An Artificial " Air-Way " for Use During Anæsthetisation.

The Hewitt airway – the first known artificial oral ‘air‐way’ 101 years since its description

“…Sir Frederic William Hewitt (1857‐1916) was ‘Anaesthetist to His Majesty the King; Physician‐Anaesthetist to St. George’s Hospital; Consulting Anaesthetist and Emeritus lecturer on Anaesthetics at the London Hospital’ (Fig. 1) [1].…”

“…Hewitt’s paper [1] is remarkable for several reasons. He recognised that upper airway obstruction was a common problem during general anaesthesia and identified some conditions that were more likely to be associated with an obstructed airway.…”

“…Hewitt asserted that ‘in most of the cases in which difficulties arise during general anaesthesia, these difficulties are directly dependent upon mechanically obstructed breathing.’ This ‘auto‐asphyxia’, as he termed it, ‘is not infrequently mistaken for chloroform overdosage, surgical shock, or other conditions’ [1].…”

“…Everyone who has paid much attention to the clinical aspects of general anaesthesia knows how frequently he has to adopt some means for preserving a free air‐way. In some cases the jaw must be pressed forwards or the chin pulled up continuously; in others, a mouth‐prop adjusted to meet the special peculiarities of the case is required; whilst in others again it is necessary to apply tongue forceps in order to insure free breathing’ [1].…”

“…Sir Frederic W. Hewitt described his ‘air‐way’ in 1908, some 60 years after the introduction of ether anaesthesia [1]. Early ether anaesthesia was light and airway obstruction was not common.…”