Transformation Of Surgery (SWHS)

• Invented different tools to make it easier to operate
• They didn't use steriliser (made the patients wound infected)

Before the 19th century:

• Lack of effective Anaesthetics held back the developmnet of surgery.
  
• Difficult to operate - patient moving around in pain.
• Operations had to be quick and simple - mistakes made - deaths
• Operations didn't go deep into the body - quick operations
• The most common type of surgery was Amputation 
• Problem solved by 1900 

Nitrous oxide (Laughing gas) 

• Discovered to have anaesthetic properties by Sir Humphrey Davy - 1799
• Success - reduced pain suffered by surgeons 
• Didn't knock patients out
• LIMITED IMPACT

• Discovered chloroform.
• Invited several doctors to his house to inhale various chemicals to see what would happen.
• Later - all the doctors were unconsious -inhaled chloroform.
• Simpson started using chloroform during operations in 1847.
• Became popular after Queen Victoria used chloroform during her eighth child in 1853.
• John Snow invented special inhaler to regulate chloroform dosage - helped to prevent heart problems.
• Enormous breakthrough
• James simpson was the first man to recieve a knighthood for his contribution to medicine.

Reasons why opposition to Anaesthetics:

• Religion - christians thought that pain during childbirth was part of God's plan for humans.
• People considered pain to be a blessing.
• Queen Victoria used chloroform - persuaded the public to use chloroform.
• 1848 - Hannah Greener died while being given chloroform a during a toenail operation. 
• Hannah Greener - first death from using chloroform - scared surgeons.
• New anaesthetics - surgeons performed more complex operations and go deeper into the body.
• Problems with blood loss and infection had not been solved.
• 1870's - death rate increased 
• Some doctors thought that an unconcious patient was more likely to die than one who was awake during surgery.

• Deaths from surgery increased because surgeons did more and more complex operations but had not solved the problem of infection.
• 1890's - surgeons still had very little understanding of how germs spread. 
• Surgeons had still not discovered what caused Gangrene and Sepsis - both big killers of surgical patients.
• 1861 - Germ Theory published.
• Even after germ theory published, it took six years for doctors to apply it to surgery and the treatment of patients.
• Joseph Lister - made the breakthrough and developed the first effective antiseptics and helped solve the problem of infection.

• Surgeons may have washed their hands with water - water may be carrying infection itself.
• The instuments, operating table and room, would not have been cleaned.
• Surgeons used to wear their oldest coat, which would have been covered in blood to show how experienced they were.

• Before the 19th century - nursing standards were not high and training was minimal
• She wanted to persue the profession of nursing but her wealthy parents were unhappy about this because at the time, nursing was not considered a suitable job for an upper-class woman.
• 1854 - Nightingale worked as a nurse on the battlefields of Crimea.
• Typical conditions - dirty wards and sheets, bad food and no privacy.
• Nightingale used her own money to rebuild a ward block and provided better meals for the sick - death rates fell sharply.
• When she returned to London she gave the government a report about what needed  to be changed - eg. better ventilation and lots of light - the government listened to her.

• Nightingale's methods eventually led to a 50% drop  in army hospital death rates.
• Her success was widely reported in the press,so people gave money to help her open the first school for nursing in Britain in 1861.
• Nursing became increasingly professional, and the role of nures was valued more highly in hospitals.
• She wrote over 200 books on nursing and hospital design/organisation. which were popular all over the world.
• By 1901 there were 68,000 trained nurses in britain - in 1850, there had not been any.

• Women were not allowed to attend university, which meant that they could not train as doctors or practise medicine professionally.
• Most people who were ill stayed at home and were treated by the women of the family or local healers, who were usually women.
• Wise women provided herbal remedies and advice on curing illnesses or infections.
• Women acted as midwives and attended births until the 17th century, when it became fashionable to have a male doctor instead - for those who could afford it.
• Nuns nursed terminal patients (untreatable patients) in hospitals within their convents until the influence of the church declined.
• Wealthy ladies provived medical care for the people on their family's lands and therefore often had some medical knowledge.

Joseph Lister discovered that Carbolic acid reduced infection.

• Lister was a surgeon
• Became curious of what cause infection after reading Pasteur's Germ Theory
• Carbolic acid was used in sewers to kill parasites.
• Lister tried carbolic acid on the microbes that were causing infecction.
• He tested it first on a child with a broken leg, the carbolic-soaked bandage enable the the wound to heal cleanly within six weeks.
• Lister started using carbolic acid to wash his hands and equiptment 
• He treated the air around patient during a n operation with a carbolic spray
• Death rate following operations dramatically fell.
• 1867- announced that no one on his wards had died from blood piosoning for nine months.
• Lister introduced catgut - sterilised and used to stitch wounds instead of uing silk which could not be sterilised.
• He developed a type of catgut that would desolve in the body after a few days and did not have to be removed.
• 1897 - Lister became Baron Lister (one of the best surgeons award)