Victorian Era Surgery

When you think of surgery, most of us get an image of being rolled into an operation room filled with surgeons and technicians. You are given anesthesia either by liquid injected into your veins or by gas that is administered through a mask placed over your mouth and nose. After the surgery is performed you wake up and after a few hours, you are allowed to go home. However, in the Victorian era surgery was different. Back then, it was not the same type of anesthesia. You were not wheeled into rooms with all kinds of machinery. In the Victorian era, surgeons were trained differently, the relationship between surgeons and physicians was not the same, surgery was practiced by different people, they were performed in different places, there were

different drawbacks, and many breakthroughs happened that we have evolved in order to use today. In the Victorian era, surgery was riskier without all the knowledge we have now.
In the late 19th century, surgeons were trained differently. First of all, there was no official training system for medical professionals in the Victorian era (Joshi Doctors). This means there was no medical school. Instead, teens would become surgeon’s apprentices. The main reason for this is because physicians believed medicine should be taught by books and antiques. Because of this, Victorian medical schools would not have been successful (Joshi Doctors). So, the apprenticeships involved reading the surgeon’s books, watching the surgeon perform surgeries, and eventually becoming the surgeon’s assistant (Hattemer). Through reading the books, surgeons in training would learn about the theories of diseases at the time. For example, they could read about what caused disease, and there were extensive changes related to this during the Victorian era. These studies were lead by Louis Pasteur. Though he was not the first to believe in this, Pasteur proved that germs caused disease (Magner 307). Despite these apprenticeships being the main training, there was still an Association of Factory Surgeons that was established in 1889 that certified these people to practice surgery (Lee).
During the end of the 19th century, there was a major difference between surgeons and physicians. Physicians were the most prestigious class of doctors, and the surgeons came right after them (Joshi Doctors). Physicians, unlike surgeons, did not do any work on or inside the human body; they only diagnosed illness and prescribed medicine. Since surgeons had to perform all tasks that involved blood or other things having to do with the human body, they did not receive the same amount of respect as physicians did (Joshi Doctors). This is also because until 1745 the surgeons were linked to barbers, as well as being forced to practice on dead bodies (Joshi Doctors). The link between barbers and surgeons began in the Egyptian era and was because doctors believed surgery to be not holy so they passed the task off to barbers (Roberts). Also, barbers already had the basic knowledge of surgery, like making precise incisions, from having to be fairly precise while cutting hair (Roberts). Also, while being a physician had its drawbacks like the fact that they did not get paid well and more, they were still more respected than surgeons (Williams). This may be because they had to be licensed from an actual college named The Royal College of Physicians (Joshi Doctors).
In the Victorian era, surgeons were the second most respected class of medical personnel (Joshi Doctors).

They provided the obvious service of performing surgeries which sometimes consisted of cutting the chest open, but they also reset broken bones and did pretty much everything physicians would or could not do (Joshi Doctors). However, at the beginning of the Victorian era, surgeons often did not perform surgery on important areas, such as the abdomen. A British surgeon, by the name of Sir John Erichsen, still believed that the abdomen, chest, and brain were inoperable in 1874 (Porter 230). This was because these areas were fairly essential to life and surgery was not the safest. With their technology or lack thereof, any operation done on a brain, chest, or abdomen was believed to be too risky. He actually believed that those would never be able to be operated upon, even though the abdomen began to be operated on no later than 8 years later. After 1850, surgeons no longer had to exclusively perform minor services such as lancing boils, but there could be more serious services, for example, Caesarian section (Porter 202). There were other surgeries such as appendectomies, or removal of the appendix, as well as cholecystectomies, or removal of the gallbladder, and surgeries on the small intestine that were all inaugurated during the Victorian era, mainly around 1882 (Porter 232). Still, with these advances, the more serious services had to be kept

