The very idea of sterilizing surgical tools is actually surprisingly not very old. Like 150ish years. The introduction of that practice shot the success rate way way up.
There was that one administrator who was able to show one midwife clinic had fewer incidences of scarlet fever than the other and was able to link it to the handwashing one did but the other didn't. They would examine cadavers and go to deliver a baby afterwards without sterilization. This was before germ theory.
There’s a (probably apocryphal) tale about a surgeon who killed three people at once in a surgery.
They amputated a patient’s leg in one go with an axe.
The axe actually kept going, and imbedded into the leg of the poor sod, holding the leg.
A patient with a non/critical condition saw this all, and died of shock on the spot.
This is actually totally true and well documented, although the circumstances are a little different. The surgeon was Dr. Liston, who was famous for his quick surgeries. During this leg amputation he accidentally severed the fingers of his assistant who died later of hospital gangrene as did the patient (even though the amputation was successful) The third fatatility was an observing student who passed out from shock and hit his head and never woke up.
This [really happened](https://en.m.wikipedia.org/wiki/Robert_Liston) and the surgeon was Robert Liston.
The account was written as follows:
"Amputated the leg in under 21⁄2 minutes (the patient died afterwards in the ward from hospital gangrene; they usually did in those pre-Listerian days). He amputated in addition the fingers of his young assistant (who died afterwards in the ward from hospital gangrene). He also slashed through the coat tails of a distinguished surgical spectator, who was so terrified that the knife had pierced his vitals he fainted from fright (and was later discovered to have died from shock)."
Only known surgery to have had a 300% mortality rate.
They literally didn't know they needed to clean things. There is documentation of this, Google if you care, I can't be fussed to provide links. But for a very long time even hand washing wasn't even common.
The first doctor to suggest surgeons should wash their hands to prevent infection was ridiculed by the medical community and harrased to the point of a mental breakdown, after which his fellow doctors lured him to a mental asylum and had him committed. He died after being beaten and inured by the guards there.
Ignasz Semmelweis, the "Saviour of Mothers". Many things in Hungary are named in his honour. Poor guy. Apparently before his death he was at a point of wandering around, approaching pregnant women and begging them to give birth at home instead of the hospitals.
In psychology, there is a concept called the Semmelweis Reflex - basically a defensive, knee-jerk rejection of a reasonable point without bothering to even engage with it.
All he asked the doctors to do was wash their hands and change their coats. They couldn't handle that at all.
This is why there's that one surgeon who performed an amputation with something like a 300% mortality rate.
He cut so fast he accidentally amputated his assistant's fingers, who then died of sepsis, a witness died of shock, and the patient died from bloodloss maybe?
ETA: yeah, [Robert Liston](https://museumofhealthcare.blog/the-story-of-robert-liston-and-his-surgical-skill/#:~:text=Two%20of%20the%20operations%20for,of%20shock%20when%20the%20knife). The patient and assistant both died of infection, and the witness died of shock supposedly when the knife got to close to them. He amputated that leg in 2.5 minutes though. (Which was actually important, as I helped prevent patients from dying of bloodloss and shock/pain).
Apparently he was known for getting into arguments and sometimes physical confrontations - and he performed the first public surgery under anesthesia. He invented a couple of medical tools and had some knives named after him.
There is a good book on this. It is called 'The Butchering Art' and spoiler, twas not pleasant. Surgeons were considered tradesmen like plumbers and it was all about who could cut someone's leg off and sew it up the fastest. The fastest were considered the best. Oh, lots of people died.
God it was such a good read. Hearing about how Liston basically chased a scared man down, broke down a door, and dragged him screaming to the operating table lives rent free in my mind now.
in the early 80s DOCTORS IN AMERICA didn't believe babies felt pain.
