Surgery/Anaesthetics affected by numerous factors: 1845-1919

War
1. The First World War applied increased amounts of pressure to the medical industry
  1. This was because it needed to increase it's methods of surgery and types of equipment.
    1. The medical industry needed to do this because new ounds were occurring, due to the rate of development of weaponry
2. As well as the increased pressure applied on the medical industry, capital from the government was injected more into the funding of arms technology
3. However, war did benefit in some ways as blood transfusions became a necessary procedure during WW1
4. Because the surgeons needed more time to investigate and treat these new wounds, anaesthetics became more popular
  1. This is because surgeons wanted to give themselves more time without the hastle and rush.
5. World war 1 applied pressure to the medical industry in developing its surgical methods.
Technology
1. As technology got better, so did the surgical equipment as new parts and discoveries aided medical projects
  1. Because new weapons were being developed, new wounds that had never been seen before had to be treated
    1. Hence new medical equipment was developed to deal with these new wounds
      1. In 1895, X ray was discovered by Willhelm Roentgen. However he did not exploit with it, he did for the good of medical purpose.
    2. For example, the invention of the hypodermic needle of Alexander Wood in 1853. This lead to accurate injections or withdrawal of blood/drug.
      1. Or the invention of the Chloroform inhaler by John Snow in 1848
2. The use of rubber gloves and using cat gut for ligature.
Key individuals
1. James Simpson accidentally discovered how Chloroform could be used when he inhaled chloroform at a dinner party.
  1. In 1848 John snow created the Chloroform inhaler so people could have safe doses of Chloroform.
  2. Simpson used Chloroform to ease the pain of childbirth
    1. Simpson was not very important as he discovered Chloroform's properties by chance
      1. It was John Snow who made Chloroform safe to use
      2. The use of Chloroform before the inhaler made the death rate go up as people were dying of overdosages of Chloroform
        This was called the black period of surgery
        More 'effective' anaesthetics such as Cocaine were used in 1884
2. In 1845 US dentist Horace Wells used Nitrous Oxide. This inspired other Physicians/ medical professionals to use anaesthetics.
  1. In 1846 William Morton discovered that Ether lasted longer than NOS. However, it irritated people's lungs and was highly flammable.
3. Karl Landsteiner discovered blood groups in 1901.
  1. This meant that blood banks could be established and in ww1 blood transfusions could be carried out more easily.
4. Joseph Listers idea of sterilising equipment with Carbolic Acid, meant that infection spread less easily as germs were killed off.
5. Louis Pasteur disproved spontaneous generation as he proved that bacteria came from the environment.
6. Robert Lister became very concerned with the death rate involved with surgery
  1. Lister studied Pasteur's idea that bacteria and germs were floating in the air (germ theory)
    1. He thought that these germs were settling on a patients wounds after surgery and causing infection
      1. So when he was operating on Anna 8 year old boy, he sprayed the wound with carbolic acid and covered the wound with carbolic acid soaked banadages
        This development lead to the sterilisation of equipment and cleanliness of operating theatres, this was aseptic surgery
        However there was opposition to Lister's work as the acid caused skin to crack and carried abad smell
        Also the nurses resented the extra work load
        Lister's work was important as before antiseptics surgery, the death rate was at a peak of 67%. After, it was only at 15%
        Also this made operations that needed time to be carried out. For example in 1896 the first heart operation took place
7. Ignaz Semmleweis
  1. He noticed, while working in Austria helping women give birth, that women who were helped by midwives, who washed their hands, did not get infected. However, women who were helped by students were. This meant that people needed to wash their hands in order to stop infection.
Pre 1845
1. Pain
  1. No reliable anaesthetic aside from the discovery of NOS'e pain supressing properties by Humphery Davy in 1799. Not very reliable as was very irritable
  2. Speed was the main factor which lead to problems in surgery
2. Infection
  1. Before germ theory in 1861, infection was the biggest killer with a death rate at approximately 50%
Anaesthetics
1. Nitrous Oxide
  1. Discovered in 1799 by Humphery Davy, first used in 1846 by Horace Wells when he was extracting teeth.
    1. Problems were that it made people giggle and then made it hard for the surgeon to operate.
2. Ether
  1. In 1846 Robert Lister used it in the amputation of a leg
  2. Very strong anaesthetic, sometimes knocking people out for days.
3. Chloroform
  1. The most dangerous before the inhaler was introduced as it was so strong it killed people
    1. The inhaler followed the death of 14 yr old Hannah Greener in 1848 after was having a tone nail removed.
  2. Queen Victoria used it at childbirth of her 8th child in 1853

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Surgery/Anaesthetics affected by numerous factors: 1845-1919

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	Created by Oliswann almost 12 years ago