2. The three major problems facing surgeons were...

6. These problems made everyday medical care difficult as so many patients were petrified and died from pain, spread of infection and severe blood loss.
So even if the surgeons carried out successful operations, their patients were most likely to die from losing too much blood or infection after.

8. In the 1700s most people still relied on barber surgeons who were the local dentist, surgeon and hairdresser.
They weren’t bloodthirsty butchers, they did care for their screaming patients and did their best to reduce the unbearable pain and fear.

9. As surgery was performed without anaesthetics
patients were usually in agonising pain.
To overcome this surgeons used alcohol, held down patients or just knocked them out.

10. However in 1846 – an American dentist called William Morton dabbled on a new breakthrough.
He put his patients to sleep for a short period of time using a gas called – ETHER.
Patients felt no pain and woke up in the next 20 minutes.

11. The idea soon caught on and a doctor called J R Liston amputated a man’s infected leg. After the hour operation – the patient woke up pain free and asked when the surgery was going to begin.
Ether was great for numbing pain for surgery, however it often irritated the patients’ eyes and made them constantly cough and vomit through operations.

12. In 1847 a Scottish doctor – James Simpson who used a new untested gas – CHLOROFORM to replace the irritating ether.
Simpson discovered chloroform by experimenting different chemicals with his friends. Chloroform was much more pleasant than ether.

13. However there was opposition (as there always is) and people argued that it was unnatural to ease a woman’s pain during childbirth. Religious reasons say that:
‘pain may be considered as a blessing’

14. What was even worse was that a patient named Hannah Greener died after being given chloroform during an operation to remove her toenail!!
REALLY!?
It wasn’t long before arguments and questions arose...
However...

15. In 1857, Queen Victoria used chloroform during the delivery of her eighth child. Due to the Queen’s approval, the society soon came to acceptance.
It wasn’t long before anaesthetics became common surgical practice.

16. By 1850, surgeons performed longer and much more better operations
By 1850, surgeons performed longer and much more better operations. As their patients were asleep they could take their time and carry it out with precision.
However patients started to die of blood poisoning and infections. No wonder – operations took place on old wooden tables, in dirty rooms and using the same instruments that were used on patients before.
Oh yeah, surgeons didn’t wash their hands either.

17. Right we have a little bit of a problem.
Although surgery was now pain free and therefore allows it to be more complex - there was still the problem of spreading infection even after a successful operation.

18. In the 21st century we take for granted that our hospitals and operating theatres are VERY VERY VERY
clean.

19. However the 19th century was a whole other story...
Hospitals were dirty places with crowds of patients herded together all carrying some sort of contagious illness.
The operating theatres were even worse – the only thing that was cleaned was the sandbox from under the table, that was used to catch the patients’ blood during surgery. Nice.

20. Oh and surgeons liked to dress to impress their patients and the...
...was the way to go. Surgeons put on blood stained coats to show how many operations they have done. So clean coats were basically not seen as experienced surgeons.

21. Surgeons as well as surgeons did not understand the importance of cleanliness – as they did not know that germs caused disease.
The gap of knowledge allowed nasty infections to spread during surgery.

22. In 1961, Louis Pasteur published his Germ Theory - which explained and proved that tiny creatures, germs, made milk, beer and wine go bad. These germs went on to cause disease in silkworms.
He then suggested that germs could also cause humans disease.

23. This was a...
As it finally put the end to the endless idea of miasma (bad air) and the theory of the four humours – which even after thousands of years still reigned over doctors.

24. Pasteur then went on to say that many of these
Could be killed by heat and he proved this in his laboratory – he even offered this advice to surgeons :
‘I would use none but perfectly clean instruments, but after cleansing my hands with the greatest care.’

25. In 1867, an English surgeon, Joseph Lister, used Pasteur’s theories in his work.
He thought that it might be germs that caused so many of his patients to die from the infamous gangrene and sepsis – an illness which causes the bloodstream to be overwhelmed by bacteria.
Lister had found out that carbolic acid was used on sewage systems and cesspools. He then applied this idea and used carbolic acid in the operating room – which he sprayed on instruments etc and...

26. It worked!!
He sprayed everything that was going to be contact with the wound and killed the germs. His patients did not get any infections.
However carbolic spray did irritate the surgeon’s hands and the patient’s flesh – and made everything smell...although the statistics speak for themselves...

27. The use of antiseptics cut the amount of amputated patients that died, from 46% - 15%!!
From this, surgeons all over the country were applying antiseptic sprays and other ways of cleaning.
Walls were scrubbed, floors were swept and equipment was sterilised. Surgeons started to wear rubber gloves, surgical gowns and facemasks during operations.

28. These changes made big impacts..
Figures in the Newcastle infirmary,1878, revealed that before antiseptics 6/10 patients died after surgery! However after antiseptics only 1/10 died!
Also soon after, surgeons attempted more and more complex and ambitious operations.
This included...

29. The first successful...
APPENDIX OPERATION
...took place in 1883.
And the first...
HEART OPERATION
...took place in 1896 to repair a stab wound.

30. At last!! More and more daring surgeries took place and were less prone to infection as there were antiseptics to sterilise the wound.
However people still died from losing too much blood during operations. Leaving one more obstacle left...

31. Patients losing too much blood was a big problem as it would mean to replace the blood with more blood. William Harvey found that blood circulated around the body.
Animal blood and occasionally human blood was used to replace the lost blood – however the body often rejected the blood and died due to the incompatible blood groups, although sometimes patients got lucky and survived.
In 1818 the first successful blood
transfusion human to human
took place.

32. In 1901, the blood groups were discovered by Karl Landsteiner allowed the transfusion of blood.
Due to the efficiency in blood transfusions, during the war – doctors and surgeons were able to replace the lost blood on the battle field more quickly as they knew what the groups were.

33. National Blood Transfusion services were set up in the UK and USA.
This allowed fresh blood supplies to be available for each blood group. However Certain religious groups such as Jehovah's witnesses who refuse to accept or give blood – even if it is a life death
situation.

34. From this point onwards surgery had only progressed to get better and better and it has.
Nowadays surgery is less worrying and more helpful.
Also hospitals offer more of a friendly atmosphere.

35. ...for watching...8D
Samiha & Priya...8D