The Transformation of Surgery

c.1845 c.1918

UNIT AIM:

•To know and understand how surgery was transformed during the late 19th and early 20th centuries•To test your understanding of source enquiry skills.

The Transformation of Surgery

The unit examines:

The reasons why surgery was limited before 1845.

The three key problems that had to be overcome before surgery could advance -

PAI N, I NFECTI ON AND BLEEDI NG.

How these problems were solved.

The key individuals responsible f or solving these problems.

The opposition to new advances in surgery.

The f actors responsible f or the advances in surgery.

The Transformation of Surgery

The skills tested are:

I nference (what can you learn/ work about the topic f rom the source?)

Portrayal (how is the topic/ subject/ person being portrayed in this source eg. in a

positive or negative way)

Source analysis (do you understand the source? Can you use the source as evidence to

support an argument? Can you ask questions about the source?)

Source evaluation for reliability (can you make a judgement about the reliability of a

source based on questions about its origin, context, purpose etc? Do these things

aff ect its accuracy and reliability?)

Source evaluation for utility (usefulness) – ( Can you make a judgement about how

useful a source is in helping your enquiry through question the origin, purpose, context

of source? Remember because a source is biased does NOT make is useless. All

sources are useful TO AN EXTENT.

Cross referencing of sources (can you compare sources looking f or points of

diff erence and/ or similarity to come to a judgement supported by the sources)

Using sources and own knowledge to make a judgement ( can you combine your

analysis and understanding of sources with your own knowledge to answer the question)

http://www.youtube.com/watch?v=AtkYJBTdDWk&feature=related

Blood and Guts: A History of Surgery

• Listen to the extract.

• Write down three words to describe surgery in the first half of the 19th century

Recommended reading:Available in the resource centre

What can you learn from this source about the state of surgery before the 1840’s?

A cartoon produced c. 1750

• This drama is set in 1842.

• Watch the clip carefully – what us it tell us about the state of surgery at this time.

Surgery and anaesthetics in the19th century

• Read the information on page 108.

Why was surgery so limited until the 19th

century?

Why was surgery limited before the nineteenth century?

The problems of performing major surgery.

PAIN

INFECTION

BLEEDING

http://www.youtube.com/user/worcesterjonny#p/a/04349AC9C197EC93/2/4ghMB4yH6nw

Activities

• Answer the questions on page 109.

The Discovery of anaesthetics

• Lesson aims:• To know how anaesthetics were

developed and what role pain relief played in the development of surgery.

• To know and understand the role of key individuals in the development of anaesthetics.

What people believed at the time:Pain, a Burden to be BorneIn the 1800s, most people expected to experience pain in their lives and relied on religion or personal fortitude to help them endure it. Pain was one of God's punishments for the wicked and purifying trials for the good; for the woman in labour, pain was the spiritual experience that would transform her into a self-sacrificing mother. Many doctors shared these views! Other physicians were concerned about the ethics of operating on a comatose patient and many were concerned about the potential risk of death from an overdose of anaesthetic.

The History of Anaesthesia

Watch the DVD and I will pause at various points for you to make notes.

Keep in mind:

• who are the key individuals?

• what problems did they face?

• how did their discoveries revolutionise medicine?

Nitrous OxideHumphrey Davy (1778-1829) suggested that the pain and shock of surgical operations might be relieved if patients inhaled nitrous oxide, a gaseous compound discovered by Joseph Priestley (who was also the first to isolate oxygen).

Wells and Nitrous Oxide

• Horace Wells was a dentist in the USA.

• He used nitrous oxide when extracting teeth.

Horace Wells

The unusual history of etherWilliam Morton a dentist and associate of Wells discovered ether was a longer lasting anaesthetic

William Morton

But what problems

were associated with ether?

Chloroform and James Young Simpson

• Why was he so determined to solve the problem of pain?

• How successful was chloroform?

• Why did some people oppose pain relief?

Chloroform

Benefits +• Much less needed to

knock out patient• Acts quickly and

completely• No problems with

coughing (ether)• Could perform more

complex operations• Surgeons be tidier – no

need for speed

Drawbacks –• Unsure of quantity to

give each patient• Drs feared it may

slow the healing process

• Reports of deaths from cardiac arrests.

Why were people opposed to anaesthetics?

• Reports of sudden deaths from chloroform• Religious beliefs – God’s plan• Long term effects of anaesthetics not

known.• Drs feared easier for a patient to die if

unconscious• Patients fear of Drs power over them• Drs may take unnecessary risks• Drs feared it may slow the healing process

The inhaler designed by John Snowand used on

Queen Victoria in child birth.

Why did this make the use of chloroform safer?

Why did the use of chloroform become widely

accepted after the Queenhad used it?

James Simpson’s statue in Edinburgh

Thousand attended his funeral.He is remembered as the father

of modernAnaesthesia.

Does he deserve that title?

Did the development of anaesthetics mean thatmore complex surgery could be carried out?

Factors in the development of anaesthetics

• Write an explanation of the role of each factor in the search for better anaesthetics.

SCIENCE AND TECHNOLOGYSCIENCE AND TECHNOLOGY

RELIGIONRELIGION

SOCIAL ATTITUDESSOCIAL ATTITUDES

PAINTHINK QUESTIONS

•What is an anaesthetic?

•What were the problems facing surgeons before their discovery?

•Why did surgery develop after anaesthetics?

•What problems still remain for surgeon and patients?

homework

Read pages 112 and complete activities 1-3

Write the answers as though they are GCSE questions each worth 6 marks.

Look at the mark scheme on page 113.

They are inference questions – read the summary on page 113.