1.  starter activity
Imagine you are the man on this operating table around List all the reasons why you might not survive this operation.

2. Possible dangers
Surgeons operated swiftly in an attempt to avoid pain, mistakes were made
No pain relief
No blood transfusions
Patients often died of infections – no sterilised equipment of uniforms, doctors didn’t wash hands or patients
Bandages reused
Trauma of the operation

3. Why was surgery so dangerous in the nineteenth century?
 Key words: anaesthetic
Why was surgery so dangerous in the nineteenth century?
 LOs
To examine why surgery was so dangerous
To identify developments in anaesthetics and their drawbacks

4.  Your task
Read about the 3 major steps forward in pain relief in the 1800s on p Complete the template provided below.
Identify which factors helped the development of anaesthetics

5. Extension task
Read through sources 2 -4 on p.167. Note down the dangers they faced.
Extension. If Paré could travel to the 1900s what would he have noticed was similar/different?
Professor James Syme, Edinburgh Royal Infirmary
Fanny Burney, novelist

6. Humphry Davy Laughing gas (nitrous oxide) reduced effects of pain
Suggested use for operations and dentistry
Drawbacks: - patient not unconscious, not always successful

7. J.R.Liston
Ether
Pioneered in US by dentist, William Moston but 1st used in UK by J.R.Liston
Drawbacks: irritant of eyes and lungs; caused sickness; inflammable

8. James Simpson Chloroform Professor of Midwifery, Edinburgh University
Used for childbirth & surgical operations
Drawbacks: difficult to measure right quantities

9.  Your task
Can you remember the reasons why people opposed Jenner & Harvey’s ideas on disease and anatomy?
Why might people oppose the use of chloroform? Read reasons 1-6 on p.172 and summarise them under these headings:
Scientific
Religious
Conservative attitudes

10. Scientific & medical People didn’t know about the side-effects
Uncertainty about dosage, e.g. Simpson & friends (1857)
Increased death rate due to surgeons taking more risks

11. Religion
Letter to Lancet (medical journal) in 1849 suggested pain was invented by God
Pain in childbirth was a result of Eve’s sinfulness

12. Conservative attitudes
Some opposed the use of pain killers in child birth because it was ‘unnatural’
Army Chief of Medical Staff (1854) thought that pain told a surgeon his patient was still alive

13.  Your task
Read p.173 and note the reasons why opposition to chloroform was overcome.
Why are the 1870s known as the ‘black period’?
 Extension. What factors helped the development of anaesthetics?

14. Overcoming opposition
Individuals – James Simpson championed use of anaesthetics in midwifery; comparisons with Paré’s
Royal approval – Queen Victoria
Black period – 1870s, 1 in 2500 died under anaesthetic, surgeons mixed chemicals or unaware of dosages
Queen Victoria with her family

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

16.  Plenary
What were the dangers of surgery early in the nineteenth century?
What contribution to surgery did the following make: Davy, Liston and Simpson
Extension. What factors led to important breakthroughs?