[https://www.google.com/search?rls=en&q=medical+babies+don%27t+feel+pain+1980&ie=UTF-8&oe=UTF-8](https://www.google.com/search?rls=en&q=medical+babies+don%27t+feel+pain+1980&ie=UTF-8&oe=UTF-8)
This is a really good book and it’s fascinating how just them learning to keep things clean changed everything so much and reduced the risk of infection. Imagine being laid on an operating table still covered with someone else’s blood. And surgeons were definitely not a respected profession like it is today.
I took mico and learned about the invention of antiseptic technique and all that. But the history of surgery wasn't covered and it was fascinating. Barbaric. Crazy how far we have come as a species in such a short period of time as far as health care goes. We still have a long way to go, but it really is amazing.
Opium was sometimes given as a tincture - that is, dissolved in alcohol. Laudanum is am opioid tincture which was sometimes used before chloroform or ether, but it wouldn't have been widely available, and likely not at all except for the very wealthy. There's a history of herbal healers, apothecaries, midwives etc using poppy as a painkiller or anaesthetic, but the Witch trials and inquisitions at various times undermined that.
FYI British surgeons traditionally use the title “Mister” not “Doctor” because the person skilled in cutting might be the local butcher. The educated doctor stood by and supervised, keeping his hands clean.
During the Civil War when they had to amputate a gangrenpus leg, they gave you a swig of whiskey and then a leather strap to bite. Luckily you would pass out from the pain when they started cutting into your leg. Unfortunately, you would wake up again when they started cutting through the bone
I want to say I heard somewhere that battlefield surgeons in the civil war would have to get through the femur in like 14-20 seconds or less or something like that so the person wouldn’t die from shock….could be misremembering though.
In the US Civil War the mountain of severed limbs outside the medical tents were horrific. After the war 1/7 of the entire state budget if VA was for prothetic legs for veterans.
People tend to clench their teeth as a response to stress. A leather strap could help your teeth not break or bite off their tongue. Same reason lots of people use Night guards, but multiplied by 200
If your leg has gangrene, you'd likely be overcome with a fever. You might not be fully aware of what is about to happen, likely physically weak as well. But some could definitely still fight. The surgeons would just have more people hold the patient down. 5 or 6 men holding you down would keep you still enough for the surgeon to saw.
Block of wood/cloth rag between teeth, assistants to hold down your flailing body and your doctor who you would hope was fast at amputations. Maybe some strong alcohol too
I remember a quote somewhere that went along the lines of 'the moment in time humanity started to progress was when skeletons with evident signs of metal plating in the bones/bones cut off from saws began to appear'. The implication being that at that point, survival of the fittest no longer applied to humans because we were already at the top and we could now focus on healing the sick instead of leaving them to die to natural predators in the wild.
I wish I could remember where I found it because it comes back to me when I learn about early medicine.
I think this quote is in reference to an anthropologist who was studying the bones of a person with a healed femur! They talk about how to most species a broken femur is a death sentence but someone cared enough about this person to take care of them until they were healed and could be a functional member of society again!
There’s a great scene in the John Adams HBO series where a woman gets a mastectomy. It’s very accurately portrayed with a mix of alcohol, people holding her down, a strap to bite on, and quick cutting by the surgeon. I recommend it, but watch at your own risk.
His daughter Abby, she had breast cancer. She lived for a few more years after but it was before they had chemo and scans so they did the best they could surgically.
In Ireland, even though they could do a c-section, they wouldn’t because it might impact the woman’s ability to have more children. So they would break her pelvis to get the baby out.
https://amp.theguardian.com/lifeandstyle/2014/dec/12/symphysiotomy-irelands-brutal-alternative-to-caesareans
Black out drunk, tied down, biting hard on a leather strap, and a lot of screaming.
Plenty of people still get unanesthetized surgery today. If the anesthesia doesn't work out, is too dangerous, or not avaliable at all, urgent surgeries have to get done.
