What was surgery like in the 1800s

Andreas Vesalius, one of the founding fathers of modern surgery and a professor in Padua in the 16 th century, completely shifted how human anatomy was understood. Prior to this point, much anatomical knowledge was based on animal dissection—the prevailing method. When dissection of human cadavers was done, physicians observed while servants cut. Vesalius was the first to suggest the hands-on approach of human dissection by physicians and surgeons. His study of human anatomy corrected ideas held from Greek and Roman misconceptions based on dissection of animals.

In , he wrote the ground-breaking De Humani Corporis Fabrica Libri Septem, which became the most comprehensive anatomy text at the time and the basis for years of anatomical study. Pare also brought the resurgence of ligating, or tying off, blood vessels during amputation to stop hemorrhage more effectively. While shifts in anatomical knowledge empowered surgeons, many procedures remained out of reach.

Physicians could not attempt complex internal surgery or prolonged operations. With the widespread use of anesthesia in the late s, patients no longer had to fear the pain of an operation. However, the threat of infection still meant death for some. His process consisted of using carbolic acid as a sterilizing agent, but it was cumbersome and many surgeons who did not accept germ theory refused it. By the 20 th Century, asepsis, or the prevention of bacteria from entering a wound or sterile environment, gained prominence.

Through methods such as boiling, using autoclaves, and chemical antiseptics, sterile operating environments could be achieved. Physicians began wearing white coats, and clean linens dressed beds and operating tables. This final shift allowed for advancements in internal surgery and success in the surgical procedures we see today.

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The modern surgeon is a highly trained professional working in a state-of-the-art operating theatre. But the medieval surgeon dressed wounds on the battlefield and the barber-surgeon extracted teeth and set bones in a shop, in between haircuts. Find out more about surgeons and surgical spaces.

Javascript is disabled. You are here: Home Objects and stories. Before surgery could become a safe and reliable treatment, three problems had to be overcome: How to stop blood loss so the patient didn't bleed to death or go into shock How to deal with the excruciating pain of surgery and How to prevent life-threatening infections. Four stories about surgery. The problem of blood loss. The art of anaesthesia. With few exceptions, complex apparatus and appliances which are credited with being ingenious, or labour-saving, or automatic, are bad.

Sheild had discussed the matter with his anaesthetist friend, Dr Hewitt. A coarse wire tray is made containing for myself six compartments. This lies in the antiseptic lotion and the six sponges are each in its own compartment. At the end of the operation the tray is shown to me with each sponge in its place.

The number of compartments may be made to vary with the number of sponges to be employed. Next as to pressure forceps, I am having constructed a white delf disc twelve inches in diameter and about half an inch thick.

In this are bored eighteen holes equidistant round the edge. These holes are plainly numbered in red figures. Added to these precautions the numbers should be written on a slate previously to operation which prevents the error of adding to the number of forceps or sponges after the operation is commenced. Many instances of surgical mistakes had never been publicised, but the fact that they were unspoken did not mean that they had never happened.

Sheild had both accepted advice and practical assistance from one of his surgical team and included them in his accounting of instruments and sponges. Ultimately, however, claimed Sheild, he was the one responsible for any errors. First, that the devices were constructed to serve as a check upon more junior members of the team in order to ensure that they were carrying out instructions carefully enough.

Those undeserving or those who took advantage of medical and surgical care were subject to repeated criticism in the press in the late nineteenth and early twentieth centuries. By , for example, it was estimated that half the population of London obtained free medical relief.

Private patients could also benefit from gratuitous treatment, as well as the privilege of recuperating in a nursing home, rather than a busy London hospital. Unfair to those less fortunate then herself, Miss Byrne is branded as undeserving and irresponsible.

In addition to the evasion of fees, there were simply more surgeons for patients to approach in the metropolis, all keen to advance themselves in specialist areas. In the past few years, historians of medicine have also drawn attention to the s and early s as a period characterised by a distinctively experimental surgical outlook.

This can be seen, on the one hand, in the sense of the scientific research, which reassuringly and firmly underpinned surgery at this point, and also, on the other, in the uncertainty created by new and untried procedures. Indeed, it was confirmed and upheld by her fellow surgeons. It did, however, expose problems which might occur in the supposedly safe, early twentieth-century operating room, both on the table and between the personnel present. The Byrne versus Thorne trial had brought to the fore issues which had disrupted the new-found respectability and confidence of the surgeon.

By , thanks to the developments in surgical science during the second half of the nineteenth century, surgeons were no longer faced with the risks of having a conscious patient upon whom surgery had to be performed quickly and with brute, though skilful, force. While speed was no longer as essential or paramount as it had once been, surgical skill was still, of course, fundamental.

