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Anesth Analg 2008; 107:1371-1375 © 2008 International Anesthesia Research Society doi: 10.1213/ane.0b013e3181838d56
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Abstract |
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 Top Abstract IntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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Gaston Labat’s textbook Regional Anesthesia: Its Technique and Clinical Application was one of the earliest regional anesthesia texts, and certainly one of the most successful. Although Dr. Labat was working on a third edition at the time of his death, its fate and the reason for a more than 30-year delay in publishing a third edition have often been speculated upon. A search of the John S. Lundy Archive revealed communications between Dr. Lundy and Labat’s widow which help explain the delay. Further searches into the collections of John Adriani, MD, help explain how he came to be the one to publish the long-awaited third edition.
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Introduction |
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TopAbstractIntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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Gaston Labat’s textbook Regional Anesthesia: Its Technique and Clinical Application1 was first published in 1922. Gaston Labat (Fig. 1) started writing the book when he arrived at the Mayo Clinic in Rochester, MN as part of an agreement that brought him from Paris. The book was intended to introduce and promulgate the European knowledge of percutaneous regional anesthesia in North America. A large part of the text was a direct translation of Victor Pauchet’s L’Anesthesie Regionale,2 with a new section that introduced the idea of the regional anesthetist as a specialist separate from the operating surgeon.3 The book was wildly successful. It became an important resource for information about regional anesthesia during the twentieth century and was used by an entire generation of pioneers in the field of anesthesiology.4 The second printing of the first edition was larger than the first printing, a most unusual occurrence in medical publishing.3 A second edition was published in 1928.5 The second edition had a second printing in 1930.
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At the time of his death in 1934, Labat was working on a third edition. The third edition finally appeared in 1967,6 edited by John Adriani. Why did it take 39 years for the third edition to appear? Was there reluctance by various people, either publishers or authors, to embark on a revision? Were legal issues, such as ownership of the illustrations and the text copyright, responsible for this gap?7 How did Dr. Adriani happen to be the editor of this third edition?
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GASTON LABAT—A BRIEF OVERVIEW |
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TopAbstractIntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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Louis Gaston Labat was an early pioneer in regional anesthesia. Born in Mauritius in the West Indian Ocean, he began his professional life as a pharmacist. He attended medical school in France, beginning in Montpellier, and finishing in Paris. It was in Paris that he met his mentor, the surgeon Victor Pauchet, from whom he acquired much of his regional anesthesia knowledge. Labat brought this knowledge to the United States, arriving at Mayo Clinic in 1920 at the invitation of Charles Mayo. At the Mayo Clinic, he began work on what would become the classic text of regional anesthesia.7
Dr. Labat left Mayo Clinic a year later in 1921 under somewhat mysterious circumstances, evidently related to his female companion being a different woman than the wife Charles Mayo had met in Paris. He was subsequently employed at Bellevue Hospital in New York City, where he practiced as an anesthesiologist until his death. The illustrations for his book were largely produced by Mayo Clinic illustrators. As part of the separation agreement, Mayo Clinic retained copyrights on these illustrations.2
Labat was one of the founders and the first president of the American Society of Regional Anesthesia.a His influence in teaching and advancing regional anesthesia has been well established,4 and many regional techniques used today are as described by Labat. He died in New York City on October 1, 1934, at 56 years of age, with the cause of death listed as myocardial insufficiency.7
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JOHN S. LUNDY, MARIE LOUISE LABAT, AND A MANUSCRIPT |
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TopAbstractIntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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At the time of his death, Gaston Labat was working on a third edition of Regional Anesthesia: Its Technique and Clinical Application (Fig. 3). Labat’s widow, Marie Louise Labat,b searched for someone to complete the work. Dr. John S. Lundy (Fig. 2) became the head of Anesthesiology at Mayo Clinic in 1924. Lundy and Labat were colleagues who had corresponded and dined together periodically over the last 10 years of Labat’s life.8 In a telegram to Dr. Lundy dated January 27, 1939, 4 years after her husband’s death, Marie Louise Labat states:
