Benefits of Developments in Surgery in the 19th Century

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nIntroduction

nIn the 1800s, the medical services offered were very unsafe. Most of the physicians who provided care lacked the necessary training, and they relied on apprenticeship. With years, the field of healthcare has been improving. More safety measures have been put in place to guarantee the safety of the patients as they receive healthcare services. More sophisticated methods have also been developed to deal with the complex health conditions (Urman and Desai 2012, p. 1). The improvements in the healthcare sector have led to decreased mortality rates. This paper is going to focus on the developments in surgery in the 19th century. The research paper will analyse the various discoveries and improvements that were made in surgery in the 19th century. This article will provide a critical analysis of the various benefits that were accrued from the improvements in surgery. The aim of this paper is to show that the cost and suffering of relatively a few people were outweighed by the benefits to many as a result of the developments in surgery in the 19th century.

nSurgery in the Early 19th Century

nIn the early 19th century, surgery operations were very unsafe. Most of the physicians who carried out the operations did not have the relevant training, and most of them learnt the skill through apprenticeship. The surgery operations were carried out without the use of anaesthetics (Poletajew, Antoniewicz, and Borówka 2010, p. 215). The patients had to persevere the pain all through the operation. It was ironic that the hospitals were the places where people experienced pain during this era. The physicians sometimes made the patients take alcohol before the amputations so as to be less sensitive to the pain (Santoro and Savica 2011, p.134). Many patients lives were lost during these operations from extreme pain. Another phenomenon that was quite common during this era was high blood loss by the patients. Tourniquets were used to reduce the blood flow from vessels around the area of operation during the amputation, but they were not very effective in controlling the loss of blood (Urman and Desai 2012, p.10). This was one factor that contributed to the many deaths during this period.

nOne of the qualifications required for physicians during this era was high speed in carrying out the operations. This was due to lack of anaesthetics which called for high speed so as to lessen the pain felt by the patient. The physicians could only carry out the operations on the outer parts of the body such as the skin (Poletajew, Antoniewicz, and Borówka 2010, p. 215). The patients who required surgery of inner parts of the body would only die from their illness as there was no remedy for the conditions. Apart from the lack of anaesthetics, the operations were also carried out without the use of antiseptics. The instruments used during the surgeries were not sterilised which led to the spread of infections among the patients (Poletajew, Antoniewicz, and Borówka 2010, p. 215). The physicians were also quite unhygienic, and they did not wear protective gear when operating on the patients. The cleanliness of the hospitals environments was also neglected which played a major role in the spread of infections. Sawdust was used to soak the blood on the floor which was very unhygienic as the dust could settle on the patients open wounds (Santoro and Savica 2011, p.139). From this analysis, it is clear that operations were very painful and risky during this era.

nDevelopments in Surgery in the 19th Century

nGiven the poor conditions of the surgery treatments in the early 19th century, a need arose to improve these conditions so as to reduce the mortality rates. Several advancements and discoveries were made so as to achieve this. The main discoveries that were made in the late 19th century were the discovery of anaesthetics and antiseptics. The first anaesthetic that was discovered was nitrous oxide gas which is also known as the laughing gas and ether (Robinson and Toledo 2012, p. 141). Ether was more effective than the laughing gas as it had a more long-lasting effect than ether. Ether had several drawbacks which influenced James Simpson, who was a young surgeon to discover chloroform which was a better anaesthetic than ether (Lopez-Valverde et al. 2010, p. 32). Chloroform lacked most of the drawbacks associated with ether and it was even more long-lasting than ether.

nIgnaz Semmelweiss was concerned about the increased death rates especially among women during childbirth due to lack of proper hygiene by the medical students. To reverse this situation, Semmelweis introduced the use of chlorine as an antiseptic for washing hands by the physicians before carrying out an operation on patients (Alexi-Meskishvili and Böttcher 2011, p. 1927). This habit was further spread to more hospitals by James Simpson, who was also concerned about the continued loss of lives as a result of poor hygiene. In 1861 Louis Pasteur discovered that infections were as a result of the microbes occurring in the air. Joseph Lister later applied Pasteurs ideas and introduced the use of carbolic acid as an antiseptic for cleaning wounds and surgery equipment (Alexi-Meskishvili and Böttcher 2011, p. 1928). Lister later discovered the use of catgut to replace silk in stitching wounds. Catgut could dissolve in the body after a few days which made it more effective in preventing the infection of wounds by microbes occurring freely in the air (Urman and Desai 2012, p.19).

nDespite Listers progress in the introduction of antiseptics, he received major opposition from most physicians who did not believe in the existence of microbes. This situation was however reversed in 1878 when Robert Koch convinced the physicians by identifying the bacterium that was responsible for blood poisoning (Alexi-Meskishvili and Böttcher 2011, p. 1929). With this discovery, Robert Koch also invented the steam steriliser which was very effective in sterilising the surgery equipment. With the knowledge of the existence of microbes, the physicians became keener on their hygiene. The physicians started wearing protective gear during operations to enhance hygiene. White shirts and aprons were introduced as the new mode of dressing for nurses and surgeons (Santoro and Savica 2011, p.147). Nurses could also wear hats in the surgery rooms. All equipment was kept clean in trays, and the dirty equipment was separated from the clean ones.

