History Surgery Pain

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  • Created by: ChrisD11
  • Created on: 17-12-15 17:29
What were the three problems of Surgery?
Pain--Blood Loss--Infection
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What was the problem of pain?
No (reliable) anaesthetic, despite earlier discovery of nitrous oxide in 1799. Patients held down during operations despite uses of alcohol etc. Speed was of the essence which led to mistakes. Death from shock was fairly common.
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What was only available pre 1845?
Only basic surgery was possible, no internal surgery only amputations
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What was the problem of Infection?
The greatest killer before the Germ Theory (1861) was understood. Death rate was approx 50%. Surgeons practised in blood stained coats or in their own clothes and surgical instruments may not have been washed. They didn't even wash their hands.
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What did Surgeons re-use alot of?
The same bandages
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Where did operations normally take place and who watched?
Operations were observed by trainees (operating theatre) and the chances of spreading infection were greater. Many operations all took place in the patient's home.
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What was the problem of Blood Loss?
A tourniquet was used to stem the flow of blood and ligatures had replaced the use of cautery iron or boiling oil to seal wounds. Ligatures were silk threads which were used to tie up blood vessels.
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What was the problem of Ligatures?
They were not sterilised at first which meant they could carry infection
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What were the early attempts to control pain and when were they created?
Nitrous Oxide in 1799, Ether in 1846 and Chloroform from 1847
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Explain the discovery of Nitrous Oxide or Laughing Gas
In 1799 a British man called Humphrey Davy used laughing gas. It was used by dentists to remove teeth.
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What were the effects of Nitrous Oxide
It eased the pain a lot and made you feel happy, It did not knock you out properly and could not be used for serious operations
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Explain the discovery of Ether
In 1846 ether was used for the first time by William Morton in a hospital in America. Ether is a chemical liquid. When you breath it in it knocks you out completely
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What are the effects of Ether
It does knock you out properly and you feel nothing. It can be used for serious operations. However, it is flammable and it damages the lungs and could cause coughing & vomiting during the operation. The effects could last for days.
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Explain the discovery of Chloroform
James Simpson, a young surgeon from Edinburgh, experimented with chemicals after inviting other doctors to his house. After inhaling chloroform, they fell unconscious. Chloroform seemed to put them to sleep without the negative side effects of ether.
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What did Simpson use Chloroform to do?
He soon begun to use chloroform to ease the pain of childbirth and wrote articles about it so that other surgeons could copy his ideas.
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What were the effects of Chloroform?
It was the most long-lasting and reliable anaesthetic- it could knock people out for long operations. It gave surgeons the chance to do longer and more complicated operations but this often just made the chances of infection greater.
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What opposition was there to Simpson's work?
Chloroform was a new and untested gas. Would there be any long lasting side effects? Hannah Greener died in 1848 after having been given chloroform in an operation to remove a toenail. Some surgeons preferred to have patients awake to fight for lives
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What opposition was there to Simpson's work (Continued)?
Religious Objectors- Victorian Britain was religious and many believed pain relief interfered with God's plan- God told childbirth would be painful in Bible. It was difficult to get the dose of it right. Until John Snow developed an inhaler in 1848.
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What opposition was there to Simpson's work (Continued)?
Chloroform could affect the heart- A number of young physically fit patients died after being given a large dose. Needed to put them to sleep. Death rate- with the introduction of anaesthetics many people died after operations due to infection.
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Was Simpson important?
No-- opposition, Simpson discovered chloroform by chance-it could have been anybody. It was Snow who made chloroform safe, The use of chloroform led to the "Black period of surgery", Other anaesthetics were deemed to be more effective later.
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What other anaesthetics were believed to be more effective than chloroform?
Cocaine was used as a local anaesthetic from 1884 and Novocaine as a general from 1905.
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Why did Chloroform lead to "BPOS"?
The death rate actually went up. Without their patients writhing in agony, surgeons could now take their time over operations and could do invasive surgery. The potential for infection without the later understanding of the germ theory was massive.
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Was Simpson that important?
Yes-- Simpson "dealt" with a major problem of Surgery-pain, In the long term after the introduction of antiseptic and aseptic surgery, many more complex and invasive operations could be carried out. Very few now died from shock,
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Was Simpson important? (Yes continued)
Surgeons could take their time-fewer mistakes were made. Operations were easier for surgeon to carry out as the patient wasn't moving, Simpson's contribution was recognised. First man to be knighted for services to medicine + 30,000 attended funeral
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Why was Simpson able to make an impact?
Technology=Snow's inhaler- Individual genius=Simpson was dedicated and convinced that his discovery would work, despite the opposition- Government=Acceptance of chloroform after Queen Vic used it during birth of 8th child in 1853
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Why was Simpson able to make an impact? (continued)
Science-Experimentation with chemicals- Chance= Unconscious by chance-Religion= Hindering factor- Attitudes= Initially negative, more positive following Queen Vic use- Communication=Simpson wrote articles about discovery
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Card 2

Front

What was the problem of pain?

Back

No (reliable) anaesthetic, despite earlier discovery of nitrous oxide in 1799. Patients held down during operations despite uses of alcohol etc. Speed was of the essence which led to mistakes. Death from shock was fairly common.

Card 3

Front

What was only available pre 1845?

Back

Preview of the front of card 3

Card 4

Front

What was the problem of Infection?

Back

Preview of the front of card 4

Card 5

Front

What did Surgeons re-use alot of?

Back

Preview of the front of card 5
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