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"I am very anxious to have Dr. Labat’s textbook on regional anesthesia revised at this time and I am writing to ask whether you would be interested in undertaking his revision. Dr. Labat also had a book virtually completed on therapeutic aspects of nerve blocking and all the pictures and text are in my possession.... I would be very happy indeed to have you associated with either or both books which could be produced in a short space of time since the material is so complete."c
Dr. Lundy replied to her on January 30, 1939 "Must consult authorities here. Will communicate with you at end of week. Will try arranging to have associate R.C. Adams do bulk of work."d A letter to the Board of Governors of the Mayo Clinic on that same day states "Dr. Labat’s book is out of print and is very valuable, and it probably would do ourselves and the profession a service by our taking part in this revision." It was approved by the Mayo Clinic Board of Governors on February 1, 1939.e
Dr. Lundy informed Mrs. Labat of the decision,f and she forwarded the materials Dr. Labat had completed to him and Dr. Adams. In a letter included with the parcel, she suggests:
"... that you revise first the present volume ‘Regional Anesthesia. It’s Technique and Clinical Application.’ Dr. Labat felt that this could be reproduced almost exactly as it is now written with the exception of a new chapter on spinal anesthesia. This would require very little time. Then the second volume could follow at whatever interval was required to complete the undertaking.... The parcel that I am sending includes the chapters exactly in the state as left by Dr. Labat in his own preparation for the book and also a number of illustrations."g
After Dr. Lundy received the materials, his enthusiasm for the project seemed to diminish somewhat. He expressed concern about completing the project without first having a publisher agree to publish the book. In a letter to Mrs. Labat on February 17, 1939, he tells her:
"We would like to know what your plans are in regard to publishing this material, if we find that we can revise it for you. Mr. Green of the W.B. Saunders Publishing Company visited me yesterday, and he stated that they would not consider publishing your book. As we must know what plans and arrangements you have made before attempting to work on it, we would appreciate your informing us at your earliest convenience."h
Dr. Lundy’s tone changes from one of enthusiasm to one of skepticism or doubt about completing the project, most likely because of the lack of publisher support. However, Mrs. Labat promptly replied and stated she had talked with Mr. Paul Hoeber from the medical department of Harper and Brothers Publishers of New York City and London, England.i Mr. Hoeber and Dr. Lundy missed each other at the Mayo Clinic in late February,j but soon were corresponding. On March 11, 1939, Mr. Hoeber wrote to Dr. Lundy about Labat’s incomplete manuscript. He wrote:
"... you now have Dr. Labat’s incomplete MS and that you might be interested in completing it. I have, over the last year and a half, discussed this material with quite a few people and had come to the conclusion that although it was probably very fine as far as it went, those active in the field probably preferred to devote their time to the writing of material entirely their own."k
He then finished the letter with "... if you feel you might want to undertake to complete the book, I would be glad to discuss possible publication with you."k
Responding to Mr. Hoeber, Dr. Lundy explained he was approached by Mrs. Labat about the project. Lundy discussed the project with Mr. Green from W.B. Saunders who had published the first two editions of Labat’s book. Lundy reported that Green had stated, "... under no circumstances would they consider reprinting the book and that if M.L. Labat could identify a publisher, they would even permit her to borrow some of the cuts."l W.B. Saunders’ position seems curious, as the book had sold well through two editions and several printings. However, the position is consistent with W.B. Saunders’ original 1921 view of the book. They had originally wanted the book entitled "Regional Anesthesia as Conducted at the Mayo Clinic—Technician Dr. Labat." Each chapter was to be introduced by a surgeon, with Labat’s technique and statistics to follow.2
Without the firm backing of a publishing house, Lundy wrote that "... it seems inadvisable for us to do it as there seems to be little reason to expect that there will be a very great demand for the book or that any publisher is very anxious to print it."m At this time, Dr. Lundy seems to have made up his mind to return the material to Mrs. Labat and pursue the project no further. Mrs. Labat made a further attempt to proceed, as she wrote on March 20, "I have ascertained that Mr. Hoeber is willing to publish the book provided you yourself would be enthusiastic about the project. This means that the way is clear for publication and that the matter rests entirely with you."n Mr. Hoeber wrote a letter to Lundy on the same day stating "Since you too seem but mildly interested in completing the material, I shall give it no further consideration."o
This ended the possibility Dr. Lundy might finish Dr. Labat’s revision of his most famous text. Dr. Lundy communicated this information to Mrs. Labat, and returned the manuscript to her.p In a subsequent letter, he added "If the manuscript is not going to be used, it would be nice if you could leave the material with some library or society, such as the American Society of Anesthetists, so that they may preserve it in memory of Dr. Labat."q
