starter activity

Imagine you are the man on this operating table around 1800. List all the reasons why you might not survive this operation.

Possible dangersPossible dangers

Surgeons operated swiftly in an Surgeons operated swiftly in an attempt to avoid pain, mistakes were attempt to avoid pain, mistakes were mademade

No pain reliefNo pain relief No blood transfusionsNo blood transfusions Patients often died of infections – no Patients often died of infections – no

sterilised equipment of uniforms, sterilised equipment of uniforms, doctors didn’t wash hands or patientsdoctors didn’t wash hands or patients

Bandages reusedBandages reused Trauma of the operationTrauma of the operation

Why was surgery so Why was surgery so dangerous in the dangerous in the

nineteenth nineteenth century?century?

To examine why surgery was so To examine why surgery was so dangerousdangerous

To identify developments in To identify developments in anaesthetics and their drawbacksanaesthetics and their drawbacks

LOs

Key words: anaesthetic

Your taskYour task

Read about the 3 major steps Read about the 3 major steps forward in pain relief in the 1800s forward in pain relief in the 1800s on p.170-1. Complete the template on p.170-1. Complete the template provided below.provided below.

Identify which factors helped the Identify which factors helped the development of anaesthetics development of anaesthetics

Extension taskExtension task Read through sources 2 -4 on p.167. Read through sources 2 -4 on p.167.

Note down the dangers they faced.Note down the dangers they faced. Extension. If ParExtension. If Paré could travel to the é could travel to the

1900s what would he have noticed 1900s what would he have noticed was similar/different?was similar/different?

Professor James Syme, Edinburgh Royal Infirmary

Fanny Burney, novelist

Humphry DavyHumphry Davy

Laughing gas Laughing gas (nitrous oxide) (nitrous oxide) reduced effects of reduced effects of painpain

Suggested use for Suggested use for operations and operations and dentistrydentistry

Drawbacks: - patient Drawbacks: - patient not unconscious, not not unconscious, not always successfulalways successful

J.R.ListonJ.R.Liston

EtherEther Pioneered in US by Pioneered in US by

dentist, William dentist, William Moston but 1Moston but 1stst used used in UK by J.R.Listonin UK by J.R.Liston

Drawbacks: irritant Drawbacks: irritant of eyes and lungs; of eyes and lungs; caused sickness; caused sickness; inflammableinflammable

James SimpsonJames Simpson ChloroformChloroform Professor of Professor of

Midwifery, Edinburgh Midwifery, Edinburgh UniversityUniversity

Used for childbirth & Used for childbirth & surgical operationssurgical operations

Drawbacks: difficult Drawbacks: difficult to measure right to measure right quantitiesquantities

Your taskYour task

Can you remember the reasons why Can you remember the reasons why people opposed Jenner & Harvey’s people opposed Jenner & Harvey’s ideas on disease and anatomy?ideas on disease and anatomy?

Why might people oppose the use of Why might people oppose the use of chloroform? Read reasons 1-6 on chloroform? Read reasons 1-6 on p.172 and summarise them under p.172 and summarise them under these headings:these headings:

ScientificScientific ReligiousReligious Conservative attitudesConservative attitudes

Scientific & medicalScientific & medical

People didn’t know about the side-People didn’t know about the side-effectseffects

Uncertainty about dosage, e.g. Uncertainty about dosage, e.g. Simpson & friends (1857)Simpson & friends (1857)

Increased death rate due to Increased death rate due to surgeons taking more riskssurgeons taking more risks

ReligionReligion

Letter to Lancet (medical journal) in Letter to Lancet (medical journal) in 1849 suggested pain was invented 1849 suggested pain was invented by Godby God

Pain in childbirth was a result of Pain in childbirth was a result of Eve’s sinfulnessEve’s sinfulness

Conservative attitudesConservative attitudes

Some opposed the use of pain killers Some opposed the use of pain killers in child birth because it was in child birth because it was ‘unnatural’‘unnatural’

Army Chief of Medical Staff (1854) Army Chief of Medical Staff (1854) thought that pain told a surgeon his thought that pain told a surgeon his patient was still alivepatient was still alive

Your taskYour task

Read p.173 and note the reasons Read p.173 and note the reasons why opposition to chloroform was why opposition to chloroform was overcome.overcome.

Why are the 1870s known as the Why are the 1870s known as the ‘black period’?‘black period’?

Extension. What factors helped the Extension. What factors helped the development of anaesthetics?development of anaesthetics?

Overcoming oppositionOvercoming opposition IndividualsIndividuals – James – James

Simpson championed Simpson championed use of anaesthetics in use of anaesthetics in midwifery; comparisons midwifery; comparisons with Parwith Paré’sé’s

Royal approval Royal approval – Queen – Queen VictoriaVictoria

Black period Black period – 1870s, 1 – 1870s, 1 in 2500 died under in 2500 died under anaesthetic, surgeons anaesthetic, surgeons mixed chemicals or mixed chemicals or unaware of dosagesunaware of dosages

Queen Victoria with her family

HomeworkHomework

Extension. Conduct some additional Extension. Conduct some additional research into C19th surgery and research into C19th surgery and produce a fact sheet on the Robert produce a fact sheet on the Robert Liston. Visit the Old Operating Liston. Visit the Old Operating Theatre website and gather Theatre website and gather information on typical surgery of the information on typical surgery of the time.time.

http://www.thegarret.org.uk/oot.htm

PlenaryPlenary

What were the dangers of surgery What were the dangers of surgery early in the nineteenth century?early in the nineteenth century?

What contribution to surgery did the What contribution to surgery did the following make: Davy, Liston and following make: Davy, Liston and SimpsonSimpson

Extension. What factors led to Extension. What factors led to important breakthroughs?important breakthroughs?