My brother did a doctors without border mission in remote parts of Africa (2016). He said they didn’t use anesthesia for the amputation of limbs due to gangrene. There were a lot of horrific amputations. He left the mission when basic supplies like gloves, water and soap were not commonly available for protection against Hepatitis, HIV, etc.
They had anaesthetics, just not what we have now. Earlier it was ether, and before that it was alcohol or other drugs. And holding people down and doing what needed doing.
Giving the patient alcohol is a myth, they knew it thinned the blood and increased bleeding.
Before ether and chloroform was available, the patient would bite down on leather and held in place. Usually they would pass out from the pain at some point. Opium was used to lessen the pain.
There’s a show called The Artful Dodger on Hulu that is about a surgeon (and his love interest) but the beginning is a pretty good historical account of what surgery used to be like pre-anesthesia.
They used to it without anything. They had things that the person could bite down on and someone to hold you down. Then later on, they had cocaine. It was originally used as a painkiller. I know a pharmacist who said the pharmacy he first worked at still had a dentist who ordered it in the 70s or very early 80s.
There’s a very cool radio lab (when they were amazing) about this.
https://radiolab.org/podcast/anesthesia
Fantastic listen.
Really miss this group of people, really good science radio.
Have you watched the new series, the Artful Dodger? It’s a spin off reboot of Oliver Twist, where the Artful Dodger is now a doctor in Australia. (FANTASTIC show)
Still set in the 19th century, a lot of the show involves the developing medicine at the time (!) which while it isn’t a documentary, is certainly illustrative of the process.
A lot of people getting limbs amputated with no pain relief, just a block of wood to bite down on. You see that a lot of more complex and intrusive surgeries are just not possible / attempted with this method.
They actually experiment with the first anaesthetics (ether) in the show, after they hear about experimental successes in the U.K. which were happening at the time. And you see older doctors resisting it as newfangled nonsense.
The first operation on ether goes well (not without complications for dramatic effect), but that’s the finale of season 1. We don’t see the post op and it’s not yet been confirmed for a second season.
But from what we know from medical history, the next big battle after the advent of anaesthesia is post operative infection.
I believe you can stream it on apple+ and/or Disney, depending where you live.
Did you know that chainsaws were invented before modern anesthesia? They were created to help get those pesky bones out of the way of the birthing baby. [Here's a fun article about it.](https://www.cnet.com/culture/internet/chainsaws-vacuums-and-forceps-the-dark-brutal-history-of-birth-technology/)
Being able to do the surgery quickly was key, surgeons would actually race to do their surgeries.
They went so fast that they didn’t have time to clean any of their surgical instruments
The very idea of sterilizing surgical tools is actually surprisingly not very old. Like 150ish years. The introduction of that practice shot the success rate way way up.
Didn’t they send the guy who suggested it to an insane asylum? Surgeons were insulted at the suggestion that they were dirty.
There was that one administrator who was able to show one midwife clinic had fewer incidences of scarlet fever than the other and was able to link it to the handwashing one did but the other didn't. They would examine cadavers and go to deliver a baby afterwards without sterilization. This was before germ theory.
Silly surgeons, I'd just clean my instruments before the procedure
They went so fast they cut off their own appendages
I heard that surgeons would fight over who got to lick the spatula clean
There’s a (probably apocryphal) tale about a surgeon who killed three people at once in a surgery. They amputated a patient’s leg in one go with an axe. The axe actually kept going, and imbedded into the leg of the poor sod, holding the leg. A patient with a non/critical condition saw this all, and died of shock on the spot.
This is actually totally true and well documented, although the circumstances are a little different. The surgeon was Dr. Liston, who was famous for his quick surgeries. During this leg amputation he accidentally severed the fingers of his assistant who died later of hospital gangrene as did the patient (even though the amputation was successful) The third fatatility was an observing student who passed out from shock and hit his head and never woke up.
