An accepted truism among clinicians and researchers attributes the persistence of the quest for a unitary mechanism of anesthetic action to the lasting influence of Hans Meyer and Ernest Overton. This article presents a different view: the experiments that led to the Meyer-Overton rule were the consequence-not the source-of a unitary paradigm that was formulated by Claude Bernard a quarter of a century earlier. Bernard firmly believed that the sensitivity to anesthesia was a fundamental criterion that separated 'true life' from 'mere chemistry.' Bernard's scientific authority in the context of 19 th century natural philosophy is responsible for establishing a unified (i.e., unitary mechanism and universality across life forms) paradigm of anesthetic action. Meyer and Overton's work was targeted at systematizing and solidifying existing knowledge within this paradigm, not at discovering novelty, and its publication did not substantially affect contemporary research. Claude Bernard's paradigm, by contrast, still influences investigations of mechanisms of anesthetic action.
PARADIGMS play a frequently unrecognized (or at least underappreciated) role in the progress of science. In fact, it has been claimed that "normal science" does not occur outside of paradigms.1 Although paradigms are essential, they do not a priori ensure ultimate success at solving the scientific puzzle to which they are being applied. Paradigms must prove utility at some stage to gain acceptance, but over time and in the absence of evolution, they may also thwart innovative thinking. Has the pursuit of a unified mechanism of anesthesia been driven by a cumulative aggregation of knowledge? Or has it been simply the result of an implicit, subconscious, unyielding paradigm?In 1950, Thomas Butler, M.D. of Baltimore, Maryland † (Associate Professor of Pharmacology, Johns Hopkins School of Medicine, 1910Medicine, -1993 remarked 'there is reason to doubt whether the search for a single theory … may not have been a misguided effort. The metaphysical desire for unification … may well have delayed arrival at a more satisfactory solution.' 2 More than 60 yr later, one may wonder whether our understanding of cognitive neuroscience in general and anesthetic mechanisms in particular would be different now if research into the latter had not been shackled to the pursuit of a unifying theory of anesthetic action.
A Superficial and Inaccurate View of HistoryInasmuch as history of research into anesthetic mechanisms is mentioned at all in contemporary reviews and textbooks, it is mostly limited to a cursory mention of the somewhat antiquated and obscure terms 'lipoid' and 'unitary.' Separation is frequently not even attempted, and for many readers these Address correspondence to Dr. Perouansky: Department of Anesthesiology, B6/319 CSC, 600 Highland Avenue, Madison, Wisconsin 53792. mperouansky@wisc.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. ANESTHESIOLOGY'S art...