Medicine in The Industrial Era - Surgery (1750 - 1900) : The Development of Anaesthetics

Medicine in the Industrial era - surgery (1750 – 1900)
At the beginning of this era surgery, even minor surgery was very dangerous. The big problems were, firstly, blood
loss, made worse by the fact that patients were awake and thrashing around in pain and secondly, due to a lack of
antiseptics, infection that killed the patient after the surgery.
The development of anaesthetics

Anaesthetics are chemicals that stop patients feeling pain. They fall into two categories: -
1. General anaesthetics – knock the patient unconscious
2. Local anaesthetics – an area of the patients body is made to feel numb stopping them feeling pain whilst
they remain awake during the surgery.
The development of general anaesthetics

Anaesthetics
The first general anaesthetic created was Nitrous Oxide, nicknamed laughing gas, which patients had to inhale. It
was first used by the Humphrey Davy in 1799. Nitrous Oxide was used regularly by American dentist Horace Wells
when he extracted teeth from 1844 onwards.
The second general anaesthetic discovered was Ether. It was first used by another American dentist, William
Morton, in 1846. It was used in an operation to remove a growth from a patient’s neck. In Britain Robert Liston used
Ether whilst amputating a leg.
The problem with both these early anaesthetics is that they sometimes made patients vomit. They irritated patients’
lungs making them cough, even whilst unconscious, making surgery difficult. They were flammable and were
therefore a dangerous fire risk. They tended to produce a very deep sleep lasting days. Finally they required large
storage tanks which were difficult for surgeons to carry around with them, at a time when surgery was still done in
patients’ homes.
The third general anaesthetic to be developed was Chloroform. It was discovered by James Simpson. He and his
colleagues were testing many chemicals that could be used as possible anaesthetics in his home. It was found that
Chloroform was effective when Simpson’s wife came home and found James and his colleagues all unconscious.
Chloroform proved very effective. Simpson used it during an operation in Edinburgh in 1847. After coming to
London, Simpson was able to popularise the chemical and it became very common in surgery. Queen Victoria used it
whilst giving birth to her eighth child in 1853.
However Chloroform was dangerous. If a patient was given too high a dose they could die, as was the case with
Hannah Greener, a 14 year old girl who died almost immediately after being given the chemical. This problem was
overcome in 1848, when John Snow developed a Chloroform inhaler that regulated the dose patients received.
The development of local anaesthetics
The first local anaesthetic to be developed in 1884 was the use of Cocaine to numb the area of the body where the
surgery was focused. However the problem with this drug was that it was highly addictive.
The second local anaesthetic to be developed was Novocaine, which was first used in 1905.
The development of antiseptics

Antiseptics are chemicals that kill germs on surgical tools and clean wounds after surgery. In doing so they limit the
chance of patients getting secondary infections, such as gangrene or sepsis, that can kill them.
The first person to develop a remedy to the problem of secondary infection was the Austrian doctor Ignaz
Semmelweiss in 1846. He noticed that many women died after giving birth to children in his hospital. He realised
that this was caused by medical students going straight from the morgue, dissecting dead bodies, to the maternity
ward to treat pregnant women without washing their hands first. He started to make the students wash their hands
with chlorinated solution. This lowered the death rate in the hospital but Semmelweiss was ridiculed, his ideas not
widely copied and eventually he lost his job. However, the British doctor James Simpson did take note and started to
do the same in London.
Antiseptics were developed by Joseph Lister. He was a surgeon at Glasgow’s Royal Infirmary where half of patients
died from secondary infections between 1861 and 1865. In 1864 Lister discovered that the city of Carlisle had used
Carbolic Acid to clean its sewers and this had killed all the germs in them. In 1865 an 11 year old boy came to the
hospital with a compound fracture in his leg, where the broken bone pokes through the skin, a wound that at this
time often killed the patient, with most surgeons opting to amputate the limb off, rather than re-setting the bone.
Lister reset the boys bone and used Carbolic Acid, soaking the bandages in the acid to treat the wound afterwards.
The boy survived!
Lister then invented a carbolic spray tank that he used to clean surgical tools and spray in the operating theatre
throughout the surgeries. After Lister became Professor of Surgery in King’s College Hospital in London this
technique was soon copied by others and became widespread in its use.
Joseph Lister went on to improve surgical thread for sewing up stitches in wounds. Before this stitches were made
using silk thread. The problem was that silk thread wouldn’t absorb Carbolic Acid so Lister started using cat gut for
stitches. This new material not only absorbed antiseptic Carbolic Acid but also dissolved after time meaning that hte
stitches would no longer need to be removed.
From Antiseptic to Aseptic conditions
The problem with Carbolic Acid was that:

 It irritated the skin, making wounds heal slower.
 It made a mess of operating theatre and nurses resented the extra work it caused.
 It caused surgical tools to rust over time.
 The equipment was expensive, heavy and cumbersome.
 Many doctors mistrusted Lister’s findings, they often tried using the method incorrectly and then reached
the conclusion that it didn’t work, other doctors had, by good luck, success without using it.
In 1878 the German doctor Robert Koch identified the germ that caused blood poisoning, proving that Lister was
right to sterilse surgical theatres and equipment
In the same year Koch developed a steam machine to clean surgical equipment. This overcame the problems caused
by using antiseptics like Carbolic Acid. From 1887 all instruments were steam sterilised. Surgeons abandoned
operating in their ordinary clothes and wore surgical gowns and face masks.
By 1890 most operations used these aseptic conditions. 1894 sterilised rubber gloves were used for the first time.

Medicine in The Industrial Era - Surgery (1750 - 1900) : The Development of Anaesthetics

Uploaded by

Copyright:

Available Formats

Medicine in The Industrial Era - Surgery (1750 - 1900) : The Development of Anaesthetics

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Medicine in The Industrial Era - Surgery (1750 - 1900) : The Development of Anaesthetics

Uploaded by

Copyright:

Available Formats

Medicine in the Industrial era - surgery (1750 – 1900)

The development of anaesthetics

The development of general anaesthetics

The development of local anaesthetics

The development of antiseptics

From Antiseptic to Aseptic conditions

The problem with Carbolic Acid was that:

You might also like