GCSE History- The Transformation of Surgery

GCSE History- The Transformation of Surgery

1. Key Words

   • Amputation
     • The cutting off of a limb
   • Anaesthetic
     • A substance that makes you less aware of pain
   • Tourniquet
     • Something tied around a part of the body to put pressure on a blood vessel and stop the blood loss
   • Antiseptic
     • Something that fights against sepsis and the microbes that create infection
   • Aseptic
     • Sterile
   • Sepsis
     • A condition in which harmful bacteria affect the flesh, normally leading to infection and decaying flesh
   • Cautery
     • The use of heat to seal blood vessels and stop bleeding
   • Ligature
     • A thread tied around a blood vessel to stop bleeding
   • Shock
     • When there isn't enough blood in the circulatory system to keep the body working properly
   • Transfusion
     • The process of giving blood from a donor to the patient

2. Dealing with Pain

   • Surgery and anaesthetics in the 19th Century
     • The most common surgical operations were amputations
     • No use of anaethetics
     • Amputations
       • Were very painful
       • Assistants were needed to hold the patient down
       • Surgeons needed to work very quickly
       • Spectators would be watching
       • Surgeon and everyone else present would be in their own clothes
         • Surgeons would wear an od apron with blood on it to show experience
   • The Discovery of anaesthetics
     • 1799- Humphrey Davy accidentally discovered nitrous oxide
       • 1844-1845- Horace Wells used nitrous oxide when extracting teeth
     • 1846- William Morton found ether had a more longer lasting affect
       • 1846- Robert Liston uses ether as an anaesthetic
     • 1847- James Simpson uses chloroform as an anaesthetic
       • 1848- First death as a result of chloroform
       • 1858- Queen Victoria uses chloroform during childbirth
       • John Snow invented the chloroform inhaler
     • 1905- Novocaine used as an anaesthetic
   • 1850-1875- The Black Period of Surgery

3. Dealing with Infection

   • Early attempts to control Infection
     • Ignaz Semmelweiss
       • 1846- Found that making the medical students wash their hands with chlorinated solution between patients reduced the death rate
     • Florence Nightingale
       • Set high standards of hygiene in the Crimean War (1854-1856)
   • Lister uses carbolic acid as an antiseptic
     • Opposition to Lister
       • Some doctors didn't accept microbes could cause infection
       • Using carbolic acid slowed down the process leading to problems of blood loss
       • Doctors didn't always copy properly so didn't get improved results
       • Lister kept changing his ideas
       • The equipment was heavy and expensive
       • Some surgeons got good results without carbolic acid
       • Nurses didn't want extra work
   • 1878- Robert Koch develops the steam steriliser

4. Dealing with Blood Loss

   • The usual way to deal with blood loss was cautery or ligatures in 17th and 18th century
     • The ligatures were developed by Ambroise Pare.
   • Storing Blood
     • 1901- Karl Landsteiner discovers blood groups
     • 1915- Lewisohn uses sodium citrate to stop blood from clotting
     • 1916- Rous and Turner use citrate glucose solution to store blood for longer
     • 1917- First blood depot in the Battle of Cambrai
     • Richard Weil found blood can be store in refrigerated conditions

5. Factors affecting the Development of Surgery

   • War
     • Harold Gillies set up a Plastic Surgery unit in 1916
     • Use of prosthetic limbs
   • Science and Technology
     • 1853- Alexander Wood invents Hypodermic needle
     • 1895- Roentgen discovers X-rays
   • Communication
     • Medical Journals
       • Lister's Germ Theory
       • The work of Semmelweiss
     • Newspapers and Public Opinion
       • Queen Victoria receiving chloroform