History - Surgery

This is all the techniques and knowledge you will need.


Pain - Anaesthetics - Problems

1800 - no anaesthetics.

Public view on surgery - surgery was a last resort.

methods of pain relief before anaesthetics - opium, mandrake, alcohol, hypnosis.

operations undertaken - quick, no deep complex operations.

limited to - removing growths, amputations.

Many still died from - blood loss, trauma.

Use of anaesthetics lead to - Black period (1846 to 1870) - as the use of anaesthetics increased the infection rates of the operations did too, with no way of cleaning the wounds or stopping infections more patients died during this time than before anaesthetic

Public view (1848) - Hannah Greeners - first death from chloroform - fall in popularity.

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Pain - Anaesthetics - Solutions

Pain stopped by - discovery of anaethetics.

Humprey davy (1799) - experimented with Nitrous Oxide - discovered that it relieved toothache.

William Morton (1846) - USA Doctor - discovered Ether to be an effective anaesthetic.

James Simpson (1847) - experimenting with chemicals - Chlorofrom discovered - began to be used during childbirth.

John Snow (1848) - develops inhaler for Chloroform - made it easier to administer.

Public View (1853) - Queen Victoria - uses chloroform during childbirth - rise in popularity

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Infection - Antiseptics and Aseptic - Problems

Before Anaesthetics - lots of amputies and simple operations often became septic and many people died from extremely bad infections

After Anaesthics - Surgeons felt more confident with carrying out more complex and longer operations

Black Period (1846 to 1870) - as the use of anaesthetics increased the infection rates of the operations did too, with no way of cleaning the wounds or stopping infections more patients died during this time than before anaesthetics.

Conditions - operations were carried out in unhygenic and dirty conditions. - It was not until the discovery and acceptance of the germ theory that surgeons understood the need for cleanliness.

After Operations - Many patients would die from infections picked up during or after surgery.

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Infection - Antiseptics and Aseptic - Solutions

Ignas Semmelweiss (1847) - reduced death rates on his maternity ward by insisting that doctors washed their hands before delivering new born children. He was mainly ignored.

Louis Pasteur (1861) - Published Germ Theory - proves germs caused disease and infection.

Joseph Lister (1865) - Made and developed a carbolic spray to kill germs in an operating theatre. - At first he faced a lot of opposition because of its size, shape and effectiveness. - Opposition was slowly overcome (1866 onwards)

William Halstead (1890) - recommended that rubber gloves should be used during surgery - this was the basis of Aseptic Surgery.

Robert Koch (1890's) - discovered that steam killed more germs than carbolic acid - steam was then used to Sterilise tools and theatres.

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Blood Loss - Blood Transfusions - Problems

Idea - been considered for centuries but no successful attempts or theories were accepted.

Jean-Baptist Deyns (1667) - First successful blood transfusion - lamb to young man - next patient died and the practice of blood transfusions were prohibited.

First transfusions (1818) - Doctors in London were transfusing blood from human to human but results were disastrous. - the red blood cells would clot and the patients would die.

Blood Groups - no knowledge of blood groups - many patients were given the wrong blood type and would die from blood clotting

Storage - No way to store the blood ready for transfusions - on-the-spot donors were needed which wasn't effective or practical as many were of the wrong blood type. 

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Blood Loss - Blood Transfusions - Solutions

Karl Landsteiner (1901) - discovered the four blood group (A, B, AB and O). He realised that transfusions would only work if the donor and the receivers blood were of the same group.

Albert Hustin (1914) - discovered that Sodium Citrate stopped blood from clotting - this made transfusions easier.

Storage (1917) - Blood Banks were set up and blood was stored ready for transfusions.

World War 1 - National Blood transfusions service was set up - Blood transfusions soon became essential in saving lives of thousands of soldiers on the battlefield.

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Types of questions - how to answer them (1)

Questions will appear in this form in the exam - 

1. (5 Mins - 5-6 lines) - What can you learn from source __ about ->

    - Pick out from the source relevant details

    - Then draw conclusion

    - DO NOT need to look at 5W's / NOP

    - Use -> 'this shows/suggests...' or 'this implies/infers that...'

2. (10 Mins - 1/2 - 2/3 sides) - What is the message/ impression of source__ ->

    - what can you see in the source

    - look at what message thats coming across

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Types of questions - how to answer them (2)

3. (12 mins -  2/3 - 1 side) - How far do sources __ suggest that ____ ->

    -5 W's - What, Who, When, Why, Where

    - How do they agree

    - How do they agree

    - Who wrote it & what that changes

    - Conclusion - sum up and say which agree and why

4. (12 - 15 Mins - 1 side) - How useful is source(s) __ / which of sources __ is more useful __ ->

    - look at what each source says

    - explain how they could be useful - 5 W's 

    - Conclusion - sum up which one(s) would be most useful and why - 5W's

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Types of questions - how to answer them (3)

5. (20 Mins - 2 - 3 sides)How far do you agree with ____ ->

    - use own Knowledge and sources knowledge that agrees

    - use own Knowledge and sources knowledge that disagrees

    - Conclusion - Balancing knowledge and sources for one side or the other and why.

