There has been drastic changes within surgery through the different scientific developments from 1845 to 1918. Surgery in the early 19th century mostly consisted of amputations ( the cutting of the limb from the body). At this time there was no real anaesthetics discovered and most patients were conscious during an operation exposing them to the pain that surgery brought. Throughout my essay i will outline the different surgical techniques that were being used mid 19th century, the causes of the complications patients faced with surgery and how they were overcome through the different ideas and beliefs of surgeons.
The uncontrollable problems such as blood loss and infection which were two key aspects that contributed to “50%” more deaths than any other factor. I will be analysing weather the introduction of anaesthetics was a sigificant turning point in the transformation of surgery and weather it was a major area that reduced the death rate figures in surgery from 1845-1918. I will also look at other key factors that assisted the decline of the death rate such as louis pasteur’s germ theory which helped inspire other further surgical developments. I will be analysing the significance of each development and its effect on Surgeons and particularly patients. My essay will also consist of the benefits and problems that came with the different types of anesthesia methods that were put in place from 1845-1918 to help diminish the death rate figures, bringing in different perspectives to help support my argument. After hours of research I believe the germ theory had a much wider effect on the whole view of surgery and it was arguably the most significant reason that led to the decline of the death rate during surgery in the 19th century. I will be using relevant evidence to help support my argument on why the germ theory was the most significant development in relation to other factors in reducing the death rate figures.
In the early 19th century surgery was a disaster. Most patients that went through surgery died because of the lack of scientific knowledge at the time. Patients had to endure agonising pain as anaesthetics had not yet been discovered. There were number of problems with surgery during the mid 19th century which caused the death of thousands of people. The first major problem with surgery in the 19th century was that hygiene wasn’t discovered. All surgeons had ordinary clothing during an operation exposing them to the germs which they could pass on to other people. Not only this surgeons had spectators watching the surgery being carried out which further increased the chances of more and more people becoming infected.
Furthermore surgeons used the same knives and saws they had used on previous patients without freeing them from bacteria by sterilizing them. This possibly contributed to a large number of deaths in the 19th century as surgeons were planting infections and bacteria into people’s body. Another issue with surgery in the mid 19th century was that surgeons didn’t find much importance in people staying alive and were more concerned with there own achievements in performing a successful operation. An example of this is from a man called Robert Liston. Robert Liston was a successful surgeon in the 19th century and he was a proud of his ability to amputate a leg in just a couple of minutes. In one case he tried to beat his own record of amputation of a leg and accidentally cut of a patient’s testicles.
He even cut of his assistants 2 fingers which ultimately lead to her death from infection. This shows how some surgeons main priority during surgery wasn’t actually to perform a successful operation with the patient remaining alive. As Robert Liston saw more importance in his speed of the operation. This outlines the attitudes of some surgeons towards surgery which could account for the immense death rate figures in the 19th century. The final significant issue that surgeons faced during the 19th century that cause a substantial amount of deaths was the problem with blood loss. Most surgeries involved amputation which would lead to extreme levels of uncontrollable blood loss. With blood groups and blood transfusion not yet discovered this was a key issue that hindered surgeons success rate after an operation. Below i will discuss how these problems were solved and weather the amendments had any significant impact on the staggering number of deaths in the 19th century.
1846. On October 16, William T. G. Morton (1819-1868) made history by being first in the world to publicly and successfully demonstrate the use of ether anesthesia for surgery. Nitrous acid was also discovered which helped reduce pain during an operation making it easier for surgeons to operate as the patient was no longer in agony.
The gas Ether however was deemed the better anaesthetic to reduce pain during surgery as it lasted longer then nitrous acid. This discovery by William t.g. Morton was extremely significant in the transformation of surgery as it meant that surgeons could now be much more careful and spend more time on an operation as the patient was no longer screaming and moving in agony. However it could be argued that ether was not as successful as it seems.
This is because of many reasons such as ether had to be carried in large bottles which made it difficult for surgeons. Not only that ether often made patients vomit and cough even when they are under anaesthesia. The biggest problem surgeons faced with Ether was that it was highly flammable which was extremely dangerous in 1847 as the only form of light was a naked flame. All these factors begin to indicate how exaggerated Morton’s discovery was. As his discovery probably had little effect on the death rate simply because of other problems such as blood loss which ensured surgeons had to operate quickly even when patient were under anaesthesia.
Which ultimately increases the chances of death during surgery as quick operations can lead to mistakes as less care is taken. Therefore although the anaesthetic Ether did help reduce pain for patients during surgery it had little effect on the death rates during surgery in the 19th century. A man named James Simpson knew the setbacks that ether had and wanted to discorver a better anaesthetic then William Morton. To do this he invited some doctors over to his house and persuaded them to inhale a gas or chemical.
When Simpson’s wife found all doctors unconscious Simpson realised he gave birth to a life saving anaesthetic called Chloroform. The thing that phased Simpson the most was that he realised his discovery was lacking the setbacks of William Morton’s Ether. Simpson first used chloroform in 1847 in London and wider acceptance of chloroform came when Queen Victoria used chloroform to give birth to her 8th child in 1853.
Her approval of it was enough to silence Simpson’s critics allowing it to be used during surgery. Although chloroform didn’t have the negative effects of ether it still had a dark side which was unveiling as it was used in operations. The biggest issue with chloroform was the issue with dosage. Too little meant that the the patient would feel pain distrusting the operation.
