Sir Ivan Whiteside Magill (1888-1986) was an Irish born anaesthetist who is famous for his involvement in much of the innovation and development in modern anaesthesia.

Originally a general practitioner, he accepted a post at the Queen's Hospital, Sidcup

Sidcup

Sidcup is a district in South East London in the London Borough of Bexley and small parts of the district in the London Borough of Greenwich.Located south east of Charing Cross, Sidcup is bordered by the London Boroughs of Greenwich and Bromley and Kent County Council, and whilst now part of...

, in 1919 as an anaesthetist. The hospital had been established for the treatment of facial injuries sustained in World War I

World War I

World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

. Working with plastic surgeon Harold Gillies

Harold Gillies

Sir Harold Delf Gillies was a New Zealand-born, and later London based, otolaryngologist who is widely considered as the father of plastic surgery.-Personal life:Gillies was born in Dunedin, New Zealand...

, he was responsible for the development of numerous items of anaesthetic equipment but most particularly the single-tube technique of endotracheal anaesthesia. This was driven by the immense difficulties of administering "standard" anaesthetics such as chloroform

Chloroform

Chloroform is an organic compound with formula CHCl3. It is one of the four chloromethanes. The colorless, sweet-smelling, dense liquid is a trihalomethane, and is considered somewhat hazardous...

 and ether

Ether

Ethers are a class of organic compounds that contain an ether group — an oxygen atom connected to two alkyl or aryl groups — of general formula R–O–R'. A typical example is the solvent and anesthetic diethyl ether, commonly referred to simply as "ether"...

 to men with severe facial injury using masks; they would cover the operative field. Following the closure of the hospital, and the diminishing numbers of patients seen from the war era, he continued to work with Gillies in private practice but was also appointed to the Westminster

Westminster Hospital

Westminster Hospital was a hospital in London, England, founded in 1719. In 1834 a medical school attached to the hospital was formally founded....

 and Brompton Hospital

Royal Brompton Hospital

Royal Brompton Hospital is the largest specialist heart and lung centre in the United Kingdom .The hospital is part of Royal Brompton & Harefield NHS Foundation Trust is a national and international specialist heart and lung centre based in Chelsea, London and Harefield, Middlesex...

s, London. He was Knight

Knight

A knight was a member of a class of lower nobility in the High Middle Ages.By the Late Middle Ages, the rank had become associated with the ideals of chivalry, a code of conduct for the perfect courtly Christian warrior....

ed by Queen Elizabeth II in 1960. He was closely involved in the establishment of the Association of Anaesthetists of Great Britain and Ireland as well as the Faculty of Anaesthesia of the Royal College of Surgeons where he developed the Diploma in Anaesthesia, the first professional examination in the specialty. Drs today can still be awarded the Magill medal for outstanding performance in the December sitting of the Final Fellowship examination

History of the Endotracheal Tube

The original tubes were cut from a roll of rubber industrial tubing by his assistant, hence the natural curve of the tube. A curved metal adaptor was designed (Magill oral and nasal connectors) and a 4" black rubber connecting hose to fit to the anesthetic circuit was adapted from an MG car brake hose and named the 'catheter mount' by Magill's theatre technician at Westminster Hospital. Originally, there was no inflatable cuff, the tube was packed either side of the sub-glottis by two green anaesthetic swabs, with ribbon gauze sewn on by hand to aid extraction at extubation of the endotracheal tube. Anaesthetic gel or ointment was used to lubricate the tube and provide some relief for the patient's sore throat post-procedure.

Magill's Developments

• Endotracheal tube, anaesthesia (The Magill endotracheal tube, oral & nasal designs)
• An anaesthetic breathing system (Magill circuit and expiratory valve)
• Intubating Forceps
• Laryngoscope
  Laryngoscope
  Laryngoscopy is a medical procedure that is used to obtain a view of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anesthesia or cardiopulmonary resuscitation or for procedures on the larynx or other parts of the upper...
  
   a straight bladed version
• Catheter mount (endotracheal tube-to-circuit connector)
• Endotracheal tube connectors, oral & nasal versions
• Magill tracheal spray (glottic anaesthetic)
• Single-lung anaesthesia
• Endobronchial tubes and bronchial blockers
• Bobbin flowmeters
• Helped establish the Diploma in Anaesthesia
• Helped found the Association of Anaesthetists in 1932

Papers by Ivan Magill

• Magill IW. "Endotracheal Anaesthesia" Proc RSM, 1928, 22(2):85-88
• Magill I. "Warming Ether Vapour for inhalation" Lancet 1921,i:1270 (letter)
• Magill I. "An apparatus for the Administration of Nitrous Oxide, Oxygen and Ether" Lancet 1923,ii: 228
• Magill I. "The Provision for Expiration in Endotracheal insufflation" Lancet 1923,ii: 68-9
• Magill I. "A Portable Apparatus for Tracheal Insufflation Anaesthesia" Lancet 1921,i: 918
• Rowbotham ES, Magill I. "Anaesthetics in the Plastic Surgery of the Face and Jaws" Proc RSM 1921, 14: 17-27
• Magill also contributed a chapter to Gillies HD, Millard R: Principles and Art of Plastic Surgery (Boston, Little Brown & Co, 1957).