Ivan Magill

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, in 1919 as an anaesthetist. The hospital had been established for the treatment of facial injuries sustained in World War I. Working with plastic surgeon Harold Gillies, 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 and 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 and Brompton Hospitals, London.

He was knighted in 1960 by HRH Queen Elizabeth II

History of the Endotracheal Tube (ETT)

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 anaesthetic 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 ETT. 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 ETT oral & nasal designs)
*An anaesthetic breathing system (Magill circuit and expiratory valve)
*Intubating Forceps
*Laryngoscope a straight bladed version
*Catheter mount (ETT to circuit connector)
*ETT connectors, oral & nasal versions
*Magill tracheal spray (glottis anaesthetic)
*Single-lung anaesthesia
*Endobronchial tubes and bronchial blockers
*Bobbin flowmeters

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

In addition Magill contributed a chapter to Gillies HD, Millard R: "Principles and Art of Plastic Surgery" (Boston, Little Brown & Co, 1957).