Surgery

Question 1

What were the three main problems associated with surgery in 1845?

Answer 1

Pain, Infection and Blood Loss.

Question 2

What was discovered in 1799 and who discovered it?

Answer 2

Humphry Davy accidently discovered that inhaling nitrous oxide made you less aware of pain.

Question 3

What were the benefits and limitations of the discovery of nitrous oxide?

Answer 3

It made patients less aware of pain. However, they were still awake and still felt some pain.

Question 4

What was discovered in 1846 and who discovered it?

Answer 4

William Morton discovered that ether was a longer lasting anaesthetic.

Question 5

What were the benefits and limitations of the discovery of ether?

Answer 5

It came with many side effects. These included vomiting, irritating lungs, very deep sleep. It was also highly flammable which made it dangerous to use in candlelight. It was also carried around in large glass bottles which was inconvenient for doctors.

Question 6

What was discovered in 1847 and who discovered it?

Answer 6

James Simpson discovered chloroform when trying out different chemicals in his kitchen.

Question 7

What were the benefits and limitations of the discovery of chloroform?

Answer 7

It did not have as many negative side effects as ether but too much could kill the patient and too little meant that they could still feel the pain.

Question 8

Who was James Simpson?

Answer 8

James Simpson was the Professor of Midwifery at Edinburgh University. He wanted to find a way to relieve pain during childbirth. He disliked ether because it had a pungent smell, it was flammable and when inhaled, it irritated the lungs and made the patient cough.

Question 9

Why did people oppose using chloroform?

Speed

Answer 9

In the early 1800s, surgeons prided themselves on how quickly they could operate because speed was the only way of reducing pain. The discovery of anaesthetics meant this was no longer important.

Question 10

Why did people oppose using chloroform?

Side-effects

Answer 10

Chloroform was untested. No one knew the long-term side effects that it would have on the bodies and minds of the patients. They also did not know the specific dosage to give a particular patent.

Question 11

Why did people oppose using chloroform?

Hannah Greener

Answer 11

In 1848, Hannah Greener died whilst being given chloroform during an operation to remove her toenail. This was the first death from the use of chloroform and this scared surgeons.

Question 12

Why did people oppose using chloroform?

Black Period

Answer 12

With patents asleep, doctors attempted to do more complex operations. This carried infections deeper into the body and caused more blood loss. The 1870s were known as surgery’s Black Period because of the high death rate. Some surgeons returned to using ether with nitrous oxide.

Question 13

Why did people oppose using chloroform?

God

Answer 13

A letter was written to the medical journal ‘The Lancet’ in 1849 stating that ‘The infliction [of pain] has been invented by the Almighty God. Pain may even be considered a blessing of the Gospel.’

Question 14

Why did people oppose using chloroform?

Women

Answer 14

When women were under the influence of chloroform it made them unladylike.

Question 15

When was the Black Period of Surgery?

Answer 15

1847-1867.

Question 16

What were the positives of chloroform?

Answer 16

Surgeons began to take more time over operations and were able to work deeper into the body, developing new operations that saved more lives.
Research into chloroform began on how to find safe dosages.
Local anaesthetics were developed.
Research led to better anaesthetics which relaxed muscles as well as simply putting patients to sleep and had fewer side effects than chloroform.
Surgery was pain-free. This also meant that fewer patients died of shock.

Question 17

What were the negatives of chloroform?

Answer 17

Chloroform made many patients vomit.
It took time for surgeons to find the right dosages.
Surgeons still operated at high speed at first. Anaesthetics did not stop Liston. He still only took 30 seconds to amputate a leg.
The problem of infection and blood loss had still not been overcome so surgery was still very dangerous and limited in what could be done successfully.
With patients asleep, surgeons at first tried operations that were too risky, leading to more deaths.

Question 18

In what ways should Simpson get all the credit for solving the issue of pain relief?

Answer 18

The use of ether had many complications, for example it was highly flammable, it irritated the lungs of the patent and made them cough, and it produced a deep sleep that lasted many hours.
The problem of pain during surgery meant that only basic operations could be carried out, which could be completed quickly.
The use of chloroform produced a deep sleep, so the use of novocaine and later curare was developed as these carried less risk of producing breathing difficulties.
James Simpson deliberately set out to find a better anaesthetic then ether and experimented with various chemicals.

Question 19

In what ways should others be credited for solving the issue of pain relief?

Answer 19

Humphry Davy discovered that nitrous oxide made people les aware of pain; it was used by Horace Wells in the USA in dentistry but the effects were not strong enough to be suitable for use during surgery.
In 1848, Hannah Greener died when chloroform was used during a minor operation.
In 1853 and 1857, Queen Victoria used chloroform during childbirth.
William Morton in the USA and then Robert Liston in Britain both used ether as an anaesthetic in 1846.
The use of anaesthetics led to an increased number of operations, but the problems of infection and blood loss had not been solved and the death rate went up.
During the 19th century, there was great public interest in scientific advances and many people attended public lectures on topics such as chemistry or gases.

Question 20

What does an antiseptic do?

Answer 20

Kill germs.

Question 21

What was Ignaz Semmelweis’ discovery and how did he discover it?

Answer 21

Ignaz Semmelweis discovered the doctors need to wash their hands between patients.
He discovered this because he noticed that the death rate was 4-5 times higher on the doctor’s ward than on the midwife’s ward. 20% of women on the doctor’s ward died of septicaemia because doctors were doing autopsies on corpses and then going to deliver babies.

Question 22

What did childbirth death rates drop to after Semmelweis’ discovery?

Answer 22

1%

Question 23

Why was Semmelweis’ discovery not accepted by doctors straight away?

Answer 23

Because doctors thought that hand-washing was time consuming. It also led to dry skin.

Question 24

What happened in 1861?

Answer 24

Louis Pasteur published his germ theory.

Question 25

What was Pasteur’s germ theory?

Answer 25

That germs were the cause of disease. He also believed that germs could be killed by heat.

Question 26

What is the purpose of carbolic spray?

Answer 26

To prevent infection.

Question 27

What happened in 1867?

Answer 27

Joseph Lister, an English surgeon, applied Pasteur’s theories to his work at the newly opened Glasgow Royal Infirmary.