Although the risks of surgery had decreased, correspondingly, surgical riskiness and the willingness of surgeons to take those risks had increased —to such an extent, indeed, in the s and early s, that both medical and lay outcry demanded that responsibility must be taken for actions. However, the experimentation of the s and s witnessed, paradoxically, the promotion of the skilful surgeon over the team; glory was attributed to the individual, blame to the team.

Success might be achieved, greater progress established through experimentation, but, claimed detractors, it was gained by risking responsibility. The paper lambasted the Dickensian youths who made up the new and future school of surgeons:.

The new school consists of [. Louche, irresponsible, idle, and careless, these were the people in whose hands lay innocent lives: clumsy and dangerous youths, who could not be trusted.

The claim that daring operative procedures represented progression was dismissed scornfully by the Chronicle , which branded contemporary surgery uncivilised and barbaric. The student sixty ago would see an occasional operation for strangulated hernia, perhaps an ovariotomy; there he would stop.

Perforation of the stomach, or the bowels, or the appendix, was left to itself; cases of acute obstruction shared the same fate; so did ruptures of the abdominal viscera from external violence. Of such success as we there was not a trace.

Whereas the Chronicle sees destruction and frailty, the BMJ envisages exploration and progress: the preservation of health rather than the wilful encouragement of illness. Risk was essential to progress. Concerns about an all-conquering surgical invasion were not just limited to popular newspapers with a non-too subtle stance on burning issues of the day. If the working-class patients are not cured through such wilful experimentation, then at least they will, in the future, benefit those of a higher class who, when it is their turn, are more likely to survive because of the sacrifice of their social inferiors.

Under anaesthetic, what patient could possibly know the difference? Here, the benefit of surgical progress — the anaesthesia — is manipulated to allow both for experimentation — the operation is a trial - and practice — so Dr Wilson can advance his career.

Operated upon by the inexperienced Wilson, the man loses his leg, and his livelihood, in an unnecessary and experimental procedure. If surgeons advance in their profession through trial and error, Aesculapius Scalpel asks his readers to consider the unconscious and neglected patient in these proceedings.

No wonder the Irish, Catholic workman can only eventually be convinced to gamble with his life by a priest. While anti-vivisectionists and anti-vaccinationists brought the rights of hospital patients into their debates, surgeons themselves were considering carefully the wider implications of surgical advancement.

Preservation and conservation became watchwords indicative of successful surgery, which could and should be supported and cheered. The encouragement of the next generation was tempered with a warning about potential over-zealousness and an awareness of the scrutinising public gaze. Even confident reflections on the innumerable advantages of nineteenth-century progress were tempered with an anxiety about the future. Although Annandale stressed that risk had been dramatically reduced for the patient because of the achievements of the past half century, intriguingly, he turns attention back to the surgeon, where the greatest riskiness is now firmly embodied.

Annandale counselled that it would do no harm to consider, through a process of focused study, alternative options, before taking up the knife.

While Bennett was an advocate of the necessity of considering alternative methods of treatment, such as massage, his impressions of surgical practice were neither extreme nor rare: No operation could be considered absolutely safe, and the risk to life should be carefully weighed before deciding on the advisability of any operation.

That a patient would certainly die if left alone was not in itself a sufficient justification of operation. The question that should guide the surgeon as to the amount of risk that could rightly be run was whether the lesion was due to curable disease or not. Of two operative procedures, by either of which the desired end might eventually be reached, the milder one should be preferred, even though less brilliant, or giving less obvious immediate results.

Routine in operating was to be vehemently protested against — as applied to any particular disease it magnified its danger.

Even operations involving no risk to life should not be undertaken without serious consideration. The interests of the patient, and not the mere attainment of a mechanical achievement, should be the first concern. Exploratory operations should not lightly be undertaken as a routine procedure on the plea that they would do no harm, even if no good resulted, for this was not always so, and in any case it was harmful in encouraging the neglect of extra-operative methods of diagnosis. Judgment was the enemy of routine, and routine was the bane of surgery.

A too great regard for the good achieved by operations discounted the value of the preventive measures of surgical disease. Surgery was said to be a handicraft, but the knowledge of when to apply its craftsmanship was of the first importance.

The brilliance of showmanship, coupled with the addiction of success, ensured that experimentation had paradoxically become routine. For William Henry Bennett, theory and practice should be supported by an ethical consideration of the benefits to be accrued to the patient who undergoes the procedure and not simply the skilfulness of the achievement.

Within his speech was a brief sentence which suggested that risk-taking was not one-sided: patient choice was also a factor. In the final sections of this article, I will explore what can be labelled patient perversity, focusing on women patients more generally, as well as specifically, at the female-run New Hospital for Women.

The fear of death under anaesthesia could also prevent some patients from agreeing to surgery in the first place, however serious their condition. Individual concerns were also fuelled by articles in the popular press about the dangers of anaesthesia.