Surgery in the 19th and 20th Centuries

Question 1

What were the three main problems with carrying out surgery?

Answer 1

Pain
Infection
Blood loss

Question 2

What is wrong with pain during surgery?

Answer 2

The patients could feel everything throughout the operation

They could die from the shock of the pain

Question 3

What is wrong with infection during surgery?

Answer 3

Once operations were over, the wound often became infected and patients could die from this

Question 4

What is wrong with blood loss during surgery?

Answer 4

Patients could bleed to death during and after the operation

Question 5

When were operations carried out and why?

Answer 5

Only in an emergency, this is because the were so horrific

Question 6

What was wrong with performing a surgery quickly?

Answer 6

It often lead to the surgeon making mistakes and cutting off the wrong part of the body

Question 7

The problem of pain was the first to be solved in the 1840s with the development of what?

Answer 7

Anaesthetics

Question 8

Give two positive impacts of anaesthetics

Answer 8

When patients were asleep they felt no pain which was good
As the patients were still, they were no longer dying from the shock of the pain, this allowed more complicated operations to be done inside the body

Question 9

Give to negative impacts of anaesthetics

Answer 9

Sometimes patients died from too much chloroform

The death rate from infection went up after anaesthetics were developed

Question 10

Why did the death rate of infection go up after anaesthetics were developed?

Answer 10

Deeper operations meant deeper infection

More operations meant more infection

Question 11

When would the full advantages of anaesthetics be seen?

Answer 11

When someone worked out how to prevent infection

Question 12

State some attitudes to the use of anaesthetics

Answer 12

Some doctors were against it (especially during childbirth) because they thought pain was sent from God and should be endured
Others were alarmed at the deaths from chloroform itself and from infection as doctors tried more complex and longer operations

Question 13

When did anaesthetics get a big boost?

Answer 13

When Queen Victoria accepted chloroform to ease the pain of childbirth in 1857

Question 14

What was the problem of infection solved by?

Answer 14

Antiseptics

Question 15

Why before 1861 did surgeons re-use bandages, wear dirty clothes and not wash their hands?

Answer 15

They did not understand what germs were and didn’t know the causes of infection

Question 16

What is gangrene?

Answer 16

Decay of part of the body due to blood supply failure

Question 17

Who research gangrene and infection to find a cure for them?

Answer 17

Joseph Lister

Question 18

What did Joseph Lister use in 1865 to kill germs during operations?

Answer 18

Carbolic acid

Question 19

Did carbolic acid work for its purpose?

Answer 19

Yes!

Question 20

Give some statistics for before and after Lister’s use of Carbolic acid

Answer 20

Before he used carbolic spray : nearly half of his amputations resulted in the death of the patient
After : only 15% died

Question 21

When did Joseph Lister publish his findings?

Answer 21

1867

Question 22

Give two impacts of antiseptics

Answer 22

Deaths from infection after operations fell

Not all doctors were as careful as Lister was being when using antiseptics, and so infections were still common

Question 23

Give three oppositions to antiseptics

Answer 23

Cleaning the wounds was hard work and slowed down operations (many surgeons still prided themselves on speed).
It seemed extreme. The carbolic spray soaked everyone and everything
Many people (including surgeons) did not believe in germs.

Question 24

Which different gases were used to send people to sleep and what dates were each of them discovered?

Answer 24

Laughing Gas - 1799 - Sir Humphrey Davey
Ether - 1846
Chloroform - 1847 - James Simpson

Question 25

Which was the most effective gas used to send people to sleep for an operation?

Answer 25

Chloroform

Question 26

Who discovered chloroform?

Answer 26

James Simpson

Question 27

What year was chloroform discovered?

Answer 27

1847

Question 28

How did James Simpson test out chloroform?

Answer 28

He tested it on himself before using it on his patients

Question 29

Give a disadvantage of Laughing Gas

Answer 29

It was weak and only numbed the area, it did not actually send a patient to sleep

Question 30

Give a disadvantage of Ether

Answer 30

It was flammable and it irritates the eyes and lungs It was inconvenient and dangerous It came in large bottles

Question 31

Give a disadvantage of Chloroform

Answer 31

Too little and it doesn't work | Too much and it kills the patient

Question 32

Who makes chloroform safe to use?

