History - Surgery Flashcards
What were the three main problems of surgery?
Pain
Infection
Blood loss
Why was it difficult to work with the patient during an amputation without anaesthetic?
The patient would scream and try to escape
Who invented laughing gas (Nitrous Oxide) and when?
Humphrey Davey in 1799
What were some disadvantages of laughing gas?
It did not completely knock out the patient
What were some disadvantages of Ether?
Made you vomit
Explosive and flammable
Irritates eyes and lungs
When was Ether discovered?
1846
Who discovered chloroform?
James Simpson
How was chloroform discovered?
Simpson and his colleagues were experimenting with different chemical and when they took chloroform, they had passed out within two minutes.
What is an advantage of chloroform?
It would knock the patient out or send them to sleep if inhaled
What were some disadvantages of chloroform?
Many people didn’t remember a thing afterwards
It would make women sexually excited
Who died in 1848?
Hannah Greener
How did Hannah Greener die?
Overdose of chloroform during an operation on her toe
Why did people oppose the use of chloroform?
Hannah Greener’s death of overdose
Many people felt it was not natural and that God wanted women to endure the natural pain of birth
Many prided themselves on the speed of operations, anaesthetics meant speed was no longer important
What was written in the letter to The Lancet in 1849?
“The infliction of pain has been invented by Almighty God. Pain may be considered a blessing of the gospel.”
What was written in the letter to the medical journal The Lancet in 1853?
“Anaesthetic is most unnatural. The pain and sorrow of child birth exert a most powerful and useful influence upon the religion and moral character of women.”
What was the Black Period of surgery?
1847-1867
Period between anaesthetics (1847) and antiseptics (1867) when things got worse in surgery
What were some advantages of general anaesthetics?
Surgeons began to take more time over operations and were able to work deeper inside the body, developing new operations that saved more lives
Research into using chloroform more effectively began
Local anaesthetics were developed
Was pain free
Research meant better anaesthetics which relaxed muscles and put people to sleep = fewer side effects than chloroform
Who was Semmelweiss?
Realised more illnesses were spread in wardens such as birth wardens as mothers and other patients were dying
Doctors did not wash their hands or wash aprons before doing another operation
Publicly said it was important to wash hands to prevent spread of disease
Why did people oppose Semmelweiss?
People believed washing hands before performing surgery was not important
Had no reason as to why it was important
Was unlikely he did as it wasn’t until after the black period that the discovery of germs was made
Many people died from infection even after a successful operation. What did surgeons believe caused this?
After recognising the high death rate, many surgeons believed it was due to the weakness of the patient
What was another name for Carbolic Acid?
Donkey engine
Disadvantages of carbolic spray?
Went everywhere Cracked surgeons skin Made everything smell Made operations more expensive Took more time
What did Robert Lister discover?
Infection would not develop in a wound if the dressing and bandage were soaked in carbolic acid before use
Despite the survival rate with Lister’s patients increasing afterward the use of carbolic acid, why did some surgeons oppose his methods?
Did not always work
Always changed
Didn’t always have the same results
What increased after the improvement of the understanding of microbes and infection?
Attempts to prevent infection getting into the wound by creating a sterile environment
What did Lister’s changing methods suggest?
It made him seem unsure of his ideas and suggested he had mistakes in his methods
Who invented the steam steriliser?
Koch
Why was the steam steriliser better than carbolic acid?
Easier way to prevent infection getting into the wound
From 1864-66, how many amputations were made without antiseptic and how many people died?
35 amp.
16 died = 45.7%
From 1867-70, how many amputations were made and how many died?
40 amp.
6 died = 15%
In 1901, who identified different blood groups?
Karl Landsteiner
Why was blood loss a major problem in surgery?
No way to replace blood lost when the patient bled heavily
Transfusions usually failed
What happened after the problems of pain and infection were overcome?
More complex operations were made
Blood loss remained a problem
What did scientists and surgeons understand about blood transfusions?
The blood groups of the patient and the donor need to match in order for a successful transfusion
The donor needed to be present for the transfusion. True or false?
True
In 1915, what was discovered about blood clotting?
Adding sodium citrate would stop clotting
In 1916, it was discovered that a person dies if blood does not circulate around the body, taking oxygen to different parts and organs. Who discovered this?
Francis Rous and James Turner
When and where was the first blood dept set up?
1917 in Battle of Cambrai
What was the blood depot?
Patients can be safely given type O blood
How did many wounded soldiers die in WWI?
Blood loss, even though many injuries weren’t fatal
What was discovered in 1916?
Blood could be stored in refrigerated conditions
What was the hypodermic needle?
Transfusions were easier to carry out
Who was Paré?
Developed metal clips to place on arteries during operations to prevent blood loss
Which famous women used chloroform during childbirth?
Queen Victoria for her 8th child
Mrs Dickens
What was cauterisation?
Putting tar on the end of a stump
Extremely painful
Stem the flow of the blood
What was cat gut used for?
Bandages
Why was Saline developed?
To prevent infection in wounds with shrapnel for soldiers
When were sterilised rubber gloves used for the first time?
1894
In what year were all instruments steam sterilised?
1897
What were the three main anaesthetics?
Laughing gas
Ether
Chloroform
What did the Lancet encourage?
Discussion of ideas between doctors
Who did Lister present his work to and where?
Pasteur and 2500 other scientists in Paris 1892
What did newspapers report?
Notable operations - Queen Victoria and childbirth and King Edward VII appendix removal
What helped doctors discover causes of disease and infection?
Bacteriology
Who developed Pedicle Tubes?
Harold Gillies
What were Pedicle tubes?
Method of plastic surgery used to treat patients in WWI
