3.2.1

Anaesthetics & Antiseptics

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Anaesthetics in the 19th Century

Before the 19th century, people often avoided surgery because it was so painful. Anaesthetics could be used but they were dangerous. This meant that most surgery was quick to try to minimise pain. Complex surgery would be too painful.

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Problems with surgery in the 1800s

  • Pain – Patients often died from clinical shock because of the pain of surgery.
  • Infection – Before Germ Theory, people did not know that microbes could cause infections. Surgeons wore the same outfit and used the same equipment for multiple patients.
  • Bleeding – Patients often died during surgery because they lost too much blood.
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Old anaesthetics

  • In 1800, physicians and surgeons gave patients alcohol (made them drunk) or gave them opium to numb the pain.
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New anaesthetics

  • Humphrey Davy was the first to use nitrous oxide (laughing gas) to stop patients from feeling pain. Horace Wells then used it in 1844 to numb the pain in dental surgery.
  • Dr James Simpson first used Chloroform in surgery in 1847. It was effective but it led to death in high doses. It killed Hannah Greener in 1848. Queen Victoria used Chloroform in childbirth in 1853.
  • Ether was first used by the American dentist William Clark in 1842 and then by Robert Liston for a leg amputation in 1846. Ether was effective but hard to inhale (it also led to vomiting) and was explosive.
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Opposition to anaesthetics

  • Anaesthetics initially increased the number of deaths in surgery. People did more complex operations and hygiene was still bad in surgeries. Doing more complex surgery for longer in an unhygienic place increased the risk of infection and fatal blood loss.
  • Some army surgeons thought that soldiers should endure the pain.
  • Some religious people thought that the pain suffered during surgery was God’s will.
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The impact of individuals

  • After Queen Victoria used anaesthetics in childbirth, anaesthetics became more popular.
  • Public demonstrations of the drugs also helped to make anaesthetics more widely accepted.

Antiseptics in the 19th Century

Anaesthetics reduced the pain in surgery but infection still killed lots of people in surgery. Antiseptics were used to kill the microbes close to wounds in surgery.

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Joseph Lister

  • A British surgeon called Joseph Lister applied Pasteur’s Germ Theory to surgery. He thought that germs explained why wounds from surgery got infected.
  • Lister used carbolic acid as a chemical which could kill bacteria. This stopped germs from infecting wounds in surgery.
  • The death rate in Lister’s patients fell from 46% to 15%.
  • Covering surgical instruments, bandages and the surgeon’s hands in carbolic acid reduced the chance of infection.
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Lister’s test

  • Lister heard about Germ Theory in 1865.
  • He tested his ideas on a boy called Jamie Greenlees who had a broken leg.
    • Instead of an amputation, Lister healed Greenlees’ fracture and the wound was not infected.
  • Lister published the results of Greenlees and ten other patients’ surgery in 1867, proving Pasteur’s Germ Theory.
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Criticism of Lister

  • Lister was heavily criticised. Most doctors still believed that chemicals caused infections rather than germs.
  • Pasteur’s ideas were not yet accepted and people still believed in spontaneous generation.
  • Carbolic acid was unpleasant for doctors to use because it irritated their lungs and skin.
  • Many surgeons tried to copy Lister’s methods but did not do it properly. This made them think that the theory was wrong.
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Effect of Lister’s ideas

  • 10x more surgeries were performed in the UK in 1912 relative to 1867 because the chance of survival increased so much.

Aseptic Surgery

Antiseptics tried to kill microbes on patients’ wounds. Aseptic surgery tried to stop microbes and germs reaching the wounds in the first place.

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Kill microbes

  • Aseptic surgery methods tried to completely eliminate bacteria before and during an operation, rather than trying to kill microbes on a specific wound.
    • By 1880, Pasteur’s Germ Theory was widely accepted by British doctors.
    • By 1900, aseptic surgery had become very common.
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Aseptic methods

  • In aseptic surgery, surgeons were scrubbed clean, wore new clothes and thin rubber gloves.
  • Surgeons used sterilised instruments and operating theatres got smaller to reduce the chance of infection.
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Practice in wars

  • These developments were largely advanced by wars, such as the Crimean War.
  • War provided test cases for surgeons to try out these new techniques.

Jump to other topics

1Medicine Stands Still

2The Beginnings of Change

3A Revolution in Medicine

4Modern Medicine

5Themes in Public Health

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