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The Renaissance

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Introduction

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 Par�. Amputated limbs had traditionally been cauterised, or sealed, with boiling oil and hot irons. Par� 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. Par� 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. Par� 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, Par� 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 Par� to overcome the medical community's opposition to his ideas. Par� would not have made the same discoveries in peacetime because he would have had no need to. Why were the medical establishment distrustful of Par�'s methods. THE INDUSTRIAL REVOLUTION What were the factors that influenced the discovery and acceptance of anaesthetics in surgery? ...read more.

Middle

Antiseptics Surgery was a dangerous prospect for a patient in the 19th century. If the shock caused by the pain and loss of blood did not kill the patient during the operation, it was very likely that infection from blood poisoning afterwards would. Although people had made a connection between dirt and disease, this knowledge was not applied to the operating room. Surgeons wore coats covered with the pus, blood and germs of countless operations! Antiseptics were first developed by Joseph Lister in 1867. he realised that germs needed to be destroyed in order to prevent infection, this became known as "antisepsis". Lister had noticed the similarity between the smells of sewers and operating rooms. He knew that carbolic acid was used to treat sewers and he tried a weaker version of it on wounds. This reduced the risk of septicaemia (infection). The number of deaths during Lister's own operations fell from 50 to 5 percent in two years. These figures show the death rates in Newcastle Infirmary before and after the introduction of antisepsis in the nineteenth century; before antisepsis: 59.2% After antisepsis: 4.0% Only 150 years ago, over 50% of patients would die from septicaemia and gangrene, following an operation. Joseph Lister introduced antiseptic spray in 1867 Lister made the connection between the smell of sewers and operating theatres and this led him to experiment with carbolic acid. James Young Simpson (1811-1870) In the early 19th century surgical operations were dreaded by patients. Anaesthetic was not discovered until 1842, so patients had to endure excruciating pain. In an amputation, the patient would be held down while the surgeon cut through all the soft tissue and bone. He horror of pain forced surgeons to work quickly, often leading to mistakes and a low survival rate. The first successful steps in the conquest of pain were taken by James Simpson. Who was JS? Simpson was the youngest son of a Scottish village baker. ...read more.

Conclusion

In many cases gangrene set in before the wound healed and there was little that could be done about it. There are stories of patients having repeated amputations on a leg in an effort to stop the infection reaching the body, to no avail. The first method of preventing infection during an operation was developed by Joseph Lister. Who was Joseph Lister? Lister was Professor of Surgery at Glasgow University. He was concerned about the number of patients who died from infection and blood poisoning after operations. He set about trying to reduce this by improving the cleanliness of operations. Where did his ideas come from? The French chemist Louis Pasteur was a major influence on Lister. Lister read about Pasteur's discovery of germs and decided that to prevent infection, he needed to ensure that the germs present in the air did not get into wounds. Lister conducted an experiment on an 11 year old boy, who had been run over by a cart and had fractured his leg, leaving the bone exposed. Once Lister had cleaned the wound, he placed a dressing covered with carbolic acid over it. Lister knew that carbolic acid had been used to disinfect drains and cesspools and therefore thought that it may have the power to kill germs. The boy survived and did not suffer from the gangrene that was common with these types of injuries. Following on from his success, Lister decided to develop his theory further by inventing a carbolic spray which could be used to spray the operating area. In addition, Lister insisted that the operating theatre was kept clean, that the surgeon wore clean clothes, and that instruments were regularly disinfected. How important was Lister? At first Lister was regarded as an eccentric and nurses resented the extra work that his obsession with cleanliness caused. But deaths from blood poisoning and gangrene were reduced and before he died, Lister's services to medicine were recognised and he was awarded a knighthood. Today the terms, "Before Lister" and "After Lister" are used to describe surgery. ...read more.

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