Answer 32

John Snow

Question 33

Who was Semmelweiss?

Answer 33

He was a doctor who assisted women during childbirth | He was also a surgeon

Question 34

How was Semmelweiss significant to reducing infection?

Answer 34

He made everyone wash their hands He thought people carried diseases on their hands Once he made people wash their hands the death rate became a lot lower

Question 35

What did people think about germs in the twentieth century?

Answer 35

They believed in 'spontaneous generation' and they didn't know that germs were so dangerous

Question 36

What did Pasteur prove regarding germs?

Answer 36

That they caused decay

Question 37

Why were people so against chloroform?

Answer 37

It was untested People didn't know the correct dosage Some surgeons thought it was better to hear the patients making noise so they knew they were alive They thought that numbing pain was unnatural Pain was considered a blessing

Question 38

Why were some people for chloroform?

Answer 38

It was new so it had potential Queen Victoria used and liked it It was less painful Surgeons could attempt more complex operations and get more experience

Question 39

Give 3 improvements to medicine which reduced infection

Answer 39

1. Washing hands with carbolic before operations to avoid infections getting into wounds 2. A carbolic spray used to kill the germs in the air and around the operating table 3. An antiseptic ligature was used to tie up blood vessels to prevent blood loss

Question 40

Give 5 oppositions to the use of carbolic acid

Answer 40

``` It was expensive It cracked the surgeon's skin It made everything smell It slowed operations down It was not accepted by trained doctors ```

Question 41

Give 3 ways that opposition was overcome regarding carbolic acid

Answer 41

It was eventually proved that it worked It liked with Koch's idea of blood poisoning Lister won an award for his ideas so they were more well known

Question 42

How did the discovery of germs impact medicine?

Answer 42

Operating theatres and instruments were cleaned Surgeons wore surgical gowns and masks They used sterilised rubber gloves More complex operations were able to take place

Question 43

When did the first successful heart operation take place?

Answer 43

1896

Question 44

What developments regarding blood were made prior to the nineteenth century?

Answer 44

Pare began using ligatures Harvey proved there was only a certain amount of blood in the body People tried using animal blood to replace the human blood lost in operations - this did not work

Question 45

Give a problem to do with blood transfusions

Answer 45

They sometimes worked but most of them didn't and people couldn't understand why

Question 46

Who discovered blood groups in 1900?

Answer 46

Landsteiner

Question 47

When did Landsteiner discover blood groups?

Answer 47

1900

Question 48

What was discovered by Landsteiner in 1900?

Answer 48

Blood Groups

Question 49

When was the first blood transfusion done using matching blood groups?

Answer 49

1907

Question 50

When were methods of storing blood developed?

Answer 50

During the First World War

Question 51

What happened during the Second World War regarding blood groups in the USA and Britain?

Answer 51

Nations Blood Transfusion centres were set up

Question 52

Who discovered X-rays? When were they discovered? And why was this significant?

Answer 52

Rontgen discovered X-rays In 1895 This was significant because it allowed doctors to look inside the body without having to cut it open

Question 53

What was antiseptic surgery (cleaning the wound) replaced by?

Answer 53

Aseptic surgery (cleaning everything in the room)

Question 54

What is keyhole surgery?

Answer 54

Cutting a tiny hole in the skin and using a fibre optic cable and cameras to see inside the body to perform delicate operations.

Question 55

Give an example of keyhole surgery

Answer 55

Mending holes in the hearts of new-born babies

Question 56

What is replacement surgery?

Answer 56

Where joints can be replaced by plastic or metal ones when the boy's joints have been worn out due to disease or age

Question 57

Who was the first heart transplant carried out by?

Answer 57

Christiaan Barnard

Question 58

When was the first heart transplant carried out?

Answer 58

1967

Question 59

When was the first heart, liver and lung transplant carried out?

Answer 59

1986

Question 60

When was the first facial transplant done?

Answer 60

2005

Question 61

Give two advantages of developing surgery

Answer 61

It is expensive and there is only a limited amount of funding for health care which limits the benefit of these improvements It raises ethical questions about what operations are prioritised