Medicine Through Time Surgery Revision

Surgery and Anatomy in the Ancient World



The Prehistoric World 

  

Surgery ‐ was limited by their knowledge of the human body and the tools they had available, however there is evidence that their procedures were successful:



 They would cut a hole in the skull in order to let out bad spirits which were believed to be the cause of severe headaches. This is called trephining  <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">(sometimes trepanning). Many patients <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> survived this operation, which is shown by skulls which show evidence that the wound <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> started to heal.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">There is evidence that prehistoric people may have used splints in order to stabilise broken bones to allow them to heal naturally.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Recent evidence has suggested that some prehistoric people were able to perform amputations which the patient also survived. This suggests that they were able to control <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">bleeding and infection to some degree.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy – their knowledge of the human body was limited. Some basic knowledge is indicated by:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Cave paintings show animals being speared through the heart which shows an understandingthat the heart is an important organ.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Attacks by wild beasts would have caused some serious injuries to people, allowing some knowledge of the inside if the body to be gained.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Ancient Egypt 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery – Ancient Egyptian surgery improved on prehistoric surgery for a few reasons:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Egyptian metal working was better so that surgeons had sharper and stronger tools to work with. They could perform more minor surgery e.g. removing tumours.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Egyptians understood that honey had healing properties and it was used to treat wounds.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">They bandaged wounds and kept them clean.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy – Ancient Egyptian understanding of the human body also improved on prehistoric times:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">The process of   <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">mummification  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">involved the removal of the internal organs of the body in order to preserve the body for the after‐life. This gave them a better understanding of the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> inside of the body. The Egyptians had names for the heart, lungs, liver etc.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The Egyptians believed the heart was the centre of the body where the soul of a person wasto be found and thinking took place. They thought that the heart was connected to the rest <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> of the body through channels.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The Egyptians wrote down their knowledge on papyrus scrolls which allowed future generations to build upon it.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">However, there were limitations to Egyptians’ knowledge:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Embalmers (who did the mummification) were not doctors and would not have passed on much knowledge about the internal organs.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ The internal organs were also preserved in separate jars, so they were not dissected.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Human dissections were not allowed because the whole body was needed for the after‐life.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Ancient Greece 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery – Greek surgery improved on the Egyptians:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">The Greeks used wine and vinegar to clean wounds. These would have acted as antiseptics.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Greek metal was even stronger and sharper than Egyptian allowing more precise surgery.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Greek surgeons even successfully operated to drain the lungs of a patient suffering from pneumonia.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The Greeks fought many wars and surgery dealing with war wounds improved with this experience, e.g. removing arrowheads, setting broken bones.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy – This was the biggest area of improvement in Ancient Greece:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Aristotle carried out many animal dissections and argued that all knowledge should be based on careful observation.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">The city of <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Alexandria <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">was founded by Alexander the Great in 331 BC. It became the centre of learning based around the university and enormous library. Alexandria was the only place <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> in the Ancient World where human dissections were allowed.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The greatest Greek doctor <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> working in Alexandria was '''<span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Herophilus. '''<span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He discovered:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ it is the brain which controls the body

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ the difference between arteries and nerves

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ the different parts of the stomach and intestines

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ the link between the beat of the heart and the pulse

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Ancient Rome 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery – the Romans continued the successful progress of the Greeks:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">They used opium as a mild anaesthetic.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The Roman Army developed more and more techniques to deal with injuries suffered in battle. Each major Roman Army camp had a sophisticated hospital.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy –

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Galen <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">(who was born in Greece) trained at Alexandria. He travelled to Rome and became doctor to the Roman Emperor. Galen performed live dissections of animals to demonstrate <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> his knowledge of anatomy. Most famously he cut the spinal cord of a pig at different places <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> to show that the nerves control different actions in the body.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Galen wrote many books about anatomy. These were largely based on his dissections of animals. The books contained a lot of useful knowledge but also had some errors as the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> human body is not the same as other animals.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 18.0pt;mso-bidi-font-size:14.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">(ii) Surgery and Anatomy from the Middle Ages to the Renaissance