Too much would be fatal and potentially Kill the patient. An example of this is Hannah Greener who died of a chloroform overdose whilst trying to remove one of her toenails. However, This was a huge issue until 1853. John Snow a British physician managed to discover a chloroform inhaler which controlled the dose of chloroform preventing an overdose and under dose.
This is key as it managed to solve the only big issue with chloroform as now chloroform could be used with the right dosage without the risk of inhaling too much or too little. Statistically the death rate before the introduction of chloroform stood at 33% for amputations. In the the years 1854-1855-1856 the death rate dropped to 28%. A 5% decrease in the death rate figures because of James Simpson’s discovery. Although the figures hadn’t dropped by a substantial amount it still shows how Simpson’s discovery indicated that the transformation of surgery was taken off slowly and that it was only a matter of time until surgery was to be transformed completely.
However things were made harder then they had to be as doctors and surgeons not only had to deal with issues with new inventions but society as a whole. Some people just didn’t want pain relief. ‘ The discovery of an effective anaesthetic was a major breakthrough in surgery since it meant the patient was not in pain, and it was welcomed by many.
However, some people were slow to accept the idea of anaesthetics, and there were drawbacks to the use of both ether and chloroform.’This quote shows the attitudes toward anaesthetics and change at the time making life much harder for surgeons and doctors. As People were too religious and felt that pain relief was interfering with gods will. Some people didn’t even understand the concept and effects of anaesthetics and therefore rejected the idea of them as a whole.
Therefore this could begin to show why there was only a 5% decrease in the death rate figures despite the introduction of a useful anaesthetic called chloroform. It’s possible that chloroform was not used enough during 1854-56, surely such an effective discovery after ether should of reduced the amount of deaths substantially more then 5%.Extreme levels of pain during an operation was not the only problem surgeons faced during the 19th century. Arguably the most significant factor that was causing the most amount of deaths was the issue with infection. After the introduction of chloroform it was evident that chloroform had saved many lives and that surgeons were starting to become more successful. They still didn’t however understand the issue with infection and germs as hygiene was not yet discovered. As a result many patients did make it out alive after surgery, however many died from gangrene or sepsis a few days later as the infection spread throughout the patients body. Working conditions were extremely unhygienic which also contributed to the death of many people including spectators.
‘In the 1940’s infectious diseases caused over a third of the deaths in Europe’. Indicating how much of a problem infection was in the 19th century. Ignaz Semmelweis was a Hungarian physician who was declared as the ‘saviour of mothers’.
He found that the amount of women that died during childbirth was significantly higher in the hospital where medical students were present then in home births were midwives would deliver the baby. The medical students that were present at the hospital wards often returned from cutting up dead bodies which exposed them to infection. This issue could Semmelweis thinking. What could possibly be the reason as to why more mothers were dying at the hospital with professionals then at home? Ignaz Semmelweis had finally discovered infection and it’s drastic effects on the human body. He believed the medical students carried something with them from the dissecting room which was causing the deaths of women during childbirth. To test his hypothesis Semmelweis ordered the students to wash their hands in a solution of chlorinated lime before entering the hospital ward. As a result of this the mortality rates dropped from 18.27 to 1.
27 percent, and in March and August of 1848 no woman died in childbirth in Semmelweis’s division. This is a massive turning point as the figures show Ignaz Semmelweis theory was true and that washing hands before a surgical procedure can and will help reduce the amount of deaths during surgery. Like every other surgeon Semmelweis also had his critics.
Despite the fact that his theory was successful in reducing the death rate, doctors made fun of his ideas as they still couldn’t get their heads around the issue with infection and germs as scientific knowledge at the time was limited. He was eventually sacked from his hospital. Despite his sacking he still gave birth to a major issue within surgery and his ideas were used by other surgeons later on. An example of this is Louis Pasteur. Arguably the most significant man in the transformation of surgery. He discovered His discovery has forever cemented his name into the history of medicine. 1856 Pasteur was visited by a man called Bigo.
Bigo would in factories that produced alcohol with sugar beet. Bigo noticed that many of his tubs of beer stores in his factory were turning sour and eventually the beer had would go off and would go to waste. This was when Bigo pleaded Pasteur to try and find a solution as to why his bear was going off as his business was suffering. This is when Pasteur used a microscope to closely inspect the tubs that the beer was stored in. After analysing through his microscope Pasteur found that there were many tiny micro organisms that were taking up majority of the tub which couldn’t been seen by the naked eye. Pasteur became adamant that these microorganisms were the reason as to why Bigo’s beer was going off. At first Pasteur only brought upon his ideas through the use of liquids. Eventually he realised that possibly these microorganisms could also be causing the death of thousands of people.
It took time for Pasteur’s ideas to be accepted by scientists and for surgeons to reach proper understanding of infection. He did however eventually manage to prove that disease and infection were caused by microbes in the air. Because of this his name will be forever cemented in the history of Medicine. Louise Pasteur did manage to discover the cause of the infection in open wounds. Now the issue was preventing it. This Is when a man called Joseph mister stepped up. He was extremely fascinated by Pasteur’s work on how germs and bacteria caused infection and thus came up with ideas of his own. In 1864 Lister realised that a certain catholic acid was used in the sewage works to help kill parasites.
Which was an effective method at the time. Because of this lister came up with a plan. He thought possibly carbolic acid could be used to kill the microbes that were causing infection on open wounds