part 3: revolution in surgery

Question 1

problems with surgery

Answer 1

• pain
• infection
• bloodloss

Question 2

what was the result of these problems?

Answer 2

• meant surgery had to be quick
• high mortality rates
• many died of infection even if they survived the operation

Question 3

nitrous oxide

Answer 3

• discovered by humphry davy in 1799
• worked as an effective local anaesthetic
• wasn’t widely used until after davy had died
• used by american surgeon horace wells publicly to remove a tooth
• however patient not given enough so reacted to procedure, convincing people it didn’t work

Question 4

ether

Answer 4

• horace wells (american surgeon) and william morton 1846
• worked effectively as an anaesthetic
• quickly became widely used by surgeons in england
• but it was flammable so needed to be stored carefully
• patients often complained of a sore throat or feeling sick after a procedure

Question 5

chloroform

Answer 5

• james simpson 1847
• discovered that it was an effective general anaesthetic
• replaced ether as most widely used anaesthetic
• allowed surgeons to start to consider more complex operations
• used by queen victoria in childbirth

Question 6

problems with nitrous oxide

Answer 6

• controlling dosage
• didn’t convince doctors straight away

Question 7

problems with ether

Answer 7

• difficult to inhale
• caused vomiting
• highly flammable
• unstable drug that killed several patients

Question 8

problems with chloroform

Answer 8

• caused dizziness and sleepiness
• can easily overdose
• not universally successful as caused a number of deaths

Question 9

opposition to anaesthetics

Answer 9

• religious argued that pain in childbirth was sent by god, so using anaesthetics in labour was interfering with god’s will
• anaesthetics could be dangerous if not used carefully, caused deaths
• army banned use of chloroform, thought soldiers should put up with the pain
• still a severe death rate from infection afterwards
• patients died as men, women and children all needed different doses e.g hannah greener died in a procedure to remove ingrown toenail as she was given too much
• chloroform had side effects like dizziness, sleepiness and unconsciousness

Question 10

significance of anaesthetics

Answer 10

• patients no longer suffered pain and died of shock
• enabled surgeons to develop more complicated procedures
• enabled doctors to gain knowledge about the body

Question 11

acceptance of anaesthetics

Answer 11

• rober liston successfully amputated a leg using ether as an anaesthetic
• surgeons tried more difficult operations as they could take longer to operate
• used to give birth to prince leopold

Question 12

how was opposition to anaesthetics solved?

Answer 12

• john snow devised a chloroform inhaler in 1850s
• made it possible to control dosage so safer use
• past was poured onto a cloth and placed over mouth and nose
• queen victoria used it in 1853 in childbirth, spoke of ‘blessed chloroform’ in easing pain
• reassured public

Question 13

joseph lister

Answer 13

• read about pasteur’s work on germ theory
• experimented on jamie greenlees who had fractured his leg
• past would have amputated
• instead set bones and used carbolic acid to soak bandages before applying them to wound
• found it prevented infection and helped wounds to heal

Question 14

impact of carbolic acid

Answer 14

• used widely in surgery
• sprayed from a pump at side of operating table
• sterilised air and equipment used
• hugely effective
• mortality rates in lister’s surgery fell from 40% to 15% making surgery safer

Question 15

lister’s reaction

Answer 15

• published results
• publicised germ theory through explanation of antiseptic techniques
• claimed infection in wounds is caused by microbes in air

Question 16

opposition to carbolic acid

Answer 16

• some surgeons complained the acid irritated their eyes and hands, making it difficult to carry out delicate surgery
• instruments and equipment were soaked in acid, making them slippery
• some found machine spraying acid got in way and made it more difficult to concentrate
• strong belief in spontaneous generation
• didn’t accept germ theory therefore didn’t accept antiseptics

Question 17

antiseptic surgery

Answer 17

• american surgeon william halstead asked a tyre company to make rubber gloves to wear in operations
• he came up with idea after speaking to a nurse who had suffered from dry skin on hands due to carbolic spray
• gloves helped make surgery cleaner and safer
• he then encouraged aseptic surgery
• aim to sterilise equipment and hands so there were no germs that could cause infection during an operation
• mean there was no need for carbolic acid use

Question 18

blood loss

Answer 18

• solved in 1901 by karl landsteiner
• he discovered blood groups
• meant blood transfusions could successfully be carried out
• therefore longer operations made safer