Surgery and the Modern Hospital, 1800-1900

Broad influences

-more demand for care:
-government regulation services
-stimulation of demand
-new discoveries

surgery in 1800

training

Elite
commoners

operations

Broken bones
Lithotomy
“Bleeding”
warfare

patient's perspective: Fanny Burney (1811)

Anesthesia

-traditional relief of pain

-"discoveries"

Anton Mesmer
HumphreyDavy
Crawford Long
Horace Wells
William Morton
James Young Simpson

-ether operation 1846, Mass General

Chloroform and Simpson

Antisepsis

Ignaz Philipp Semmelweis

Joseph Lister

Acceptance of Lister

Initially slow
Lessons from Franco-Prussian War, 1870-71

French amputations: 13,200
Deaths from gangrene and fever: 10,000

Surgery in 20th century:

Billroth

Surgery fads:

appendectomy, tonsils, hysterectomy

New areas:

mastectomy and other cancers; brain and heart surgery

Conclusion: relation of surgery as treatmnen to

diagnosis

nursing

hospitals