Surgery- Anaesthetics and Antiseptics

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Before

Surgery in the early 19th century is dangerous and painful. There is no way to relieve the pain felt by patients during operations. Surgeons do not yet know how to control blood loss or infection, and operating theatres are dirty and dangerous places to be.Some surgeons superstitiously prefer to wear their ‘lucky’ coat in the operating theatre – a coat worn during a successful operation in the past. They do not wash their ‘lucky’ coat between operations in case this breaks their run of luck.The operating table is often blood-stained. The floor around it is sprinkled with sawdust to stop the surgeon from slipping on blood and other waste as he speeds around the table, carrying out his operation at breakneck speed!Surgery is usually a last resort, and the most common operations are amputations, which can be completed quickly. Robert Liston amputated a leg in two and a half minutes. Unfortunately, such was his haste that he cut off the patient’s testicles as well. Patients are lucky to survive operations without any harmful side effects.

After

Modern operating theatres are clean and safe. State-of-the-art equipment helps surgeons to perform delicate and intricate operations using techniques like keyhole surgery. Some surgeons are experimenting with robotic parts to help them carry out operations. Hightechnology scanners enable surgeons to probe deep inside parts of the body.Surgeons today can carry out operations that could only have been dreamt of 40 to 50 years ago. Although the first human heart transplant only took place in 1967, heart transplants are carried out quite frequently now. Transplants of other body organs are common. Many people agree to donate their organs when they die so that they can be used for transplants, helping other people to recover from illness and to stay alive. Some medical scientists hope that it will become possible to clone human organs for transplants.

The problem of pain

Surgeons had long had to face the problems of pain, infection and bleeding. This was still true in the early 19th century. There were no effective anaesthetics. To help numb the pain during an operation, surgeons gave their patients drugs like opium and mandrake, or tried to get them drunk. A few surgeons used ‘mesmerism’ (hypnosis), hoping this would lead the patient to ignore the pain. Surgery had to be quick. Deep internal operations were out of the question. Most surgery was limited to removing growths or amputating limbs. Even so, many patients died from the trauma of the excruciating pain.During the late 18th century the science of chemistry had made some progress. In 1772 Joseph Priestley (1733–1804), an English chemist, discovered that oxygen was a gas. Other chemists were also investigating the properties of different substances. In 1799 Humphrey Davy (1778–1829) discovered that pain could be relieved by inhaling nitrous oxide (‘laughing gas’). He wrote a pamphlet saying that nitrous oxide might be successfully used by surgeons as an anaesthetic. The medical profession ignored his suggestion.

Early successes

During the early 1840s a number of experiments were made to find an effective anaesthetic. In 1842 an American doctor, Crawford Long, found that ether was a useful anaesthetic, but he did not publicly announce his discovery.On 10 December 1845 an American dentist, Horace Wells (1815–48), watched people inhaling nitrous oxide as an amusement at a fair. He noticed that, under the infl uence of the gas, they could injure themselves and feel no pain. The next day, Wells had a tooth painlessly taken out after inhaling the gas. He tried to demonstrate painless tooth extraction to some medical students at a hospital in Boston, USA. What he did not know was that some people are not affected by nitrous oxide. Wells’ volunteer yelled as the tooth was taken out and the students left the demonstration shouting ‘Humbug! Humbug!’On 16 October 1846 William Thomas Green Morton (1819–68) persuaded John...
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