Dr James Simpson and Anaesthetics
1847 – Prof of Midwifery at Edinburgh University – wanted to find an alternative anaesthetic to Ether, which would not
irritate the lungs. One evening, he and some friends inhaled some Chloroform. Simpson was the first to awake, finding his
friends unconscious, but otherwise well, on the floor. He began to use it with great success to relieve the labour pains of
women in childbirth.
Mistakes were made with the new anaesthetic in the years following – overdoses put the patients to sleep permanently!
Some objected to its use for religious (pain during childbirth had been created by God) and surgical (surgeons needed to work
quickly) reasons – Simpson faced much criticism in spite of his high position in the medical profession.
1857 – Queen Victoria used Chloroform during the birth of her 8 th child – this encouraged doctors and patients to trust
Chloroform, but Ether remained in common use.
(Today – modern anaesthesia is an exact science, carried out by a specialist anaesthetist, who has access to a wide range of
anaesthetics. The drug Curare is used to relax the muscles so effectively that only a light anaesthesia is often required, further
reducing the undesirable side-effects of anaesthesia.)
Sir Joseph Lister (1827 – 1912) and Antiseptics
1861 – Prof of Surgery at Glasgow University – concerned about the level of cleanliness in operating theatres and hospitals
in general. At that point, he, like other doctors, believed a ‘poisonous miasma’ (bad smells in the air) might cause wounds to
turn septic.
1865 – Learned of Pasteur’s work on microbes – realised that germs in the air and on surgical dressings might be causing
infection. He knew that Carbolic Acid was used to clean out sewers and guessed that it reduced the smells in sewers by killing
bacteria. He carried out an experiment on an 11 year old boy who had fractured his leg, exposing the bone. He cleaned the
wound and dressed in a bandage soaked in Carbolic Acid. The boy recovered – no gangrene developed.
1867 – Lister knew that germs were still in the air and could get into the wound during surgery. He invented the Carbolic
Spray Pump – it created an antiseptic environment in the operating theatre.
Amputations done by TOTAL CASES RECOVERED DIED
Lister 1864-66 35 19 16
1867-70 40 34 6
1877 - Prof of Surgery at Kings College, London. Many surgeons, doctors and nurses still did not accept his teachings, but
later Lister was awarded a knighthood, honouring him for his contribution to surgery and gained international recognition in
1892 when he and Pasteur were jointly honoured at a scientific convention at the Sorbonne University in Paris.
(Today the history of surgery is commonly divided into two different periods: Before Lister & After Lister – such was the
significance of his work.)
Blood Transfusion: The Final Element in the Revolution in Surgery
The only ways of preventing blood loss before transfusion was by being a quick surgeon and by tying up the veins with silk
threads immediately after an operation (Paré’s Ligature Method).
1667 – Blood transfusion attempted for the first time – direct transfusion from vein to vein – did not always work;
sometimes caused blood clots; patients died, no one knew why.
Throughout 19th Century – transfusion continued to be an unpredictable procedure.
1901 – An Austrian doctor, Karl Landsteiner, discovers that blood falls into four main blood groups (O, A, B, AB) – this
explained why some transfusions failed. (Received Nobel Prize for this in 1930 – the importance of his work was not
recognised at first).
First World War (1914-18) Methods for storing large quantities of blood were developed – needed for huge casualties – now
loss of blood could be compensated for.
1939 Landsteiner, now living in USA discovers that each of the blood groups were themselves divided into 2 types – rhesus
positive (most common type) and rhesus negative. This removed the unpredictable element of transfusions.
1940s onwards Most rich countries begin to build up ‘blood banks’- reserves of blood for surgery. (World War II (1939-45)
speeded up this development.)
KEY FACTOR:
These advances would have been possible without: Pasteur and Koch’s work on germs: blood storage could not be
safe without sterile containers.