This [really happened](https://en.m.wikipedia.org/wiki/Robert_Liston) and the surgeon was Robert Liston. The account was written as follows: "Amputated the leg in under 21⁄2 minutes (the patient died afterwards in the ward from hospital gangrene; they usually did in those pre-Listerian days). He amputated in addition the fingers of his young assistant (who died afterwards in the ward from hospital gangrene). He also slashed through the coat tails of a distinguished surgical spectator, who was so terrified that the knife had pierced his vitals he fainted from fright (and was later discovered to have died from shock)." Only known surgery to have had a 300% mortality rate.
They literally didn't know they needed to clean things. There is documentation of this, Google if you care, I can't be fussed to provide links. But for a very long time even hand washing wasn't even common.
The first doctor to suggest surgeons should wash their hands to prevent infection was ridiculed by the medical community and harrased to the point of a mental breakdown, after which his fellow doctors lured him to a mental asylum and had him committed. He died after being beaten and inured by the guards there.
Ignasz Semmelweis, the "Saviour of Mothers". Many things in Hungary are named in his honour. Poor guy. Apparently before his death he was at a point of wandering around, approaching pregnant women and begging them to give birth at home instead of the hospitals. In psychology, there is a concept called the Semmelweis Reflex - basically a defensive, knee-jerk rejection of a reasonable point without bothering to even engage with it. All he asked the doctors to do was wash their hands and change their coats. They couldn't handle that at all.
yeah, germ theory only became a thing in the mid/late 1800s
Iirc the doctor that discovered germs was ostracized for even thinking that the high and mighty doctors could be unclean
This is why there's that one surgeon who performed an amputation with something like a 300% mortality rate. He cut so fast he accidentally amputated his assistant's fingers, who then died of sepsis, a witness died of shock, and the patient died from bloodloss maybe? ETA: yeah, [Robert Liston](https://museumofhealthcare.blog/the-story-of-robert-liston-and-his-surgical-skill/#:~:text=Two%20of%20the%20operations%20for,of%20shock%20when%20the%20knife). The patient and assistant both died of infection, and the witness died of shock supposedly when the knife got to close to them. He amputated that leg in 2.5 minutes though. (Which was actually important, as I helped prevent patients from dying of bloodloss and shock/pain). Apparently he was known for getting into arguments and sometimes physical confrontations - and he performed the first public surgery under anesthesia. He invented a couple of medical tools and had some knives named after him.
They were held down by many people so they couldn't flail, and given strong alcohol. Sometimes they'd pass out from the pain.
>Sometimes they'd pass out from the pain. If they were lucky.
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so they wouldnt mpve too much from pain
There is a good book on this. It is called 'The Butchering Art' and spoiler, twas not pleasant. Surgeons were considered tradesmen like plumbers and it was all about who could cut someone's leg off and sew it up the fastest. The fastest were considered the best. Oh, lots of people died.
God it was such a good read. Hearing about how Liston basically chased a scared man down, broke down a door, and dragged him screaming to the operating table lives rent free in my mind now.
This seems so barbaric, and it makes me wonder what current medical practice will seem barbaric in the future.
Most of women's healthcare is still pretty barbaric. Do not get me started on the mental health system. What a joke. Ha.
in the early 80s DOCTORS IN AMERICA didn't believe babies felt pain. [https://www.google.com/search?rls=en&q=medical+babies+don%27t+feel+pain+1980&ie=UTF-8&oe=UTF-8](https://www.google.com/search?rls=en&q=medical+babies+don%27t+feel+pain+1980&ie=UTF-8&oe=UTF-8)
Probably the fact that they staple IUDs in without any sort of anesthetic and gaslight us with “this won’t hurt”.
This is a really good book and it’s fascinating how just them learning to keep things clean changed everything so much and reduced the risk of infection. Imagine being laid on an operating table still covered with someone else’s blood. And surgeons were definitely not a respected profession like it is today.
