The Development of Modern Surgery Flashcards
What were the three big issues with surgery?
Pain, bleeding, infection.
What had been used as pain relief?
Alcohol, opium (the opium poppy gives morphine), mandrake
Who first suggested the use of nitrous oxide (laughing gas) as an anaesthetic?
Humphrey Davy in 1799 - but he was ignored.
What was nitrous oxide being used as?
A fairground novelty.
Who next tried to use nitrous oxide for a medical purpose?
Horace Wells, in 1845, wanted to demonstrate use in dentistry - but his patient was unaffected by nitrous oxide, so he was ignored too.
Who discovered the anaesthetic properties of ether?
Crawford Long, 1842, but he did not publish his findings.
Who carried out the first public demonstration of ether as an anaesthetic?
William Morton 1846
What are the problems with using ether as an anaesthetic?
It is an irritant, and also explosive.
Who found an alternative to ether as an anaesthetic?
James Simpson, in 1847
What alternative to ether did James Simpson find?
Chloroform.
What is the problem with chloroform?
It sometimes causes the heart to stop, causing sudden death
What was chloroform used for?
As an anaesthetic for operations, and for pain relief during child birth.
Why is local anaesthetic better than general anaesthetic?
General anaesthetic is very risky for the patient.
Who first investigated using local anaesthetics?
William Halstead, in 1884
What substance did William Halstead use for local anaesthetic?
Cocaine
What happened to William Halstead as a result of his experiments into using cocaine as a local anaesthetic?
He became addicted to cocaine.
What was people’s reaction to anaesthetics?
Some were very suspicious of doctors putting them to sleep. Others had religious objections, especially to the use of pain relief during child birth,
What was the surgeon’s reaction to the availability of anaesthetics?
They could perform longer, more complicated operations.
What happened to the death rates after the introduction of anaesthetics?
They went up, as bleeding and infection had not been overcome.
What was the “black period” of surgery?
The period between 1846 and 1870, when the death rate after surgery was very high as anaesthetics had been introduced but bleeding and infection were still a big problem.
Where were operations carried out?
Even in patients own houses, as no one had any idea of hygiene.
What did the surgeons do that caused deaths?
They did not wash their coats, a coat covered in blood was a badge of honour; they did not wash the instruments between patients.
What is the name for methods that kill germs?
Antiseptic.
What is the name for methods that exclude germs?
Aseptic.
Who first started using antiseptic methods to reduce infection rates?
Semmelweis used chloride of lime as a hand wash for the doctors to control the spread of puerperal fever (an infection of women after giving birth).
Why was Semmelweis idea not much used?
Chloride of lime is very unpleasant.
What gave Lister the idea of using carbolic acid in operating theatres?
He had seen carbolic acid sprays being used in sewage works to reduce the smell.
When did Lister start using carbolic acid in operating theatres?
early 1860s.