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<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">The Middle Ages 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">After the fall of the Roman Empire, there was a period of decline in knowledge and understanding of surgery and anatomy during the Dark Ages. After this, the Middle Ages saw a recovery of knowledge.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">By the end of the period (about 1450 AD) the standard of surgery and anatomy was probably back to <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> Roman levels.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery – surgeons were looked down on by other doctors in the Middle Ages. Surgery was not thought to be a proper part of medicine. Most surgeons were barber‐surgeons who learned their <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> trade as apprentices not at university.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Compared to the Dark Ages, there was significant improvement in surgery during the Middle Ages:

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The large number of wars in the Middle Ages gave surgeons plenty of opportunity to practise operations. Pictures of ‘Wound Men’ show all of the injuries that surgeons learnt to deal with.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">John of Arderne was the most famous medieval surgeon in England. He developed new methods based on careful observation and practice.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Surgeons in the Middle Ages made mild anaesthetics using hemlock and henbane

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">However, surgery in the Middle Ages was still limited in development because:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgeons still relied on supernatural beliefs such as consulting a Zodiac chart to work out the best time to operate on a patient.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy – unlike surgery, anatomy was considered to be a proper part of medical training and was studied at the universities where doctors trained. Like surgery, knowledge of anatomy began to <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> improve in the Middle Ages after the decline of the Dark Ages:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">At first dissections were banned by the Church which ran all of the universities where anatomy was studied. This was because the body would be needed in the after‐life. Later in the Middle <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> Ages, the Church allowed each university to do one dissection per year on a convicted <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> criminal’s body. These dissections were carried out by an assistant whilst the professor would <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> read out from Galen’s books. If there was a difference between the body and the book, they <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> thought that the body must be wrong. Despite these limitations, these dissections did <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> improve people’s knowledge of anatomy.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery – most surgery in the Renaissance stayed much the same as in the Middle Ages. Surgeons mostly only performed three operations – trephining, amputations and removing tumours.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">One <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> surgeon who did make advances during the Renaissance was <span style="font-size:13.0pt;mso-bidi-font-size: 11.0pt;font-family:"Calibri-Bold","sans-serif";mso-bidi-font-family:Calibri-Bold">Ambroise Paré <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt; mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family: Calibri">:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">After working as a barber‐surgeon, Paré got a job as a surgeon for the French Army. The traditional method of treating gunshot wounds was to pour boiling oil into the wound to <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> cauterise it (burn it). This was agonisingly painful. Paré ran out of boiling oil during one battle <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> when there were lots of French casualties – he was forced to improvise. He came up with a <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> new ointment using turpentine, which he had read about in a book about Roman surgery.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The new ointment worked very well and he never used boiling oil again.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Paré also used ligatures (made of silk thread) to tie the ends of arteries after he had done an amputation. This was instead of the traditional method of cauterising the stump with a hot <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> iron bar. Again, this was better because the patient did not suffer agonising pain. The one <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> drawback with Paré’s ligatures was that he did not know they had to be sterilised, so the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> wounds often got infected and many surgeons stuck to the old cauterising method.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anatomy ‐ there were certain features of the Renaissance which allowed advances to be made in the knowledge of anatomy:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Reduction in the power of the Church <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">– this meant that universities were not limited to one dissection per year any more. It also encouraged doctors to challenge the work of Galen, who the Church had believed was right about everything.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Scientific study <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">– there was much more interest in the Renaissance about finding out things through observation and experiment rather than just relying on books.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">New artistic techniques <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">– much more accurate pictures could be drawn of the human body which allowed doctors to learn more and share their knowledge.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">The printing press <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">– books could now be mass‐produced so doctors could circulate their new knowledge much more widely and quickly.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Two doctors in the Renaissance who made hugely important breakthroughs were

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Andreas Vesalius <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">and '''<span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">William Harvey. '''

