Surgery in the Nineteenth Century

1. Surgery in the Nineteenth Century The development of Modern Surgical techniques: an overview.

2. Surgery in 1800 • Surgery in the early 19th Century was very dangerous. Patients were at risk of dying from: • Pain • Infection • Blood Loss

3. 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.

4. Problems with painkillers Nitrous Oxide, Ether and Chloroform were all opposed by large numbers of surgeons. WHY?

5. 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.

6. The problems with painkillers • Ether is a rather unstable drug which had the rather unfortunate side effect of killing several patients!

7. 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.

8. 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.

9. 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! The problem of Infection Early operations were not conducted in clean environments

10. 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.

11. 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.