Holy Week for me does not evoke religion or vacation rest, but family and science, because my son was born by caesarean section on Good Friday in Seville 37 years ago, and his first days of life were difficult due to a serious infection. Fortunately, he was born in a time and a country where he could have qualified personnel and specialized material in a large public hospital. My daughter’s delivery 10 years later had no complications, in addition to the pains -not light- of a normal childbirth, which could be mitigated thanks to the scientific advances that allowed the development of epidural anesthesia.
Although the struggle to control pain is as old as the human being and labor pains have accompanied the females of Homo sapiens since it exists as a species, on a few occasions this fight was directed specifically to relieve them. However, women in labor have been the indirect beneficiaries of the disasters of war by going enjoying the advances in anesthesia that were made to ease the pain of the soldiers. The most important milestone was the American Civil War, during which a clinical trial of substances, doses and methods of administration of anesthesia of gigantic proportions was carried out.
But to whom we mothers owe an immeasurable debt of gratitude is to Fidel Pagés, a military doctor born in Huesca in 1886, who published in March 1921 an article called ‘Metameric anesthesia’, in which he described the effects of epidural anesthesia. In it he explained “the possibility that depriving a segment of the body of sensitivity provides, leaving with it the portions that are above and below the medullar segment” and he added “I dissolved 375 mg of novocaine in 25 cc of saline, proceeding to inject it between the second and third lumbar vertebrae. The result of this attempt encouraged us to continue studying this method, which in clinical practice we call metameric anesthesia”.
Despite the relevance of his finding, his death at the age of 37 and the fact that his article had not been translated, caused metameric anesthesia to be forgotten and rediscovered by Italian surgeon Achilles Dogliotti, who presented it as his own discovery at the Congress of the International Society of Surgery, held precisely in Madrid in 1932. This oversight was corrected that same year by the Argentine surgeon Alberto Gutierrez, user of this anesthesia since 1929, who in an article claimed Fidel Pagés as its true discoverer; From then on, the Aragonese was recognized by the international scientific community, including Dogliotti, as the true discoverer of this type of anesthesia.
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Fidel Pagés studied medicine in Zaragoza and, after graduating, entered the Military Health, where one of his first destinations was the Military Hospital of Melilla. Because of his knowledge of French and German, he was chosen to oversee the prison camps in Austria-Hungary during World War I and soon after founded the Spanish Journal of Surgery. The Annual disaster surprised him by working at the Melilla Hospital, where he coordinated surgical services. As had happened to his colleagues during the Civil War, the suffering of the soldiers and the lack of medical resources led him to investigate alternative and efficient methods to relieve pain quickly and safely; this was how he developed epidural anesthesia. It began to be applied in obstetrics in 1935, since it relieves pain during childbirth without altering the rest of the physiological functions of the parturient. Today it is also used in interventions on the legs, pelvis and genitals.
Although pain is one of the main alert and defense mechanisms of the human body, women who were born in the fortunate part of the world we can have relatively easy births thanks, among other things, to the discoveries of Dr. Pagés. One way of showing our gratitude is to work so that our sisters who were born in countries where there is still no quality perinatal care can also escape the biblical curse you will give birth to your children in pain.