THE RENAISSANCE

what were the factors which influenced change in the treatment of wounds is this period?

Improved anatomical know-ledge in the Renaissance led to a better understanding of the body. The use of new, more powerful weapons in wartime created new problems for surgeons. Army surgeons were well used to performing amputations on the battlefield, although the amputees often died from loss of blood. Advances in the treatment of wounds were the result of a number of factors – warfare, chance discovery and the individual efforts of the French barber-surgeon, Ambroise Paré.

        Amputated limbs had traditionally been cauterised, or sealed, with boiling oil and hot irons. Paré found the use of cauterisation distressing and happened upon a much better and less traumatic way of treating soldiers under his care. He ran out of hot oil on one occasion in the battlefield, and instead applied a mixture of egg whites, rose oil and turpentine to the soldiers’ wounds. He found that the new method left his patients in less pain, and with little inflammation to the wound area. Paré also developed a technique for stemming bleeding after amputation. He used silk thread to make ligatures which halted blood flow from the arteries. Unfortunately although his method was sound, many soldiers were still to die from infection. Paré wrote many books, but it was his collected “Works on Surgery” published in 1575 which made him famous.

Because he was only a barber-surgeon, Paré was never accepted by the Paris College of Physicians, who tried to stop the publication of his texts. He did however have the support of the king, to whom he was personal physician. The royal approval enabled Paré to overcome the medical community’s opposition to his ideas. Paré would not have made the same discoveries in peacetime because he would have had no need to. Why were the medical establishment distrustful of Paré’s methods.

THE INDUSTRIAL REVOLUTION

        What were the factors that influenced the discovery and acceptance of anaesthetics in surgery?

        Until the mid-19th century, surgery was extremely painful and dangerous, so major operations were not possible. Surgeons would give patients a drug like opium or try to get them drunk before an operation but there were no effective anaesthetics.

        In 1799 Humphrey Davy discovered that the gas nitrous oxide (“laughing gas”) could dull pain and published a pamphlet to bring attention to this.

        Unfortunately, most surgeons ignored this discovery. Those that did use it found that it did not work on everyone, so the search continued.

        In October 1846, a Massachusetis Dentist, William Thomas Green Morton painlessly removed a tumour from a man’s neck, after giving him ether; a gas which had been recently discovered. News of the operation reached Britain very quickly and by the end of the year, several successful operations had been performed using it.

        In 1847 James Simpson, the professor of midwifery at Edinburgh University discovered chloroform, which was quicker acting than ether and didn’t have its side effects.

        Surprisingly, many people opposed the introduction of anaesthetics. Some religious people thought that it was God’s intention for women to feel pain during childbirth. Others worried that surgeons would not have the experience to give the right dose, and people sometimes did die from overdoses of ether and chloroform. It worried other people that they wouldn’t know what the surgeon was doing to them while they were unconscious.

        However, little opposition remained after Queen Victoria was given chloroform for the birth of her eighth child in 1853. in addition, positive press reports did much to combat peoples fears. Chloroform remained the most popular anaesthetic until 1900, when it was realised that it could damage the liver.

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        Discovery is often the result of a chain of experimentation.

Royal approval helped bring about the acceptance of anaesthesia.

The administration of anaesthesia required expertise and standards before being accepted.

Did the first world war advance medical practice in anatomy and surgery?

        The First World War interrupted general medical research, but it created other opportunities for surgeons and doctors. New techniques were needed to deal with the terrible carnage of the battlefields. Surgeons had to develop new skills quickly instead of competing with each other, they now worked together to find answers. Governments devoted industrial resources to provide equipment ...

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