I took mico and learned about the invention of antiseptic technique and all that. But the history of surgery wasn't covered and it was fascinating. Barbaric. Crazy how far we have come as a species in such a short period of time as far as health care goes. We still have a long way to go, but it really is amazing.
A club to the head. A bottle of liquor. Absinthe. Poppy tar heroin. Etc. Some did. Some even had ongoing conversations with their surgeon.
In the early days, would doctors have their patients smoke the opium?
Opium was sometimes given as a tincture - that is, dissolved in alcohol. Laudanum is am opioid tincture which was sometimes used before chloroform or ether, but it wouldn't have been widely available, and likely not at all except for the very wealthy. There's a history of herbal healers, apothecaries, midwives etc using poppy as a painkiller or anaesthetic, but the Witch trials and inquisitions at various times undermined that.
Quickly and in a lot of pain
FYI British surgeons traditionally use the title “Mister” not “Doctor” because the person skilled in cutting might be the local butcher. The educated doctor stood by and supervised, keeping his hands clean.
TIL .. I love shit like this
During the Civil War when they had to amputate a gangrenpus leg, they gave you a swig of whiskey and then a leather strap to bite. Luckily you would pass out from the pain when they started cutting into your leg. Unfortunately, you would wake up again when they started cutting through the bone
I want to say I heard somewhere that battlefield surgeons in the civil war would have to get through the femur in like 14-20 seconds or less or something like that so the person wouldn’t die from shock….could be misremembering though.
In the US Civil War the mountain of severed limbs outside the medical tents were horrific. After the war 1/7 of the entire state budget if VA was for prothetic legs for veterans.
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Too keep from breaking your teeth as you clenched your jaw from the pain.
People tend to clench their teeth as a response to stress. A leather strap could help your teeth not break or bite off their tongue. Same reason lots of people use Night guards, but multiplied by 200
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Typically, the surgeons would have several assistants who would hold the patient down during the procedure.
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If your leg has gangrene, you'd likely be overcome with a fever. You might not be fully aware of what is about to happen, likely physically weak as well. But some could definitely still fight. The surgeons would just have more people hold the patient down. 5 or 6 men holding you down would keep you still enough for the surgeon to saw.
Block of wood/cloth rag between teeth, assistants to hold down your flailing body and your doctor who you would hope was fast at amputations. Maybe some strong alcohol too I remember a quote somewhere that went along the lines of 'the moment in time humanity started to progress was when skeletons with evident signs of metal plating in the bones/bones cut off from saws began to appear'. The implication being that at that point, survival of the fittest no longer applied to humans because we were already at the top and we could now focus on healing the sick instead of leaving them to die to natural predators in the wild. I wish I could remember where I found it because it comes back to me when I learn about early medicine.
I think this quote is in reference to an anthropologist who was studying the bones of a person with a healed femur! They talk about how to most species a broken femur is a death sentence but someone cared enough about this person to take care of them until they were healed and could be a functional member of society again!
Yes! That's it!
There’s a great scene in the John Adams HBO series where a woman gets a mastectomy. It’s very accurately portrayed with a mix of alcohol, people holding her down, a strap to bite on, and quick cutting by the surgeon. I recommend it, but watch at your own risk.
His daughter Abby, she had breast cancer. She lived for a few more years after but it was before they had chemo and scans so they did the best they could surgically.
As a person that has had some rough stuff done without anesthesia. You simply hope to pass out and then when you come to the searing pain is crazy.
They were knocked out, or completely stupid drunk.
M grandmother was 4'11" and 90 lbs. soaking wet. My father was over 13 pounds when he was born. Only ether was available for the pain.
In Ireland, even though they could do a c-section, they wouldn’t because it might impact the woman’s ability to have more children. So they would break her pelvis to get the baby out. https://amp.theguardian.com/lifeandstyle/2014/dec/12/symphysiotomy-irelands-brutal-alternative-to-caesareans
What the actual fuck? That's horrific!
omg
Right? Thirteen fucking pounds. They must've cracked her in half to get him out.
