Nobel Archives, where files are accessible after 50 years, has shown, that four medical pioneers were nominated for their anesthesia discoveries, most of them even several times, but none of them was eventually chosen. “The missed Nobel Prizes are proof for the difficulties of new concepts of anesthesia to become accepted by the surgical community at the beginning of the 20th century,” says Professor Heiner Fangerau, Director of the Duesseldorf Department for History, Theory, and Ethics of Medicine.
According to the will of the founder Alfred Nobel the Nobel Prize goes to the scientist who “during the preceding year, shall have conferred the greatest benefit on mankind”. The criterion that the discovery has happened in the year before the nomination was almost never taken literally, says Nils Hansson. However, the anesthesia publications were simply years too old. This also applied to the publications which later on highlighted the outstanding relevance of the discoveries. Nominations of Nobel Prize candidates can only be delivered by experts invited by the Nobel Committee as well as by former Nobel Prize winners. Furthermore, the scientific members of the Karolinska Institute in Stockholm have a nomination right. Nominations are reviewed and decided by the Nobel Committee for Physiology and Medicine.
Nominations for the discovery of local and regional anesthesia in particular, the Berlin surgeon Carl Ludwig Schleich (1859 – 1922) was a serious contender for the Nobel Prize. He was nominated four times by external experts and reviewed by the Nobel Committee, but his discovery was judged as too old. Schleichs groundbreaking work was the development of infiltration anesthesia, the injection of local anesthetics in the surrounding tissue of nerves and nerve bundles which made major operations like visceral surgery or limb amputations possible without pain. General anesthesia with ether and chloroform was already discovered in the middle of the 19th century – in the Pre-Nobel-Prize Era – but had become discredited because of severe side effects and lethal complications, when Schleich developed the method of local anesthesia with cocain further. In 1892 he presented the new technique at the annual conference of the German Society of Surgery where it was met with general disapproval. Schleichs later nominations for the Nobel Prize by the cancer surgeon Vinzenz Czerny (Heidelberg), the neurosurgeon Fedor Krause and the ENT surgeon Gustav Killian (both Berlin) in the years 1913, 1915 and 1920 were not successful.
Who was to carry the scientific crown for the discovery of local anesthesia anyway? The experts did not agree. Was it the Viennese ophthalmologist Carl Koller (1857 – 1944), who presented in 1884 the first application of cocaine as local anesthetic at the German ophthalmology conference and also received four nominations? Or was it the Berlin surgeon August Bier (1861 – 1949), who was nominated for the discovery of spinal anesthesia? Another candidate was the surgeon Heinrich Braun (1862 – 1934) (Leipzig/Zwickau) who, according to experts, had made the necessary refinements to put Schleich’s method into clinical practise.
Disagreement, lapse of time and strong competitors from other medical subjects prevented that at least one of the pioneers of anesthesiology was able to enter the holy grail of medicine.
No Silver Medal for Nobel Prize Contenders – Why Anesthesia Pioneers
Were Nominated for but Denied the Award Nils Hansson, Ph.D., Heiner
Fangerau, M.D., Annette Tuffs, M.D., Igor J. Polianski, Ph.D.:
Department for History, Theory und Ethics of Medicine, University
Hospital Duesseldorf Dr. Nils Hansson , 0049 211 14303, Email: