Stethoscopes, X-Rays, and Dishwashers Flashcards
What was anesthesia viewed as a way to do what?
Ways and the desire to control pain–ideas of harnessing medicine. Search to control pain and infection.
What was surgery before anesthesia?
- no pain relief
- bit on wood or leather, alcohol
How did they attempt to deaden pain before anesthesia?
- alcohol
- opium
- mandrake (root) soaked in wine
When did Humphry Davy inhaled___?
- 1975
- Nitrous oxide
What was nitrous oxide dubbed as and used as?
dubbed as laughing gas and used recreationally more so than in clinics.
Why did nitrous oxide fail to gain support from medical profession?
After public demonstrations failed, one of its main proponents (Horace Wells, dentist) grew addicted to chloroform and committed suicide.
Nitrous Oxide was not used because it was difficult to get___results, people were___sizes.
- consistent
- different
What was the first intervention in pain relief? What did it come out of?
- Nitrous oxide
- Came out of theatre performance
Who was the first to use ether?
Dr. William thomas Gren Morton, a dentist in Boston, was the first to anaesthetize a patient with ether before removing a neck tuner.
Why did Morton try to tamper with ether?
to produce his own anaesthetizing agent, for financial gain.
-he thought he could make money
How did Morton administer ether? Did it work?
by face masks
-failed, but the attempts of ether caught to attention of practitioners throughout Europe
What did ether lead to?
further experimentation which lead to chloroform
Who discovered chloroform?
James Young Simpson, surgeon in Edinburgh, allegedly while experimenting with chloroform, Simpson opened a bottle and everyone in the room fell asleep. In 1831
Who was a famous person to use chloroform that caused scandal?
Queen Victoria in 1853 during the birth of her son Leopold
What were the protests about that followed Queen Victoria’s use of chloroform?
Some were religious but most were medical on safety grounds
What was chloroform eventually seen as?
Safe and acceptable to use as a general anaesthetic
Why was ether replaced by chloroform?
Because ether which irritated the lungs and caused vomiting whereas chloroform was powerful and easy to administer
___proved invaluable for deadening pain, but did nothing to hider infections.
Anaesthesia
What was singularly tragic in surgery?
Sepsis
What struck mother after childbirth? What was it believed it was caused by?
- the puerperal fever
- ‘putrid’ matter introduced into the uterus by the attendants (miasmatic theory)
Who was Oliver Wendell Homes? What did he advise?
Boston, regarded the childbed fever as an infection whose ‘gears’ were transmitted by birth attendants. Ac doctor should wait at least a day between an autopsy and a birth, he advised, and should change his suit and wash with chlorinated water
Who rebutted Homes?
Influential obstetricians rebutted him with the orthodox wisdom that puerperal fever was neither contagious nor perish the thought–caused by doctors.
Franco-Prussian War (1870_ \_\_\_amputations \_\_\_gangrene and fever deaths \_\_\_% died \_\_\_% \_\_\_led to death
- 13200
- 10 000
- 76%
- 100%
- amputations
What is significant about the 1840s Vienna General Hospital?
It had a maternity ward divided into 2 sections:
War One- childbed fever raged; mortality was 29%
Ward Two: lower rate of childbed fever; mortality rate was 3%
Why was there a difference in the mortality rate of the two maternity ward son Vienna General Hospital?
One is run by midwives and one is run by med students who performed surgery and anatomy and did not wash their hands.
What is Ignaz Semmelweis?
Assistant physician at Vienna hospital observed that the births in Ward One were handled by medical students whereas the births in Ward Two were attended by midwifery public.
What were blood and guts on surgery clothes viewed as?
a badge of honour
What was Semmelweis’ experiment?
He had the medical students and midwives change places. The high mortality rate followed the medical students.
When did Semmelweis order hand-washing with chlorinated water before deliveries? What was the result?
Man of 1847 and birth wards mortality plummeted
What happened to Semmelweis?
He continued to be ridiculed by disbelieving colleagues. In Budapest he introduced chlorine disinfection and morality rates from puerperal fever declined. He was institutionalized in a Viennese mental hospital where he allegedly died of a streptococcal infection.
What are Semmelweis reforms?
Hand washing, wishing with alcohol, scrubbing before surgery and autopsies.
What is Joseph Lister known as?
the founder of antiseptic surgery
What did Joseph Lister develop?
a way of preventing infections of wounds and surgical incisions with chemical antiseptics.
What were conditions like when Lister became a surgeon in 1852?
- appalling.
- most surgeons operated with unwashed hands and dirty instruments while wearing bloodstained operating coats that were never washed.
- the patients rested in beds with dirty linens that were often not changed between patients
What was the cause of infection experienced by nearly all surgical patients and the smell of putrefaction in surgical wards attributed to?
“bad air” and was considered unavoidable
What was Joseph Lister’s religion?
Quaker
Where was Lister a surgeon?
Edinburgh
What did think would would become infected by? What was he puzzled by?
- felt wounds became infected by ‘stinking matter’ (miasma)
- puzzled by gangrene (from amputations)
Who did Lister study and what did he become interested in?
Lister studied Pasteur and became interested in bacteria
- Rotting
- Poisoning
- Fermenting
When and what was Lister’s first trial?
- 1865
- Soaked lint in carbolic acid and linseed oil and dressed wound
- Wound healed, infection free
- Saw carbolic acid as key
What was carbolic acid used for?
- washing hands
- washing wounds
- spray in operating theater
What did Lister believe about bacteria and carbolic acid?
That bacteria existed every and that carbolic acid neutralized or killed it
Why did many practitioners mock Lister?
for his belief in invisible bacteria/micro-organisms
Why did mortality rates significantly decline with?
the introduction of antisepsis
What other improvements helped with the reduction of mortality rates after the use of antisepsis?
- rubber/latex gloves
- surgical masks
- gowns
- hand scrubbing
- nightingale hospital reforms (better ventilation, light, opening up the wards)
