Problems In Surgery And Their Solutions

The problems of pain, infection and bleeding and how they were solved.

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The Problem Of Pain

In the 1800s, there were no effective anaesthetics.

Many surgeons would give their patients drugs such as opium or mandrake, some would try and get their patients drunk and some would use 'mesmerism' (hypnosis) hoping the patient would ignore the pain.

All surgery had to be done quickly-deep, internal operations were out of the question.

Surgery was usually limited to removing growths or amputating limbs. Even then, many patients would die from the trauma of the pain.

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How This Was Solved

The problem of pain in surgery was solved by the discovery and development of anaesthetics.

Humphrey Davy experimented with nitrous oxide and discovered that it relieved toothache (1799).

Robert Liston began to use ether during surgery-it was effective but had many nasty side-effects.

James Simpson was experimenting with many chemicals one night and he discovered that chloroform was an effective anaesthetic. He began to use it for women during childbirth.

There was a lot of opposition to cholorform when in 1848 15 year old Hannah Greener became the first person to die from chloroform. Much of this opposition was overcome when in 1853 Queen Victoria used chloroform during the birth of Prince Leopold.

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The Problem Of Infection

Now that surgeons had solved the problem of pain during surgery, they felt confident about carrying out longer, more complex operations.

However, this lead to the time between 1846 to 1870 being known as the 'Black Period' of surgery.

Operations were still being carried out under unhygienic conditions. Because this was before Pastuer proved the Germ Theory correct, surgeons did not understand the need for cleanliness.

As a result, many patients would die from infections developed after the operation.

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How This Was Solved

In 1847, Ignaz Semmelweiss reduced death rates on his maternity ward by insisting that his doctors washed their hands before operating. His discovery was mostly ignored.

In 1861, Louis Pasteur published his Germ Theory, which proved that germs caused disease and infection.

In 1865, Joseph Lister developed and used a carbolic spray to kill germs in the operating theatre. At first, he faced a lot of opposition because the spray was large and awkward to use and many surgeons were cynical about it's effectiveness.

However from 1866 onwards, opposition to his work was slowly overcome.

In 1890, William Halstead recommened that rubber gloves be used during surgery-this was the beginning of aseptic surgery.

It was also during the 1980s that Robert Koch discovered that hot steam killed more germs than carbolic acid.

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The Problem Of Bleeding

The idea of transfusing blood had been considered for centuries. Jean-Baptist Deyns successfully transfused blood from a lamb to a young man in 1667. The man lived, but because the next patient died, the practice was prohibited.

By 1818, doctors in London were successfully transfusing blood from human to human, but most transfusions were disastrous because the red blood cells would clot together and the patients would die.

There was no knowledge of blood groups and as a result, many patients were given the wrong blood, which would then clot.

There was also no way to store blood, so there had to be on-the-spot donors, which was not effective or practical.

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How This Was Solved

In 1901, the four different blood groups were discovered by Karl Landsteiner. He realised that transfusions would only work if the donor's blood matched the receiver's blood.

In 1914, Albert Hustin found that sodium citrate stopped blood clotting, making transfusions easier.

In 1917, the storage of blood in blood banks began.

During World War II, the National Blood transfusion Service was set up.

Blood transfusions became essential in saving the lives of thousands of soldiers on the battlefield.

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Great notes ^^


This is good :)

Beckie Gude

Really great notes, thank you so much!

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