James Moore and a quiet beginning of modern regional anaesthesia.

In contrast to the public spectacle of the Ether Demonstration in 1846, modern regional anaesthesia had a quiet beginning in 1784. That year, James Moore (1762-1860), a Scottish junior surgeon, published the first English book devoted solely to anaesthesia: 'A Method of Preventing or Diminishing Pain in Several Operations of Surgery'. Using a purpose-made iron nerve compressor, Moore successfully anaesthetised the lower limb and completed a near-painless below-knee amputation with John Hunter (1728-1793). Similarly, he also performed the first brachial plexus anaesthesia, introducing the concept of 'plexus anaesthesia'. Beyond this achievement, Moore's 50-page book covers essential perioperative practices that are still relevant today. With the recent rediscovery of a Moore's compressor in Scotland by the authors, this paper critically analyses Moore's contribution. It reframes his narrative through frameworks such as the sociological tipping point, self-experimentation, anatomical analysis and collaboration, challenging the prevailing historical paradigm.