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Andreas Vesalius <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">became Professor of Anatomy at Padua University in Italy in 1537. He contributed a huge amount to the understanding of anatomy in the Renaissance because:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">He studied the human body itself and did not just rely on Galen’s books. Vesalius is said to have stolen the body of an executed criminal when he was a student in order to study the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> skeleton. He performed many public dissections at the university.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He pointed out several mistakes which Galen had made including:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ the human jaw is only one bone not two as Galen had said

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ the septum in the middle of the heart does not have tiny holes in it as Galen had claimed

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He wrote a book on anatomy called <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt; font-family:"Calibri-Italic","sans-serif";mso-bidi-font-family:Calibri-Italic">On the Fabric of the Human Body <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">, which was read across Europe. The book contained many accurate pictures of the human body.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">William Harvey <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">proved that the heart is a pump and that the blood circulates around the body.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Harvey is typical of the Renaissance because:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He challenged Galen’s ideas about the heart and the nature of veins and arteries.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">He proved his ideas through careful experimentation, observation and measurements. For example, he dissected live lizards to observe their hearts beating. He tried to force thin rods <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> and liquids the wrong way up arteries to show th <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">at the blood circulated in one direction.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He wrote a book about his discoveries.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">He faced opposition from other doctors who were unwilling to believe that Galen could be wrong.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Conclusion

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Both Vesalius and Harvey made very important discoveries about anatomy which laid the foundation

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">for future advances. However, during the Renaissance their ideas did not contribute much to improving treatments or surgery. For example, William Harvey continued to use bleeding as a <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> treatment even though he had proved that there is the same amount of blood in the body at all times.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Ambroise Paré did improve the treatment of gunshot wounds but this would only have affected a small number of people.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 18.0pt;mso-bidi-font-size:14.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">(iii) Surgery and Anatomy since 1800

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 18.0pt;mso-bidi-font-size:14.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">The Nineteenth Century 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">In 1800, surgery was still very dangerous. The death rate during and after surgery was still very high – around 50% ‐ for three main reasons: PAIN, INFECTION and BLOOD LOSS. Over the next century (plus a little bit) these three problems were reduced and surgery became much safer.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Pain

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Many patients died of shock due to the pain of surgery. In the 1840s surgeons became interested in chemicals which could relieve pain, i.e. <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">anaesthetics <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">. The first of these was <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt; font-family:"Calibri-Bold","sans-serif";mso-bidi-font-family:Calibri-Bold">nitrous oxide <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt; mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family: Calibri">(laughing gas) which was especially used by dentists. It was not ideal though because it could not knock out patients sufficiently for major operations. The second chemical tried was <span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">ether <span style="font-size:14.0pt; mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">. This was more powerful but it has some drawbacks – it irritated the patients’ lungs; it made patients vomit; and it was mildly explosive.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">In 1847, <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">James Simpson  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">decided to try to find a more suitable anaesthetic. He sniffed a range of chemicals until he found <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">chloroform  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">. This was powerful enough to knock out patients without the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> side effects of ether. He first used small doses to ease the pain of women giving birth. Simpson faced <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> a lot of opposition, for example:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Some religious leaders thought that it was unnatural and against God’s wishes for the pain of childbirth to be reduced.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Some doctors were concerned that it was difficult to decide on the correct dose (this was made worse when one patient died of too much chloroform in 1848.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Other doctors claimed that chloroform might have long‐term side effects which were not yet <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> known.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Simpson argued back against all of these objections and he was greatly helped when Queen Victoria used chloroform to help with the birth of her eighth child in 1 <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">857. After this, chloroform became <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> widely used for all types of surgery.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Anaesthetics were hugely successful in overcoming pain in <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> surgery, however, they actually made the problem of infection worse. This was because surgeons <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">could now take longer over operations as the patient was not writhing around in agony and they could also cut more deeply into the body. Both of these developments meant that more germs could get into the body.

