| History H364/H546 | DR. SCHNEIDER |
| History of Medicine and Public Health |
Surgery and the Modern Hospital, 1800-1900
These readings focus on treatment of illness in the nineteenth century. One of the key developments in modern scientific medicine was the transformation of surgery and its corresponding impact on hospitals. As Porter puts it, "Surgery changed more in the nineteenth century than in the previous 2,000 years." The main question for this week is what was involved in those changes, and what was their impact, both for surgeons and patients as well as health care generally.
Porter, 360-74 "Nineteenth Century Medical Care"
What was the practice of surgery like in 1800, from the standpoint of:
-training (both elite and other)
-operations attempted
-where surgery was peformed and techniques used
For a specific example, refer to
Frances Burney, "A Mastectomy: letter of September 30, 1811," reprinted in Rothman, et al., Medicine and Western Civilization (New Brunswick: Rutgers University Press, 1995), ed. David J. Rothman, et al., 383-89
(You'll have plenty to think about without specific questions.)
In addition to Porter's description of the changes and their impact both for surgeons and patients as well as health care generally, by the end of the 19th century, see the following additional readings.
Henry Jacob Bigelow, "Insensibility During Surgical Operations Produced By Inhalation" Boston Medical And Surgical Journal (1846)
For whom was this article written?
Upon what kinds of patients was it tested? How successful was it?
How widely did the author think the practice could and should be adopted?
"Answer to the Religious Objections to the Use of Ether in Obstetrics and Surgery" by James Young Simpson (1849)
What were the arguments against giving women ether or chloroform during childbirth?
What were Simpson's arguments against these objections
Ignaz Philipp Semmelweis."The Etiology, Concept, and Prophylaxis of Childbed Fever (1861)," Rothman, Medicine and Western Civilization, 240-46
What clue led Semmelweis to question the existing etiology (causal explanation) of childbed fever?
What potential causes did Semmelweiss eliminate in arriving at his conclusion about the cause and prevention of the disease?
Joseph Lister (1827-1912), "Antiseptic Principle Of The Practice Of Surgery," 1867, excerpt
How did the research of Pasteur change Lister's mind about what caused "suppuration" [formation of pus]in wounds? Did it matter?
What did Lister do to prevent suppuration?
What kind of in juries did he test his methods on and how successful were they?
Porter, 597-627 "Surgery"
Read quickly through this chapter for general answers. It will be reviewed later in conjunction with medicine in the twentieth century.
In what ways was surgery in the 20th century an extension of developments in the nineeenth century?
Who was Billroth and how does he symbolize wider changes?
When and in what ways did surgeons go too far?
What area had the most spectacular success?