A full in depth notes summary of AQA GCSE Medicine in the 19th Century. These notes managed to get me a grade 8 on my AQA History GCSE in 2022. All notes have been made using class notes, teacher notes and AQA History guides. All notes that i have made are Dyslexia friendly, are colourful and easy ...
19th century medicine
The problem of pain
- In 1800, surgery was a terrifying prospect because surgeons could not control
or stop pain during an operation.
- Before 1800, there were some pain deadening substances that had been
known for centuries, such as hashish, mandrake and opium. But it was
difficult to judge an effective dose.
- Alcohol was used but it stimulated the heart and caused heavy bleeding in a
wound.
- The result was that surgeons had to operate quickly to reduce pain and would
not attempt complicated internal surgery.
New anaesthetics
Nitrous oxide- an account published by Humphery Davy in 1800, described its
effects- hysterical laughter and no pain. Not used until 1844 when the American
dentist Horace Wells used it to remove teeth.
Ether- in 1842, William Clark, another American dentist, used ether for tooth
extraction and in March that year, Dr Crawford Long removed a neck growth from a
patient using it. In 1846, William Morton gave a public demonstration of ether
anaesthesia. In December 1846, Robert Liston amputated a leg using it. But it was
difficult to inhale, caused vomiting and was highly flammable.
Chloroform- a safe and effective anaesthetic, discovered by Dr James Simpson in
1847.
The reasons for the opposition to anaesthetic
- Surgeons were used to operating quickly and on a conscious patient
- Some army surgeons during the Crimean War (1853-1856) thought that
soldiers should dutifully put up with the pain
- In the early days of using chloroform, some patients died because it was not
understood that patients of different sizes needed different amounts of
chloroform. Famously Hannah Greener died from an overdose in 1848 during
an operation to remove her toenail.
- There were religious objections as pain in childbirth was thought to be God’s
will.
Objections overcome
In 1853, Queen Victoria used anaesthetics for childbirth which made it acceptable
and fashionable. However anaesthetics didn’t revolutionise surgery because there
was still a high death rate from infections introduced by operations.
, 19th century ideas on infection
Surgery carried a high risk of infections. Surgeons believed that chemicals in the
wound caused the infection but they were puzzled why some deep wounds healed
quickly, and other surface scratches proved fatal. Surgeons tried to keep the patient
healthy and the wound clean. If it became infected, they used cauterising or acid to
burn away the affected tissues.
Challenging spontaneous generation
Contagionists Anti-contagionists
Believed infection was spread by contact and Believed infection was caused by the
could be controlled by quarantine. environment: epidemics such as cholera could
be controlled by cleaning.
In 1864, surgeon Thomas Wells first Doctors like James Simpson wanted hospitals
suggested infection was non chemical and relocated or rebuild as they thought infection
referred to Pasteur’s discoveries. was in their walls or atmosphere (miasma)
Louis Pasteur’s Germ Theory
Pasteur proved that spontaneous generation was wrong and that germs, not
chemicals, caused decay.
Germy Theory in Britain: Joseph Lister
In the late 1860’s, Pasteur’s germ theory came to the attention of British doctors, and
revolutionsed surgery because of the work of Joseph Lister (1827-1912).
Lister was a Professor of Surgery in Glasgow, and was shown Pasteur’s research by
Thomas Anderson, a Professor of Chemistry. Lister thought that Pasteur’s Germ
Theory might explain surgical infection. Anderson also recommended carbolic acid
as a chemical that killed bacteria.
Lister and the antiseptic approach
- Spray carbolic acid on the surgeon’s hands and operating area
- Soak the instruments and bandages in carbolic acid.
- In August 1865, he mended the fractured leg of a young boy, Jamie
Greenless.
- As the skin of Jamie's leg was broken it was likely to be infected and usually
would be amputated.
- Instead, Lister set the bones and used dressings that had been soaked in
carbolic acid.
- After 6 weeks, Jamie walked out of hospital.
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