19th Century Medicine: changes in surgery

Question 1

What did Humphry Davy first use as an anaesthetic in 1795?

Answer 1

Nitrous oxide (laughing gas)

Question 2

What did William E Clarke use as an anaesthetic to remove a tooth in 1842?

Answer 2

Ether

Question 3

What anaesthetic did James Simpson discover while experimenting with chemicals?

Answer 3

Chloroform

Question 4

In what year did James Simpson discover chloroform?

Answer 4

1847

Question 5

Which surgeon famously amputated a leg in two-and-a-half minutes but accidentally cut off his patient’s testicles as well?

Answer 5

Robert Liston

Question 6

What was the limitation of nitrous oxide as an anaesthetic?

Answer 6

The patient did not go completely unconscious

Question 7

What were the limitations of ether as an anaesthetic?

Answer 7

It irritated the eyes and lungs

It had a vile smell

It came in a large, heavy bottle that was difficult to carry around

Question 8

Why did surgeons oppose the use of chloroform in surgery?

Answer 8

They were so used to operating quickly on patients that they refused to use anaesthetic

Question 9

How could chloroform kill a patient?

Answer 9

If they were given an overdose

Question 10

Who gave birth to their eighth child using chloroform in 1853?

Answer 10

Queen Victoria

Question 11

Why was it important that Queen Victoria spoke positively about chloroform?

Answer 11

As the monarch, she would be listened to and give chloroform more credibility

Question 12

What happened to the number of deaths in surgery following the introduction of chloroform and why?

Answer 12

They went up - the problems of infection and blood loss became worse with longer surgeries

Question 13

What did Ignaz Semmelweis recommend doctors should do at Vienna General Hospital?

Answer 13

Wash their hands with chloride of lime

Question 14

How did Semmelweis discover the importance of hand-washing?

Answer 14

He realised that the death rate for women giving birth in hospital was higher than those giving birth at home, because doctors would deliver babies after dissecting dead bodies without washing their hands

Question 15

What name was given to the infection that killed women in maternity wards?

Answer 15

Childbed fever

Question 16

What happened to the death rate in maternity wards following the introduction of handwashing?

Answer 16

It went down from 18% to 2%

Question 17

What happened to the death rate in maternity wards when Semmelweis insisted doctors wash their instruments?

Answer 17

It went down further from 2% to 1%

Question 18

Why were Semmelweis’s ideas about the spread of disease rejected?

Answer 18

Doctors preferred to believe that disease was spread by bad air (miasma) as Pasteur had not yet made his Germ Theory

Question 19

Where did Joseph Lister first encounter carbolic acid?

Answer 19

Sewage treatment

Question 20

Describe Joseph Lister’s first use of carbolic acid on a fracture

Answer 20

In 1865 he applied carbolic acid to a young boy’s broken leg and used dressings soaked in carbolic acid to keep it clean. He removed the first dressing after 4 days and the wound was healing well

Question 21

How did Joseph Lister use carbolic acid in the operating theatre?

Answer 21

He used carbolic acid on the surgeon’s hands, the wound, surgical instruments and dressings, and even sprayed it in the air

Question 22

How did Joseph Lister help prevent blood loss in surgery?

Answer 22

He created an antiseptic ligature to tie up blood vessels

Question 23

When did Joseph Lister publish the results of his work on carbolic acid?

Answer 23

1867

Question 24

Why did some surgeons oppose the use of carbolic acid in surgery?

Answer 24

It dried out skin, made their hands sore and left an odd smell

Question 25

Thanks to Lister, what happened to the death rate in amputations between 1864-66 and 1867-70?

Answer 25

Reduced from 46% to 15%

Question 26

What was the limitation of Lister’s work?

Answer 26

He did not understand microbes - he thought one microbe caused all disease

Question 27

What was Joseph Lister’s long-term impact on surgery?

Answer 27

Led to aseptic surgery: the removal of all germs from the operating theatre (steam-sterilised instruments, surgical gowns, face masks and rubber gloves)