Magill Forceps

WLMD ID: akxd
The British anesthesiologist, Sir Ivan W. Magill (1888-1986) brought considerable energy and ingenuity to the job of working with plastic surgeons on cases of facial and jaw injuries sustained during WWI. Together with his colleague Dr. Stanley Rowbotham (1890-1979), he developed new methods which led to the current prominence of endotracheal anesthesia. The two men introduced a technique of blind intubation (placing an endotracheal tube through the nose into the larynx, without the aid of a laryngoscope), along with improved tools: an intubating forceps, and nasal tubes that were easier to use. These are still in use today. Magill described his forceps in 1920. Previously, breathing tubes would be inserted using a pliable metal rod (stylet). The rounded ends of the new forceps did less damage to the tissues of the nose and throat than could occur when using a stylet, while allowing a good grip on the tube. The bend in the handles moved the user’s own hand to one side, providing a clear view of the process. The forceps became popular for other uses, as well. Dr. Magill’s abilities, and his active leadership in the specialty, earned him numerous honors. He was knighted for his services to the Royal Family in 1946.

Catalog Record: Magill Forceps

Access Key: akxd
Accession No.: 2000-05-04-1 O

Title: [Magill forceps.]
Author: Magill, Ivan W. (Whiteside), 1888-1986.

Title variation: Alt Title
Title: Nasal intubating forceps.

Title variation: Alt Title
Title: Magill forcep.

Title variation: Alt Title
Title: Magill’s intubation forceps.

Publisher: Pakistan : Rusch, [between 1940 and 1995?].

Physical Descript 1 forceps : stainless steel, other metals ; 13 x 3 x 24 cm.

Subject: Intubation, Intratracheal – instrumentation.
Subject: Surgical Instruments.
Subject: Airway Management – instrumentation.
Subject: Airway Management Equipment.

Note Type: General
Notes: The early date in the date range for the possible year of manufacture is an
estimate based on the decade (1940s) when the manufacture of surgical
instruments in Pakistan began to increase significantly (Ahmed, 2010). The
end date is also an estimate chosen because it is five years before the year
that it was donated (2000). The date range could change if documentation
indicates the range should be corrected.

Note Type: General
Notes: The title is based on the common name for the object.

Note Type: Citation
Notes: Ahmed A. Pakistan Surgical Industry: Structure, Issues/Problems &
Recommendations. Rawalpindi, Pakistan: Rawalpindi Chamber of Commerce &
Industry; September 1, 2010. https://www.rcci.org.
pk/wp-content/uploads/2012/12/SurgicalIndustry.pdf. Accessed August 19, 2014.

Note Type: Citation
Notes: Hesham A. Magill’s Forceps. Internet J Anesthesiol. 2006;12(2). https://ispub
com/IJA/12/2/4687. Accessed January 30, 2015.

Note Type: Citation
Notes: Hall CE, Shutt LE. Nasotracheal intubation for head and neck surgery.
Anaesthesia. 2003;58(3):249-250. https://onlinelibrary.wiley.com/doi/10.1046/j
1365-2044.2003.03034.x/pdf. Accessed January 30, 2015.

Note Type: Citation
Notes: Kilner TP. Ivan Whiteside Magill, C.V.O., D.Sc., F.R.C.S., honorary member,
British Association of Plastic Surgeons. Br JPlastic Surg. 1953;6(3):150-152.

Note Type: Citation
Notes: Magill IW. Appliances and preparations: forceps for intratracheal anaesthesia
Br Med J. October 30, 1920;2(3122):670. https://archive.
org/details/britishmedicaljo21920brit. Accessed August 19, 2014.

Note Type: Citation
Notes: Maltby JR. Magill Forceps: Sir Ivan Whiteside Magill (1888-1986). In: Notable
Names in Anaesthesia. London: Royal Society of Medicine Press, Limited;
2002:123-125.

Note Type: Citation
Notes: McLachlan G. Sir Ivan Magill KCVO, DSc, MB, BCh, BAO, FRCS, FFARCS (Hon),
FFARCSI (Hon), DA, (1888-1986). Ulster Med J. 2008;77(3):146–152. https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC2604469/. Accessed January 30, 2015.

Note Type: Citation
Notes: Rowbotham S. Intratracheal anaesthesia by the nasal route for operations on
the mouth and lips. Bri Med J. October 16, 1920;2(3120):590-591.

Note Type: Citation
Notes: Sternbach G. Ivan Magill: Forceps for intratracheal anesthesia. J Emerg Med.
1984;1(6):543-545.