short.
When surgeons finally performed surgeries or their other jobs, they often worked in buildings that resembled factories. However, when the surgeons were called upon by the wealthy, the patients would pay for the surgeons to treat them at home (Malheiro Hospitals). The wealthy would do this because hospitals were not seen as a good place. These factory-like hospitals included overcrowded hospital rooms and, before the Victorian era, surgeries being done without using any type of anesthesia (Malheiro Hospitals). But the poor were forced to go to hospitals because they could not afford to have surgeons or any other doctors come to them. There were only a few actual hospitals in the 19th century. The factory-like hospitals were also not the cleanest which resulted in sickness among the workers and other patients. During the Victorian era, the Sanitary Act of 1866 forced these places to ventilate properly and carry on other acts to eliminate dangers to patient and workers’ health (Lee).
There were many drawbacks to being a surgeon in the Victorian era. The biggest negative was the fact that surgeons did all of the unwanted work that had the opportunity of coating them in blood (Williams). Because of this they often wore their blood stained uniforms as an honor. Another drawback was the fact that handwashing was not widely practiced, which spread infection (Williams). This was a drawback because it meant the surgeons were the cause of the 74% mortality rate among hospital patients who had an amputation at the thigh in the 1870s (Magner 295). In the end, most of the surgeries were successful but resulted in fatal infections. Next, you could only be a surgeon before 1850 if you were male. Even then, the male surgeons could not touch their female patients no matter if it was for research or treatment (Williams). The only exception to this was if it was an emergency like Caesarian section. This renders the idea of surgeons useless if they could not even touch their patients. This ended in 1850 but resulted in a gap of research for women (Williams). Finally, a drawback to being a surgeon was what other surgeons did with that power. For example, in 1872 Robert Battey removed ovaries in women that were considered to be hysterical, insane, or peculiar (Porter 228). This created a certain stigma against surgeons because surgery was being used for questionable uses.
The Victorian era spanned from 1837 to 1901.

In those 64 years, surgeons made many discoveries that caused important advancements in the world of surgery. There were new ways of dealing with infection that also improved public health (Porter 110). These consisted of washing wounds with vinegar, wine, freshly voided urine, or boiled water, then cleaning the wound of foreign objects, then covered in a simple bandage meant it would heal without trouble (Magner 295). These ideas were discovered by Joseph Lister around 1865. Lister was the first to challenge the idea that infection of a wound was inevitable. He found that if a wound was covered in a clean lint dressing and soaked in linseed oil and carbolic then it would not get infected (Porter 231). This discovery was called antisepsis. However, his ideas were not widely accepted. In fact, many surgeons did not like the smell of carbolic, and other’s problems with this were the reason his teachings were not accepted by the American Surgical Association (Porter 231). Another example of the improvement of public health was handwashing. In earlier practices, surgeons did not wash their hands because it was not proven effective until after 1867, and would go from the morgue to laboring women which caused the infant and female mortality rates to increase (Williams). However, Lister also found handwashing helps prevent infection at the same time he discovered the wound dressing (Porter 231). So, during the Victorian era, hand

washing was enforced as it was proved to be effective in controlling infection and putrefaction (Williams). However, the biggest surgery advancements were the introduction of anesthesia and asepsis. Before anesthesia was introduced on October 16, 1846, surgeons had to be very skilled (Joshi Amputations). Performing surgery required a “swift hand, sharp knife, and cool nerve of the operator” (Porter 207). However, when anesthesia was discovered it became a tool that sped up the evolution of surgery. It overcame two major obstacles that surgeons and patients faced: pain and infection (Magner 279). There were many different types of anesthesia, one of which was cocaine introduced by a surgeon named Karl Koller. Surgeons used cocaine as anesthesia in the 1880s because it constricts blood vessels. This made surgery easier in areas where there are many blood vessels. (Magner 293). Another major advancement was asepsis. This was the prevention of introducing germs into surgical sites, which was introduced by William Halsted (Magner 300). He stated, “He would not only use perfectly clean instruments and heat-sterilized water and bandages, he would willingly submit his hands to a rapid flaming after washing them with the greatest care” (Magner 300). When Halsted ceased working as a surgeon, he shared his ideas at Johns Hopkins in the 1890s and was a major leader in the spread of asepsis (Magner 300).
So, surgery in the Victorian era was different than it is now because of those who were surgeons and their schooling, there were different drawbacks, the relationship between surgeons and physicians was not the same, and many breakthroughs happened that we have evolved in order to use today. Surgeons had to go through little to no schooling and therefore different people were surgeons. In those times, there were different negatives to being surgeons due to human rights and the technology available. Over the hundred or so years, the relationship between physicians and surgeons have changed as well as the respect that has come with the jobs. Finally, there were many new breakthroughs in the world of surgery, such as anesthesia and efforts to ensure better hygiene.