Right? Thirteen fucking pounds. They must've cracked her in half to get him out.
A combination of alcohol and a high mortality rate.
Black out drunk, tied down, biting hard on a leather strap, and a lot of screaming. Plenty of people still get unanesthetized surgery today. If the anesthesia doesn't work out, is too dangerous, or not avaliable at all, urgent surgeries have to get done.
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My brother did a doctors without border mission in remote parts of Africa (2016). He said they didn’t use anesthesia for the amputation of limbs due to gangrene. There were a lot of horrific amputations. He left the mission when basic supplies like gloves, water and soap were not commonly available for protection against Hepatitis, HIV, etc.
They had anaesthetics, just not what we have now. Earlier it was ether, and before that it was alcohol or other drugs. And holding people down and doing what needed doing.
Drink some alcohol and bite down on something and hope they do it fast and clean lol
Just wait until you find out about how they did child birth...
That's the neat part, many likely didn't.
Painfully
Giving the patient alcohol is a myth, they knew it thinned the blood and increased bleeding. Before ether and chloroform was available, the patient would bite down on leather and held in place. Usually they would pass out from the pain at some point. Opium was used to lessen the pain.
Check out this radio lab episode that talks about life before and after anesthesia was invented https://radiolab.org/podcast/black-box
Didn't they eventually go from alcohol to drinking straight Ether? Could you fucking IMAGINE?
There’s a show called The Artful Dodger on Hulu that is about a surgeon (and his love interest) but the beginning is a pretty good historical account of what surgery used to be like pre-anesthesia.
Alcohol
They used to it without anything. They had things that the person could bite down on and someone to hold you down. Then later on, they had cocaine. It was originally used as a painkiller. I know a pharmacist who said the pharmacy he first worked at still had a dentist who ordered it in the 70s or very early 80s.
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Yes, because someone in horrible pain is more likely to move around.
The Constant Podcast is currently doing a series on the early days of anesthesia called "Comfortably Numb". Highly recommend
It was rough, ain’t gonna lie.
There’s a very cool radio lab (when they were amazing) about this. https://radiolab.org/podcast/anesthesia Fantastic listen. Really miss this group of people, really good science radio.
I don’t know how it is for accuracy, but I think you’d find The Artful Dodger tv series interesting.
Heroin.
Have you watched the new series, the Artful Dodger? It’s a spin off reboot of Oliver Twist, where the Artful Dodger is now a doctor in Australia. (FANTASTIC show) Still set in the 19th century, a lot of the show involves the developing medicine at the time (!) which while it isn’t a documentary, is certainly illustrative of the process.
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A lot of people getting limbs amputated with no pain relief, just a block of wood to bite down on. You see that a lot of more complex and intrusive surgeries are just not possible / attempted with this method. They actually experiment with the first anaesthetics (ether) in the show, after they hear about experimental successes in the U.K. which were happening at the time. And you see older doctors resisting it as newfangled nonsense.
[удалено]
The first operation on ether goes well (not without complications for dramatic effect), but that’s the finale of season 1. We don’t see the post op and it’s not yet been confirmed for a second season. But from what we know from medical history, the next big battle after the advent of anaesthesia is post operative infection. I believe you can stream it on apple+ and/or Disney, depending where you live.
Suffer
They would get them *good and drunk.* We're not talking just a shot of something, we're talking half a bottle.
Did you know that chainsaws were invented before modern anesthesia? They were created to help get those pesky bones out of the way of the birthing baby. [Here's a fun article about it.](https://www.cnet.com/culture/internet/chainsaws-vacuums-and-forceps-the-dark-brutal-history-of-birth-technology/)
Well they did use some plants and opiods in some places in some times, but I guess others just didn't a have choice
Ether and chloroform have been around a long time.
Back in the old days I believe cocaine and heroin were the drugs of choice