Faculty: Health, Education, Medicine and Social Care
School: School of Allied Health
Category: Allied and public health
7 October 2014
John Redmond is Senior Lecturer in our Faculty of Medical Science, where he teaches Operating Department Practice and Paramedic Science. He was asked to give a lecture on the history of surgery as part of Universities UK week.
Recently I was asked to give a talk at Peterborough City Museum on the history of surgery. I gave two talks on 13 June, one in in the afternoon and another in the evening, to the paying public. Peterborough City Museum was originally the Cities Infirmary and has a Victorian Operating Theatre dating from 1910.
Some key points from my talk follow.
- Originally surgeons were not surgeons in the modern sense. Most were barbers, who combined small surgical operations with performing bloodletting and tooth extraction.
- In the medieval period, barber-surgeons travelled around the country. They would take up residence in a castle, treat the occupants and also care for any soldiers who were injured in the many small battles that were undertaken between rival factions.
- From the 1500s to the middle of the 1600s surgeons experimented with new methods. Cauterising wounds was still popular and helped prevent infection, but some surgeons rejected these established methods in favour of more innovative approaches. In the mid-1500s Ambroise Paré, a French war surgeon, popularised the use of ligatures to control bleeding after amputation; he also used bandages to cover wounds.
- In the early 1800s the most important talents a surgeon could possess were speed and accuracy. Surgeons were famed for their speed, particularly in amputation. As there was still no effective anaesthetic, they had to perform the procedures quickly and were limited to external tumours, amputation and trephining.
- The development of new anaesthetic gases changed the experience of surgery for the patient and surgeon. With the patient rendered unconscious, surgery could become more invasive which gave the surgeon the opportunity to be both slower and more methodical. The anaesthetic gas ether was first used in 1846 for dental extraction.
- In 1847, challenging the firmly held convictions of the medical profession at the time, James Young Simpson demonstrated that a woman could be safely relieved of pain during a difficult and traumatic labour by administrating ether as a general anaesthetic.
- He subsequently introduced chloroform on 8 November 1847, describing its use in a widely acclaimed pamphlet entitled ‘Account of a new anaesthetic agent’. Within weeks of this publication chloroform had almost completely replaced ether.
- Simpson was attacked for using chloroform to relieve pain in childbirth and it was not until Dr John Snow administered chloroform to Queen Victoria that the use of anaesthetic drugs in this way became respectable. Simpson was also a pioneering figure in the battle against hospital acquired infections.
- The development of germ theory provided an understanding of how to prevent post-surgical infection. In 1867 Joseph Lister published a paper in The Lancet detailing how spraying a mist of carbolic acid over a wound and then wrapping it in carbolic-soaked bandages controlled infection. This method of killing all known germs was called antisepsis. It was followed in the 1900s by asepsis, which prevented any bacteria from coming into contact with the wound. These twin developments revolutionised surgery.
- By the beginning of the 1900s surgery was usually less painful and risky, but many patients continued to die from internal infection and blood loss. It was not until the development of safe blood transfusion and antibiotics such as penicillin in the early 1940s that surgery became relatively safe.
- During World War Two, Archibald McIndoe achieved international fame for his pioneering work in plastic surgery on Battle of Britain fighter pilots. The skills developed by McIndoe and his team on members of the ‘Guinea Pig Club’ set standards used on burns victims throughout the rest of the war and in the years after. Nobody likes war, but during these times we do find that our medical knowledge improves significantly.
Want to know more? Why not attend one of our taster days in either Paramedic Science or Operating Department Practice?