Surgery in the nineteenth century

Surgery in the 1800s
1. Dangerous
2. No way of controlling...
  1. Blood loss
  2. Pain
  3. Infection
3. Dirty conditions- clothing, floors, tables, instruments
4. Carried out at breakneck speeds
Pain: early improvements
1. Laughing gas used as a painkiller by Humphrey Davy
2. Ether used as an anaesthetic by Robert Liston in1846
3. Chloroform used to knock you out by James Simpson
4. Problems?
  1. All three were dangerous if too much was taken and some had nasty side effects
  2. Many surgeons opposed painkillers- pain was a good thing sent from God and let you know the patient was alive
  3. Errors in the application of anaesthetics led to scepticism
  4. Led to surgeons performing more 'risky' operations as they felt more confident
5. The use of anaesthetics reduced the amount of pain that patients suffered, they also suffered less shock
Blood loss: improvements
1. Blood groups
  1. 1901: Karl Landsteiner discovered that humans had three types of blood which he called A, B, O. In the following year group AD was discovered.
2. Storing blood
  1. 1914: it was found that sodium citrate stopped drawn blood clotting in a syringe (gave doctors a little more flexibility)
  2. Real breakthrough was when blood cells were seperated from the liquid part and stored in a glucose solution. Bottles of corpuscles could be stored and dilluted with a saline solution when needed.
  3. Blood banks were developed
3. Blood transfusions
  1. First did animal - animal blood transfuions
  2. Animal - human done by French doctor Jean Denys in 1667
    1. Didn't understand why some went well and others did not
  3. James Blundell was the first to carry out human - human blood transfusions. Described as 'the farther to modern blood transfusions'
Infection: improvements
1. 1840s Ignaz Semmelweiss realised that doctors were spreading germs around hospitals from not washing their hands after touching other patients. He made doctors in his hospital wash their hands after every patient.
  1. Death rates fell, however many people opposed him so high death rates continued in most places. His ideas were not widely spread.
2. Joseph Lister developed and used a carbolic acid to disinfect theaters. He used bandages soaked in it. He then developed a spray that drenched the air, hands. instruments and patients. Results were remarkable (46% to 15%).
  1. Carbolic acid burnt skin and irritated lungs, lead to aseptic surgery rather than antiseptic.
  2. William Halstead: gloves, face masks, gowns worn.
  3. Koch develops sterilisation by heat/boiling

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Surgery in the nineteenth century

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	Created by ellamae gibson about 11 years ago