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Source Skills - Inference and portrayal

main points ->

- What details have been included

-What is the centre of attention ( and how has the artist made it the centre of attention)

- Whether people have been shown interacting with each other

- whether anything has been deliberately missed out

Summary ->

- An inference is information that can be worked out from the source even if it is not actually stated or shown in the details

- Portrayal is about the image or message created by the source.

- In your answers you should make clear what it is that you have worked out and which part of the source has helped you to make that inference or portrayal

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Source Skills - Source Analysis

Main Points ->

- when analysing a source you have to break it down into sections and look at each part separately

- sometimes the question will ask you to justify an inference which means that you will need to break down the source and see if each individual section has a connection to the inference

Summary ->

- Inference and portrayal are linked to source analysis

- You need to look at all the details in the source in order to work out what extra information can be extracted from it

- You can work out portrayal from the details that the author/artist has chosen to include

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Source Skills - Reliability

Main points ->

- Before analysing any source you have to first judge for reliability - you have to look at content and context

5w's ->

- Who - who wrote the source? - what would their view on the event be?

- What - what is the source? - if it is a diary entry what will it be affected by emotions?

- When - were they writing it at the time? - if written after would they have missed some elements? but would they also have the ability to look back and get the overall picture?

- Why - why was the source written? - was it written to make people believe something?

- Where - were they at the event? - newspapers will not have been at the event but will have the public's views on it

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Source Skills - Cross-Referencing

Main Points

- Have a clear idea of what it is you want to check in the first source

- Check the second source to see what is says about those details. Are they confirmed, challenged or just not mentioned?

- What attitude is shown in the first source? Is it positive or negative? Does it stress any particular aspect?

- Check the attitude of the second source. Is it similar or different?

- Look at the differences between the sources. Are they small differences, e.g. numbers different, or big differences that might even contradict each other?

- Weigh up the importance of the similarities and differences between the two sources

Summary - It is very rare to find a source that totally agrees with another, so you need to make a judgement about how far the second source backs up the first one, based on what have found in the process of cross-referencing. This includes a careful matching of detail but should also take into account other issues of reliability as well. 

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Source Skills - Usefulness

questions you should be asking yourself ->

- How did this development happen?

- Did the doctor feel this was progress and use this new technique afterwards?

- How quickly did this new technique get accepted?

- What was the experience like for the patient?

- How was this an improvement other previous methods 

Summary -> Sources are used in different ways depending on the focus of the historians enquiry. All sources should be evaluated each time they are used.

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Source Skills - Comparing the value of sources

- Content - What clues are there to show how well the historian understands and has researched the topic?

- Language - Are there any examples of loaded language where the historians attitude might affect the reliability of the source?

- Origins - Who is the historian? Do they have expert knowledge? when were they writing and is that important?

- Intention - Is the historian writing this for any particular purpose, e.g. to celebrate 100 years of anaesthetics or to argue with another historian?

- Nature - What sort of source is it - part of a series, a visual work or even a television documentary?

- Selection - Has the historian chosen to focus on one event or aspect? has anything been missed out?

Summary -> Historians' views must be evaluated in the same way as other sources. Primary sources are not automatically better than secondary. The value of any source depends on how the source context helps the historian while taking account of the sources' reliability or nature and origins to see if that gives the source any added weight.

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Source Skills - Making a judgement

Main points ->

- What topic knowledge do you need? do you need any? is it asking you only about the source?

- What does the question want you to do? 

- How do you do it? What other factors that could have lead to it? Did anything other than those factors influence the result?

Summary -> There is not usually a 'right' answer to these judgement question, but remember to look at all sides of the issue involved and to back up your answer using evidence from the sources and your own knowledge.

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It was very useful but the question answering section was too source based, you need to say how to answer other kinds of questions aswell.



Morton didn't discover ether it was warron.



And queen victoria used chloroform to deliver her 8th baby in 1857 not 1853



Ignaz semmelweiss was in 1846, lister discovered carbolic spray in 1867 and the black period was the 20 year period between 1847 (chloroform) and 1867 (carbolic acid), I change my mind this information is rubbish.



To Nick: Queen Elizabeth used Chloroform for the birth of Prince Leopold in 1853 and then in 1857 with Princess Beatrice as well.

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