Dr. Lundy sent one more letter to Mrs. Labat after he received word that Ralph M. Tovell might be interested in preparing the revision. In a letter dated June 14, 1939, Tovell wrote:
"This business of Labat’s book rather intrigues me. I have been wondering if it might not be possible for me to make something of it, if you have already decided against it for any of the members of your staff. I would be glad to hear from you regarding this, quite well realizing some of the difficulties of the situation."r
Lundy answered that he had already returned the manuscript to Labat’s widow and he would be glad to inform her of Tovell’s interest.s On June 29, Lundy wrote to Mrs. Labat to tell her of Dr. Tovell’s interest in undertaking the project.t
There is no further mention of the Labat text in any of the Collected Papers of John S. Lundy until Dr. Lundy received word from Thomas Nelson & Sons Publishing Company in 1949. They wrote to Lundy expressing an interest in reprinting Labat’s classic text and requested contact information about Labat’s family. Lundy’s reply is surprising, stating he had only one encounter with Dr. Labat in his life and had no idea how to find his widow. Lundy further stated Dr. E.A. Rovenstine was in touch with W.B. Saunders in an attempt to get Labat’s book reprinted. However, he suggests that those efforts stalled, stating "Since Saunders were [SIC] interested in my book, Clinical Anesthesia, they were not interested in Doctor Labat’s Regional Anesthesia (Fig. 4)."u Lundy goes on to say he believes Dr. Rovenstine has permission from Labat’s widow to sign a contract with them (Saunders).u
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JOHN ADRIANI—AT LAST, A THIRD EDITION |
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TopAbstractIntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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Labat’s classic text remained unrevised until 1957, when Dr. John Adriani (Fig. 5) was approached by Mr. Dusseau from W.B. Saunders and asked "... if you would be interested in authorship of a new work on Regional Anesthesia, in the pattern of the great monograph by Gaston Labat, whose second edition was published in 1928."v Dusseau goes on to state that "For complicated reasons, it is not feasible to think of an actual revision of the Labat classic ..."v He explains that the difficulty with a revision "... arises from our inability to find Dr. Labat’s heirs whose second edition was published in 1928." Dr. Adriani responded that he would be happy to revise Labat’s monograph, but that he felt strongly that it should be a revision rather than a new text.w Dusseau reiterates the concerns of not being able to find the heirs of Labat, and the concerns of using the original artwork which had been done at the Mayo Clinic. However, he later writes "... I have just come back from the Mayo Clinic and have discovered that they have available there about 165 drawings from the original Labat work."x
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Fortunately, Dr. Adriani eventually persuaded the publishers to accept a revision of Labat’s text. After a meeting in New York City, Dr. Adriani and W.B. Saunders agreed to proceed with a revision of Labat’s text, with the understanding that one third of Dr. Adriani’s royalty would be held in escrow for a period of 1 year, permitting an heir to Dr. Labat to make a claim.y Dr. Adriani’s efforts were nearly thwarted by personal health issues, including several surgeries, and many other commitments. However, 10 years after the agreement with W.B. Saunders, Dr. Adriani finished his revision of the third edition. It was finally published in 1967 (Fig 6).
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The third edition was never as popular as the original, although sales warranted a second printing in 1985.9 Correspondence between Dr. Adriani and W.B. Saunders over those 10 years provides no record or mention of the revision begun by Labat that Dr. Lundy had for a short period of time before returning it to Marie Louise Labat.
In the preface to the third edition, Dr. Adriani states his former teacher, Dr. Emery Rovenstine, confided in him 30 years earlier that he was arranging with Dr. Labat’s widow to complete the revision. However, difficulties were encountered, the specifics of which are unknown, and the project was never completed.6
We now know that Lundy was Mrs. Labat’s first choice to publish the revision. However, for reasons unknown, Mrs. Labat did not pursue publication until she sent it to Dr. Lundy in 1939, 4 years after her husband’s death. There is no record of the revision after Dr. Lundy returned it to Mrs. Labat. Mrs. Labat also referred to another textbook on "therapeutic aspects of nerve blocking" which was evidently nearly complete at the time of Labat’s death.c
We do not know the fate of Gaston Labat’s third revision of his classic textbook Regional Anesthesia: Its Technique and Clinical Application. Additionally, no copy has ever been found of his second manuscript on "nerve blocking," and the only reference to its existence is the telegram from Marie Louise. No heir ever claimed the royalty set aside for the third edition of Labat’s textbook. The fate of Marie Louise Labat remains a mystery.
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ACKNOWLEDGMENTS |
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The authors would like to thank Mr. Patrick Sim and the staff at the Wood Library-Museum and Renee Ziemer and the staff of the Mayo Foundation Historical Suite for their assistance in preparing this manuscript.
