Surgery

• 19th century surgery was unpleasant with no anesthesia, lack of infection prevention, and high mortality rates
• Main causes of death in 19th century surgery were pain, infection, blood loss, and shock
• Amputation procedure in the 19th century


  Patient held down, limb tied with a tourniquet, deep cut to the bone, limb removed swiftly, cauterization or ligatures used, stump wrapped with bandages
• Success rate of 19th century surgeries was about 50/50 with common infections and shock from blood loss
• Dangers of 19th century surgery included pain, infection, blood loss, and shock, all of which were deadly
• In the 1840s, a new anesthetic, ether, was introduced but was dangerous if not used carefully
• James Simpson discovered chloroform's anesthetic properties in 1847, leading to a safer and more effective anesthesia
• Anesthetics in childbirth

  Prevent excessive pain, allowing for safer deliveries and calmer medical interventions
• Church's opinion on anesthetics: 'Anesthetics were seen as against the will of God, who made childbirth painful as a punishment'
• God made childbirth painful as a punishment for mankind after Adam and Eve ate the forbidden fruit in the Garden of Eden


  Childbirth pain is a punishment
• If God had wanted childbirth to be pain-free, he would have made it so

  Intervening in such matters is against the will of God almighty
• Her Majesty: 'Most definitely supports the use of chloroform in the relief of pain during childbirth<|>Partook of chloroform during the birth of both Prince Leopold in 1853 and Princess Beatrice in 1857 with most agreeable effects'
• The queen was the head of the Church of England


  Many of the church's objections to chloroform dried up once the queen had shown her support
• Chloroform

  • Highly successful anesthetic
  • Quite risky
  • Used by the queen during childbirth with agreeable effects
• Nitrous oxide (Laughing Gas)


  • Important anesthetic
  • Reasonably safe
  • Has an analgesic effect
  • Patient remains awake and responsive
  • Not as powerful as chloroform
  • Can have unwanted euphoric effects
• Chloroform, ether, and laughing gas help deal with pain


  At least some of the pain has been dealt with
• Infection needed to be sorted in surgery
• Joseph Lister


  • Found a way to prevent infections during surgery
  • Used carbolic spray to sterilize equipment and reduce infections
  • Percentage of patient deaths after operations fell from 46 to 15 percent
• Joseph Lister's discovery


  1. Patients died from infections after successful operations

  2. Used carbolic spray to kill bacteria and prevent infections

  3. Led to antiseptic surgery
• Carbolic spray was used in antiseptic surgery
• Pros of Lister's carbolic spray

  • Reduced fatalities in operations
  • Inspired by Pasteur's germ theory
  • Killed bacteria to make surgery cleaner
• Cons of Lister's carbolic spray

  • Stung and irritated the lungs and patient's wounds
  • Made surgeon's hands sore and uncomfortable
  • Didn't go as far as aseptic surgery
  • Later superseded by steam cleaning
• 19th century surgery

  Anesthetized with chloroform, sterilized tools with carbolic acid, surgeon qualified and professional but not wearing specialized or sterilized clothes, used carbonic spray to sterilize air and hands, patient no longer needed to be held down, deeper and more ambitious procedures performed, wound carefully stitched up with sterilized stitches or ligatures
• Use of chloroform anesthetic

  Allowed surgeons to take longer to perform operations and reduced pain for the patient
• Discovery of germ Theory by Louis Pasteur in 1861


  Further progress in surgery with Joseph Lister's antiseptics in 1867, reducing the risk of patients dying of infection
• Identification of diseases based upon specific bacteria by Robert [__] in 1882

  Development of vaccines and better understanding of how people were getting sick from specific bacteria during operations
• Progress in 19th-century surgery
• Edward Jenner's vaccinations in 1798 prevented smallpox and saved billions of lives, although not entirely relevant to surgery
• Chloroform anesthetic discovered by James Simpson in 1847 allowed surgeons to take longer to perform operations and reduced pain for the patient
• Discovery of germ Theory by Louis Pasteur in 1861 suggested that bacteria and germs cause disease, leading to further progress in surgery with Joseph Lister's antiseptics in 1867
• Robert [__] identifying diseases based upon specific bacteria in 1882, leading to the development of vaccines and better understanding of how people were getting sick from specific bacteria during operations
• Progress in 19th-century surgery solved many dangers: pain relieved through anesthetics, infection risk reduced with understanding of germs, blood loss helped by anesthetics keeping patients calm, and shock reduced with less pain and blood loss