Transcript Surgery in the Nineteenth Century

Surgery in the Nineteenth
Century
The development of Modern Surgical
techniques: an overview.
Surgery in 1800
• Surgery in the early
19th Century was
very dangerous.
Patients were at risk
of dying from:
• Pain
• Infection
• Blood Loss
Pain: Early improvements
• Humphrey Davy experimented with
Laughing gas as a painkiller.
• Ether was successfully used by Robert
Liston in 1846.
• James Simpson then used Chloroform, most
famously on Queen Victoria.
Problems with painkillers
Nitrous Oxide, Ether
and Chloroform
were all opposed by
large numbers of
surgeons.
WHY?
The problems with painkillers
• Nitrous Oxide is
actually laughing gas!
• It wasn’t very
effective, at one
demonstration the
patient moaned in pain
– and the demonstrator
was booed off.
The problems with painkillers
• Ether is a rather
unstable drug which
had the rather
unfortunate side effect
of killing several
patients!
The problems with painkillers
• Chloroform was not
universally successful,
there were a number
of deaths caused by it.
• Many surgeons were
now weary of the
different anaesthetics
– none of which had
yet been proven.
Queen Victoria’s use of
chloroform during childbirth
helped to make it more widely
accepted.
Fighting pain: a success?
• The use of anaesthetics such as Chloroform
reduced the amount of pain that patients suffered.
• Patients and surgeons were more confident that
the operation would be painless.
• Errors in the application of anaesthetics led to
scepticism.
• Some forms of anaesthetic had nasty side effects.
The problem of Infection
• In 1800 the cause of
disease was not fully
understood.
• As a result operating
theatres were not as
clean as they could be.
• Pasteur’s GERM
THEORY changed all
that!
Early operations were not
conducted in clean
environments
Fighting Infection
• Joseph Lister realised
that germs in the
theatre had to be
destroyed.
• He used carbolic acid
to kill germs, having
seen it used in sewers.
• Carbolic Acid was the
first ANTISEPTIC.
Lister performing surgery.
Fighting Infection
• In 1878 Robert Koch discovered that bacteria
caused septicaemia.
• He also discovered that hot steam killed more
germs than carbolic acid.
• He introduced ASEPTIC surgery as a result.
• The Aseptic method is applied to all equipment in
the theatre, creating a ‘germ free’ environment.