The History of Surgery and Anaesthesia
Today we are only restricted from operating on patients because of the weighing up factor, if it is likely that the patient would die or suffer greater physical or mental damage as a result of an anaesthetic or operative procedure, the anaesthetist and surgeon would agree to either resuscitate the patient before surgery and then operate when the patient’s condition improves or make a decision not to do the procedure at all.
However there are emergencies which will take precedence over a medical condition when the certain outcome would be the death of the patient without the procedure, i.e. an Abdominal Aortic Aneurysm (AAA) or a patient that has suffered a head injury and requires a craniotomy to remove the clots. It is the case that even these are also subject to a medical filter especially when the consultants decide that the likely outcome will be, with or without the procedure, death.
Apart from these obvious restrictions surgery today does not have many limitations now that we have Anaesthetics, especially general Anaesthesia.
Prior to the discovery of General Anaesthesia, surgery had strict limitations, and was mainly carried out on the wounded following a battle on land or sea.
This was mainly due, to the nature of the injuries obtained during war, all these wounds were dirty wounds and when a limb was involved, the likelihood of the affected area to become gangrenous was so great that it generally meant the amputation of that limb. This was necessary to save the life of the serviceman.
There were surgical procedures carried out in peacetime but this was a rare occurrence.
In these times of peace, surgical conditions that were operated upon were very similar to that of war i.e. limbs were amputated because the unfortunate person had been run over by a carriage or fallen foul of machinery as opposed to bomb bullet or shrapnel.
There was however a high mortality rate which resulted from a number of factors;
· The excruciating pain of the procedure,
· The postoperative infection
· The patients had few reserves of strength, due to loss of blood pre/during and post-surgery.
· The poor fitness of the patient. (The soldier’s survival rate was higher as he was young and fit)