nBenefits of the Discoveries made in Surgery in the 19th Century

nThe advances made in the field of surgery in the 19th century had many benefits which are still evident to date. With the introduction of anaesthetics, the doctors could carry out the operations more carefully without haste (Veit 2013, p. 5). This reduced the instances of death resulting from hasty operations. With the introduction of anaesthetics, the number of deaths resulting from pain trauma was also reduced (Robinson and Toledo 2012, p. 143). The methods used prior to the introduction of anaesthetics were highly painful which led to the death of many patients from pain. Anaesthetics paved the way for the introduction of more complex operations (Urman and Desai 2012, p. 1). Physicians could now carry out operations on the internal organs of the body which led to the saving of many lives. It can, therefore, be seen that anaesthetics played a major role in enhancing the field of healthcare in surgery.

nThe introduction of antiseptics can also be attributed as one of the major contributions to the field of surgery during this era. It played a major role in reducing the number of deaths that were caused by poor hygienic conditions in hospitals (Veit 2013, p. 5). The improved hygienic conditions increased the patients trust on the physicians. A major decrease in the mortality rate was identified with the invention of the antiseptics. The knowledge of the existence a bacterium that caused blood poisoning played a major role in enhancing the hygiene of the physicians and the patients (Worboys 2011, p. 111). By solving the problem of lack of antiseptics and anaesthetics paved the way for more discoveries that were aimed at improving healthcare. The physicians could now focus on better ways of reducing the loss of blood, during operations which was another factor that caused the loss of many lives during operations (Veit 2013, p. 10).

nCost Associated with the Developments in Surgery in the 19th Century

nThere were many costs that were associated with the developments in surgery in this era. During these advancements, the physicians made trial and error attempts to identify the best solutions to the underlying issues. This involved experimentation on patients which led to the suffering of a few patients. For instance, with the introduction of ether as an anaesthetic, various patients suffered from the side effects of this gas. The anaesthetic caused vomiting, it caused the irritation of the lungs, and it made patients fall into a deep sleep which lasted for days (Lopez-Valverde et al. 2010, p. 32). Chloroform which was introduced to counter the shortcomings of ether also had several shortcomings that affected various patients. Lack of proper dosage caused the patients a lot of pain and in some instances, it led to death. The Carbolic Acid, which was introduced to be used as an antiseptic, was damaging to the skin which made it quite unpopular among the physicians (Lopez-Valverde et al. 2010, p. 33). The new discoveries in surgery led to the purchase of expensive equipment and redesigning of facilities. This, in turn, led to increased cost of healthcare which reduced the affordability of these services to most people.

nConclusion

nFrom this analysis, it is evident that the developments made in the 19th century led to a major transformation in the field of surgery. The major changes discussed in this paper are the invention of anaesthetics and antiseptics in the 19th century. The paper has analysed the nature of surgery that was carried out prior to these inventions. The operations were barbaric and highly risky. These changes highly revolutionised the field of medicine (Veit 2013, p. 9). The paper has provided the endless benefits that resulted from the developments made in surgery in the 19th century. From the paper, it is evident that there were several shortcomings that resulted from these advancements. Various patients suffered from the application of the inventions in their treatment. Despite these shortcomings, it is evident that the benefits of the developments in surgery in the 19th century outweighed the cost of suffering of relatively a few people (Urman and Desai 2012). Physicians should carry out more research works to continue with the advancements in healthcare. This will aid in reducing the mortality rates.

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nReferences

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nLopez-Valverde, A., Montero, J., Albaladejo, A. and Gomez de Diego, R. 2010. The Discovery of Surgical Anesthesia: Discrepancies Regarding Its Authorship. Journal of Dental Research, vol. (90), no. (1), pp. (31-34).

nPoletajew, S., Antoniewicz, A.A. and Borówka, A., 2010. Kidney removal: the past, presence, and perspectives: a historical review. Urology journal, vol. (7), no. (4), p. (215).

nRobinson, D. and Toledo, A. 2012. Historical Development of Modern Anesthesia. Journal of Investigative Surgery, vol. (25), no. (3), pp. (141-149).

nSantoro, D. and Savica, V. 2011. Development of the concept of pain in history. JN, 24(Suppl. 17), pp. (133-136).

nUrman, R. and Desai, S. 2012. History of anesthesia for ambulatory surgery. Current Opinion in Anaesthesiology, p. (1).

nVeit, R., 2013. “A Ray of Sunshine in the Sickroom”: Archaeological Insights into Late 19th-and Early 20th-Century Medicine and Anesthesia. Northeast Historical Archaeology, vol. (25), no. (1), p. (5).

nWorboys, M. 2011. Practice and the Science of Medicine in the Nineteenth Century. ISIS, vol. (102), no. (1), pp. (109-115).