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Footnotes |
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aThe "original" American Society of Regional Anesthesia (ASRA) was founded in 1923 in NY. It was one of the two national societies which co-sponsored the American Board of Anesthesiology in 1938. The ASRA merged with the American Society of Anesthetists in 1941. The current ASRA was formed de novo in 1975 by Alon P. Winnie, L. Donald Bridenbaugh Jr, Harold Carron, P. Prithvi Raj, and Jordan Katz without knowledge of "Labat’s" society.
bLabat married Marguerite Brunaud in 1902. It was an unhappy marriage and Labat left her in 1907. It is not known if he was ever formally divorced. Marie Lousie Labat was Gaston Labat’s "widow." It is clear that she was Gaston’s companion during his time in the United States. In his will, Labat left the bulk of his estate to Marie Louise Gervason, a friend and named Marie Louise Gervais Labat as "executor." It is unclear if these are the same indidviduals. However, for the puposes of this article, Marie Louise Labat will be referred to as Mrs. Labat.
cTelegram from Marie Louise Labat to John S. Lundy, MD, January 27, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
dTelegram from John S. Lundy to Marie Louise Labat, January 30, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
eMemorandum to the Mayo Clinic Board of Governors, January 30, 1939. Notations on the memorandum indicate it was approved on February 1, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
fTelegram from John S. Lundy to Marie Louise Labat, February 9, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
gLetter from Marie Louise Labat to John S. Lundy, February 11, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
hLetter from John S. Lundy, MD to Marie Louise Labat, February 17, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
iLetter from Marie Louise Labat to John S. Lundy, MD, February 21, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
jLetter from John S. Lundy, MD to Marie Louise Labat, February 28, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
kLetter from Paul B. Hoeber to John S. Lundy, MD, March 11, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
lLetter from John S. Lundy, MD to Paul B. Hoeber, March 14, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
mMeeting of the Board of Governors, July 13, 1921. Record of the Administrative Board of the Mayo Clinic 1918–1921. Mayo Clinic Foundation Archives, Rochester, MN.
nLetter from Marie Louise Labat to John S. Lundy, MD, March 20, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
oLetter from Paul B. Hoeber to John S. Lundy, MD, March 20, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
pLetter from John S. Lundy to Marie Louise Labat, March 22, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
qLetter from John S. Lundy, MD to Marie Louise Labat, April 14, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
rLetter from Ralph M. Tovell, MD to John S. Lundy, MD, June 14, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
sLetter from John S. Lundy, MD to Ralph M. Tovell, MD, June 18, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
tLetter from John S. Lundy, MD to Marie Louise Labat, June 29, 1939. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
uLetter from John S. Lundy, MD to Nona R. Johnson, July 1, 1949. The Collected Papers of John S. Lundy, Mayo Clinic Foundation Archives, Rochester, MN.
vLetter from John Dusseau to John Adriani, MD, October 27, 1957. John Adriani papers 1925–1988. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 453.
wLetter from John Adriani, MD to John Dusseau, November 7, 1957. John Adriani papers 1925–1988. Located in Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 453.
xLetter from John Dusseau to John Adriani, MD, December 23, 1957. John Adriani papers 1925–1988. Located in Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 453.
yLetter from John Dusseau to John Adriani, MD, March 17, 1958. John Adriani papers 1925–1988. Located in Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 453.
Accepted for publication June 5, 2008.
Supported by the Departments of Anesthesiology, Ochsner Clinic Foundation and Mayo Clinic Foundation.
This was previously presented as an abstract at the 2003 ASA Annual Meeting, San Francisco, CA on 10/14/03.
Reprints will not be available from the author.
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REFERENCES |
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TopAbstractIntroductionGASTON LABAT--A BRIEF OVERVIEWJOHN S. LUNDY, MARIE...JOHN ADRIANI--AT LAST, A...REFERENCES |
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- Labat G. Regional anesthesia: its technic and clinical application. New York: W.B. Saunders Co, 1922
- Pauchet V, Sourdat P, Labat G. L’Anesthésie Régionale. Paris: Libraire Octave Doin, 1921
- Cote AV, Vachon CA, Horlocker TT, Bacon DR. From victor pauchet to gaston labat: the transformation of regional anesthesia from a surgeon’s practice to the physician anesthetist. Anesth Analg 2003;96:1193–200
[Free Full Text] - Bacon DR. Gaston Labat, John Lundy, Emery Rovenstine, and the Mayo Clinic: the spread of regional anesthesia in America between the world wars. J Clin Anesth 2002;14:315–20
- Labat G. Regional Anesthesia: its technic and clinical application. 2nd ed. New York: W.B. Saunders Co, 1928
- Adriani J. Labat’s regional anesthesia: techniques and clinical applications. Philadelphia: W.B. Saunders, 1967
- Brown DL, Winnie AP. Biography of Louis Gaston Labat, MD. Reg Anesth 1992;17:249–62[Web of Science][Medline]
- Pulido JN, Bacon DR, Rettke SR. Gaston Labat and John Lundy: friends and pioneer regional anesthesiologists sharing a mayo clinic connection. Reg Anesth Pain Med 2004;29:489–93[Web of Science][Medline]
- Adriani J. Labat’s regional anesthesia: techniques and clinical applications. Philadelphia: W.B. Saunders, 1985
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