19th Century Medicine: changes in surgery Flashcards
What did Humphry Davy first use as an anaesthetic in 1795?
Nitrous oxide (laughing gas)
What did William E Clarke use as an anaesthetic to remove a tooth in 1842?
Ether
What anaesthetic did James Simpson discover while experimenting with chemicals?
Chloroform
In what year did James Simpson discover chloroform?
1847
Which surgeon famously amputated a leg in two-and-a-half minutes but accidentally cut off his patient’s testicles as well?
Robert Liston
What was the limitation of nitrous oxide as an anaesthetic?
The patient did not go completely unconscious
What were the limitations of ether as an anaesthetic?
It irritated the eyes and lungs
It had a vile smell
It came in a large, heavy bottle that was difficult to carry around
Why did surgeons oppose the use of chloroform in surgery?
They were so used to operating quickly on patients that they refused to use anaesthetic
How could chloroform kill a patient?
If they were given an overdose
Who gave birth to their eighth child using chloroform in 1853?
Queen Victoria
Why was it important that Queen Victoria spoke positively about chloroform?
As the monarch, she would be listened to and give chloroform more credibility
What happened to the number of deaths in surgery following the introduction of chloroform and why?
They went up - the problems of infection and blood loss became worse with longer surgeries
What did Ignaz Semmelweis recommend doctors should do at Vienna General Hospital?
Wash their hands with chloride of lime
How did Semmelweis discover the importance of hand-washing?
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
What name was given to the infection that killed women in maternity wards?
Childbed fever
What happened to the death rate in maternity wards following the introduction of handwashing?
It went down from 18% to 2%
What happened to the death rate in maternity wards when Semmelweis insisted doctors wash their instruments?
It went down further from 2% to 1%
Why were Semmelweis’s ideas about the spread of disease rejected?
Doctors preferred to believe that disease was spread by bad air (miasma) as Pasteur had not yet made his Germ Theory
Where did Joseph Lister first encounter carbolic acid?
Sewage treatment
Describe Joseph Lister’s first use of carbolic acid on a fracture
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
How did Joseph Lister use carbolic acid in the operating theatre?
He used carbolic acid on the surgeon’s hands, the wound, surgical instruments and dressings, and even sprayed it in the air
How did Joseph Lister help prevent blood loss in surgery?
He created an antiseptic ligature to tie up blood vessels
When did Joseph Lister publish the results of his work on carbolic acid?
1867
Why did some surgeons oppose the use of carbolic acid in surgery?
It dried out skin, made their hands sore and left an odd smell
Thanks to Lister, what happened to the death rate in amputations between 1864-66 and 1867-70?
Reduced from 46% to 15%
What was the limitation of Lister’s work?
He did not understand microbes - he thought one microbe caused all disease
What was Joseph Lister’s long-term impact on surgery?
Led to aseptic surgery: the removal of all germs from the operating theatre (steam-sterilised instruments, surgical gowns, face masks and rubber gloves)
