Transformation Of Surgery (SWHS)

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Romans

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

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 
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The First Anaesthetics

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
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James Simpson

  • 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.
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Opposition to Anaesthetics

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.
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Dealing With Infection

  • 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.
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Breakthroughs in dealing with infection before 186

  • 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.
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Florence Nightingale

  • 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.
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The role of women in medicine from 1350 to 1850

  • 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.
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Joseph Lister (carbolic acid)

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)
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