Changes in Surgery (1845-1945)

Changes in Surgery (1845-1945)

1. Anaesthetics

   • Ether
     • Worked because patient felt no pain
     • American dentist called William Moston
     • Put patients to sleep for a short time
     • However: It irritated eyes and caused coughing and vomiting
     • 1846
   • Chloroform
     • 1847
     • James Simpson, Scottish doctor
     • Worked but fear of long term side effects
     • Some believed that it was unnatural to ease women's labour pains
     • Hannah Greener died after being given chloroform which heightened controversy
       • 1848
     • 1857
       • Final breakthrough
       • Queen Victoria used chloroform in the birth of her 8th baby
       • Became common as backed by the Queen
   • Pain was an obstacle as it could put people off having life saving operations

2. Antiseptic Surgery (fighting germs)

   • Carbolic Acid - Joseph Lister
     • Decided to use carbolic acid after reading Pasteur's report
     • He wanted to find a way to kill germs rather than just preventing them
       • Made the connection that germs were coming from doctors' hands
     • Used it to spray anything that might come into contact with the wound
     • Problems
       • Cracked surgeon's skin and irritated
       • Made everything smell
       • For people who still believed that speed was the key, it slowed them down too much
       • It was expensive
       • Doctors didn't like being told what to do
       • It didn't work as effectively for some surgeons because they weren't as systematic
     • 1867 the English surgeon began to develop his antiseptic
     • went on to use sterilised tools

3. Aseptic Surgery (preventative)

   • Germ theory - 1861, Pasteur's recommendations
     • Have clean hands
     • Have clean instruments (rapidly heated - sterilised)
     • Use only lint bandages and sponge previously heated to 130-150 degrees
   • From 1887, all interments were steam sterilised
   • German surgeons developed techniques to keep the germs away
     • These techniques became common in the operating theatre
   • 1889 - Halstead introduced latex gloves after problems with sore hands due to carbolic acid
     • Protected patient as well as surgeon
     • Also introduced caps, masks and gowns to surgery