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Before the 19th century operations were horrific procedures, and most patients died
from post-operative shock, infection, or loss of blood. In some London hospitals the death
rate after operations was over 80 per cent.
The 19th-century up-turn in surgery actually pre-dated anaesthetics and antiseptics. Many
new ideas were trialled in America (eg Dr Thomas McDowell performed an ovariotomy in
1809), with some success. One suggestion is that American surgeons were happier to try out
new techniques on Black slaves.
The improvements in anaesthetics (to protect patients from pain) and antiseptics (to protect
patients from infection) occurred because surgery without them was too traumatic, and
patients couldn't survive it. New blood transfusion techniques also saved many lives.
Anaesthetics for pain
1842: Crawford W Long (America) used ether as an anaesthetic while operating on
a neck tumour (but did not publish details of his operation).
1845: Horace Wells (America) tried unsuccessfully to demonstrate that laughing
gas would allow him to extract a tooth painlessly.
1846: Dr JC Warren (America) removed a tumour from the neck of Gilbert Abbott
1846: Robert Liston (Britain) removed a leg using ether - 'this Yankee dodge'.
1847: James Simpson (Britain) discovered chloroform.
1884: Carl Koller (Germany) discovered that cocaine is a local anaesthetic.
Antiseptics and blood transfusions
For infection - antiseptics
1847: Ignaz Semmelweiss (Hungary) cut the death rate in his maternity ward by
making the doctors wash their hands in calcium chloride solution before treating
1854: Standards of hospital cleanliness and nursing care rose rapidly under the
influence of Florence Nightingale.
1865: Joseph Lister (Scotland) - basing his ideas on Pasteur's Germ Theory cut the
death rate among his patients from 46 to 15 per cent by spraying instruments and
bandages with a 1-in-20 solution of carbolic acid.
1890: Beginnings of aseptic surgery - surgeons started boiling their
instruments to sterilise them - WS Halstead (America) started using
rubber gloves when operating - German surgeons started to use face
The term `the black period of surgery' refers to the time in the
nineteenth century when more people died as a result of infections.
These had been caused by operations performed after anaesthetics
which allowed the surgeons to operate more deeply inside the body.
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For blood loss - blood transfusions
1901: Karl Landsteiner (Austria) - discovered blood groups. Transfusions had been
tried before but usually killed the patient because of clotting. Matching blood
groups stopped this happening.
1913: Richard Lewisohn discovered that sodium citratestopped blood
clotting during an operation.
1938: The National Blood Transfusion Service was set up in Britain.…read more