Changes in Surgery 1845-1945 Flashcards
What three problems did surgeons face in 1845?
Pain, Infection and Bleeding
How did surgeons overcome the problem of pain?
Ether (1846) used by J.R. Liston during a leg amputation. However, it had very unpleasant side effects and was very flammable.
Chloroform (1847) used by James Simpson and some friends at his home. They realised that it could be used as during surgery. However, it led to unexplained deaths. The dose given could not be measured or controlled.
Why did some doctors and surgeons oppose anaesthetics?
They were uncomfortable for patients.
Some doctors believed that pain was good for healing.
People didn’t understand how they worked.
Didn’t understand the side effects that new substances could have on the body.
Why were anaesthetics finally accepted?
John Snow developed a chloroform inhaler to make it safer to use. The final breakthrough came when Queen Victoria accepted the use of chloroform as an anaesthetic during the delivery of her eighth child.
How did surgeons overcome the problem of infection?
Joseph Lister and the discovery of antiseptics:
Heard that carbolic acid was used on sewage. He knew sewage had a similar smell to gangrene so sterilised his tools in it and created a carbolic spray to be used during surgery.
He had read the work of Pasteur on his germ theory.
Why did some people oppose antiseptics?
Lister’s methods slowed down surgery.
The spray was uncomfortable for doctors to use, it affected their skin.
Pasteur’s germ theory was not widely accepted in 1857.
Surgeons did not copy his methods correctly and were therefore disappointed with their results.
What is Aseptic Surgery?
This is the removal of all possible germs from theatres to ensure absolute cleanliness.
The following methods were introduced…
Operating theatres and hospitals were rigorously cleaned.
All surgical instruments were steam sterilised.
Sterilised rubber gloves were first used and surgeon’s hands were scrubbed.
How was the problem of bleeding in surgery overcome?
During World War One doctors discovered how blood could be bottled, packed in ice and stored where it was needed. This discovery helped to save many lives.
Blood transfusion was improved further in WW2, blood could be stored for longer, civilians donated blood.
What are the key features of the work of James Simpson?
Key feature: Discovers Chloroform as a pain killer (anaesthetic) / Overcomes opposition to chloroform.
Facts:
A surgeon but hates pain. Discovers chloroform while smelling chemicals.
Some people do not like it as they say God wants us to feel pain
Uses chloroform successfully during childbirth and in other operations.
Deaths lead John Snow to create the inhaler which makes it safe.
Some patients overdose from too much chloroform splashed on the cloth.
Queen Victoria uses it in child birth which ends opposition.
Importance:
First effective anaesthetic—better than Ether and others used before. It is the first widely accepted and relatively safe anaesthetic.
What are the key features of the work of Joseph Lister?
Key feature: Uses Carbolic Acid/Changes hospital practices.
Facts:
Reads the germ theory & soaks his instruments in carbolic acid
Moves to London and becomes a famous surgeon.
Creates a carbolic spray to use during surgery.
People begin to accept his ideas and build upon them.
Many surgeons oppose his methods, they find them messy and uncomfortable.
Importance:
Reduces the death rate in surgery by 30%. His anti-septic methods lead to further changes such as rubber gloves and fully sterilised hospitals (aseptic surgery).
How far did surgery change in the years 1845-1945?
Paragraph 1:
Pain - The development of anaesthetics, Simpson, Snow and Chloroform.
Paragraph 2:
Joseph Lister and the development of antiseptics.
Paragraph 3:
Developments during WWI - X Rays and the Storage of blood.
Paragraph 4:
Developments during WWII - Skin grafts and Plastic Surgery.
