Surgery in the Nineteenth and Twentieth Century

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The Three Main Problems

Before the 19th century there were 3 main problems with surgery.

Pain - Patients could die from the shock of pain. Patients could feel everything through thoughout the operation.

Infection - Once an operation was over the wound could become infected and cause death.

Blood Loss - Patients could bleed to death during operations

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  • Operations were only carried out in emergencies.
  • Surgeons had to be fast because of pain and bleeding.
  • The speed often led to mistakes such as cutting off the wrong part of the body.

These were solved in the 19 & 20th century.

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Anaesthetics and James Simpson

  • The problem of pain was solved in the 1840s
  • Different gases were used to send patients to sleep. The best being Chlorform- discovered by James Simpson, 1847


:) Felt no pain during operations

:) Operations could be slower, more complicated

:( Could die from overdose

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Opposition to Anaesthetics

  • Some doctors though pain was sent from God and should be endured - especially during childbirth.
  • Some alarmed by the deaths from chloroform.
  • Some alarmed by infections, because of more complex operations.

Anaesthetics got a boost after Queen Victoria used chloroform during childbirth.

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Antiseptics and Joseph Lister

The problem of infection was solved with antiseptics.

Joseph Lister knew about the germ theory. In 1865 he started to use Carbolic Acid to kill germs during operations.

Before: nearly half of his amputations resulted in death

After: only 15% died

:) Death rates from infection fell

:( Not all surgeons were careful - some infection

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Opposition to Antiseptics

  • Cleaning wounds was hard work and slowed operations. Many surgeons still prided themselves on being fast.
  • It seemed extreme, carbolic acid soaked everyone and everything.
  • Many people didn't believe in germs. (Something so small couldn't cause something so big)
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Blood Transfusions

Helped with blood loss

Landsteiner discovered the different blood groups.

  • In 1907 the first blood transfusion took place
  • WW1 - storing blood introduced
  • WW2 - National Transfusions Centres set up.

Paré began using ligatures.

Harvey proved only a certain about of blood in body.

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  • 1895 - Rontgen discovered x-rays
  • Doctors and surgeons could see inside the body without operating
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Aspetic Surgery

Antiseptic surgery (cleaning the wound) was replaced with aseptic su0.

Surgery (cleaning everything in the room)

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Modern Surgery


  • Keyhole Surgery - Cutting tiny hole and using fibre-optic cables to see inside body.
  • Replacement Surgery - Joints can be replaced by plastic or metal ones.
  • Transplant Surgery - Transplant many vital organs from one body to another.
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Plastic Surgery

  • Development of skin grafts from WW1, doctors paid attention to the appearance of patient after operation.
  • WW2 - Archie McIndoe used penicillin to prevent infection from reconstruction.
  • 1st facial implant was in 2005.
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