Note Type: Physical Description
Notes: One non-locking forceps for endotracheal intubation, made of polished
stainless steel; Approximately 14 cm after the finger and thumb handles the
forceps curves to enable the user to insert the ends into the oropharynx
without obstructing the view; The ends are circular and serrated on the inner
surface; Marked (stamped or engraved) on one side near the screw connecting
the blades is, “RUSCH STAINLESS”; Marked (stamped or engraved) on the other
side near the screw connecting the blades is, “PAKISTAN”.

Note Type: Reproduction
Notes: Photographed by Mr. Steve Donisch on September 18, 2013.

Note Type: Acquisition
Notes: Donated to the WLM by Ferdinando B. Schiappa, MD in 2000.

Note Type: Historical
Notes: Magill forceps are used to aid in the insertion of nasotracheal and gastric
tubes, the placement of absorbent packs in the pharynx, and the removal of
foreign bodies. The angle of the handles prevents the user’s hand from
obstructing the view to the end of the forceps, where the work is being
performed. Magill Forceps come in a variety of adult and pediatric sizes.

In 1920, when British anaesthetist Ivan Whiteside Magill introduced these
forceps, he and fellow anaesthetist Stanley Rowbotham had been administering
anesthesia for surgeries on the face for about one and a half years. This was
at London’s Queen’s Hospital for Facial and Jaw Injuries where patients came
to have severe injuries and malformations of the face and mouth surgically
corrected.

Because the surgeons often needed access to the areas that would be covered
by a mask, the most common method of anesthesia at that time, open-drop ether
would not work for these surgeries. Magill and Rowbothom used a
less-established method of anesthesia called intratracheal insufflation. This
involved passing a tube through the mouth or nose into the trachea (windpipe)
Anesthetic gas mixtures and air were continuously blown through the tube by
a motorized pump.

For surgeries where it was best not to have the tube enter through the mouth,
Magill and Rowbotham developed a method that involved inserting the tube
through one of the nasal passages (nasotracheal intubation). From the nasal
passage, the tube entered the back of the throat where the forceps could be
used to gently grasp the tube and guide it through the larynx (the voice-box
and opening to the trachea). Later, Magill developed a method for
nasotracheal intubation without the use of a laryngoscope (blind nasotracheal
intubation).

Magill and Rowbotham are recognized for popularizing and advancing nasal
intubation techniques. Nasal intubation is still used today when inserting a
tube through the mouth is not feasible. The short article that introduced the
new forceps was the first of many publications that document Ivan Magill’s
pioneering contributions to the development of anesthesiology.

For more biographical information on Sir Ivan Magill, see the website caption
for the Magill Forceps (https://woodlibrarymuseum.
org/museum/item/777/magill-forceps), and the catalog records and website
captions for the Magill Laryngoscope (SydneyPlus key: aleq) and Magill Tubes
(SydneyPlus keys: akvu, akvv, akvw, akvx, akvy; https://woodlibrarymuseum.
org/museum/item/778/magill-nasal-tubes).

Note Type: Publication
Notes: Arshad Z, Abbas H, Gupta L, Bogra J. Magill Forceps- an aid for difficult
intubation. Internet J Anesthesiol. 2013;31(1). https://ispub.
com/IJA/31/1/14449. Accessed August 19, 2014.

Note Type: Publication
Notes: Bowes JB, Zorab JSM. Sir Ivan Magill’s contribution to anaesthesia. In:
Rupreht J, van Lieburg MJ, Lee JA, Erdmann W, eds. Anaesthesia: Essays on Its
History. Berlin: Springer-Verlag; 1982:13-17.

Note Type: Publication
Notes: Company milestones. Teleflex website. https://www.teleflex.
com/en/aboutUs/milestones/index.html. Accessed August 19, 2014.

Note Type: Publication
Notes: Magill IW, Macintosh RR, Hewer CL, Nosworthy MD, McConnell WS. Lest we
forget: an historic meeting of the section of anaesthetics of Royal Society
of Medicine on 6 December 1974. Anaesthesia. 1975;30(4):476-490.

Note Type: Publication
Notes: Rowbotham ES, Magill I. Anaesthetics in the plastic surgery of the face and
jaws. Proc R Soc Med. 1921;14:17–27.

Note Type: Publication
Notes: Rusch. Teleflex website. https://www.teleflex.com/en/emea/brands/rusch/.
Accessed August 19, 2014.

Note Type: Publication
Notes: Thomas KB. Sir Ivan Whiteside Magill, KCVO, DSc, MB, BCh, BAO, FRCS, FFARCS
(Hon), FFARCSI (Hon), DA: a review of his publications and other references
to his life and work. Anaesthesia. 1978;33(7):628-634.

Note Type: Exhibition
Notes: Selected for the WLM website.