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<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;tab-stops:61.7pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;tab-stops:61.7pt;mso-layout-grid-align:none;text-autospace:none"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Infection

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;tab-stops:61.7pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">In 1864, <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Joseph Lister <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">read Louis Pasteur’s work on Germ Theory and became convinced that germs were the cause of ‘hospital fever’ (the name for the infection which many patients died of after surgery). Lister decided to look for something which would kill the germs in his operating theatre. He developed <span style="font-size:13.0pt; mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif";mso-bidi-font-family: Calibri-Bold">carbolic acid <span style="font-size:14.0pt; mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">as the first <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">antiseptic <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">He tried it out on a boy called James Greenlees who had badly broken his leg. Normally the leg would have been amputated, but Lister set the leg straight and wrapped it in bandages soaked with carbolic acid. The boy’s leg healed perfectly and he suffered no infection. Lister then developed a carbolic acid spray to disinfect the area around an operation. Later, he soaked all of his tools in the acid too. The death rate for Lister’s operations fell from 50% to 15% in just 4 years.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Like Simpson, Lister also faced a lot of opposition, for example:

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Many surgeons still did not believe in Germ Theory. They could not accept that something as small as a germ could kill a human.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Lister was not a good public speaker. His speeches were quite boring and his written notes were very detailed and hard to read.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Lister kept changing his methods to improve them, but some surgeons said this was because they were no good.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Carbolic acid irritated surgeons’ hands and skin.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">‐ Operations with carbolic acid became slower and more expensive which put a lot of surgeons off.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Lister slowly overcame this opposition when he showed that the death rate in his operations had fallen as low as 5%. He was also helped by the work of Robert Koch who discovered the specific bacteria which causes septicaemia in 1878. Lister could then demonstrate that his carbolic acid could kill the germ which caused blood poisoning.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Aseptic Surgery  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">was an improvement on Lister’s antiseptic surgery. In the 1880s and 1890s, surgeons developed new techniques which aimed to prevent germs getting into the area of the operation at all.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">These new ideas included:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Sterilising surgical instruments with steam. In the 1880s, Robert Koch demonstrated that steam <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> was more effective than carbolic acid at sterilising the tools.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">William Halsted <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">, an American surgeon, invented sterilised rubber gloves in the 1890s.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Operating theatres and hospitals were rigorously cleaned.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">As a result of these improvements new types of surgery could be attempted. The first successful <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> operation to remove an appendix happened in the 1880s and in 1896 the first operation to repair a <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> heart was carried out.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">The Impact of the First World War 

<h3 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Blood Loss

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgeons had tried blood transfusions for many years to try to overcome the problem of excessive bleeding during surgery. However, they could not work out why many patients died after receiving <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> blood from someone else. In 1901, a German doctor (Landsteiner) discovered that there were different <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> blood groups and that you could only give certain types of blood to different patients.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">After this discovery successful blood transfusions could take place, but there was one major limitation - the person giving blood and the patient receiving it had to be lying next to each other because if they tried to store the blood it would simply start to clot.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">During the <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">First World War (1914 '<span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math"">‐ '<span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">18) <span style="font-size:14.0pt; mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">the need for a better method of blood transfusion became urgent. There were thousands of wounded soldiers whose lives could be saved if a way of storing blood could be discovered. During the war scientists worked together and actually developed two ways of storing blood:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">They found that if you separate the blood cells from the liquid part of blood (plasma), the cells could be stored in ice. When they were needed, the blood cells could be rehydrated with saline <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> solution.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Other doctors discovered that by adding sodium citrate to blood it stopped it from clotting

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h4 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Conclusion

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Between 1840 and 1918, therefore, the three main causes of death during and after operations (pain, infection and blood loss) had been massively reduced. However, surgery in 1918 was still more <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> dangerous than it is in the present day because, throughout the rest of the 20 <span style="font-size:9.0pt; mso-bidi-font-size:7.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">th <span style="font-size:14.0pt; mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">century and up to the present day, scientists and surgeons have continued to make important breakthroughs in the <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> technology and safety of surgery.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">X‐Rays

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">X‐rays had first been discovered by a German scientist – William Röntgen – in 1895. He discovered that the rays could pass through human flesh but not bone or metal. X‐ray machines were immediately developed and installed in hospitals.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The First World War had a significant impact on the development of x‐ray technology because of the number of wounded soldiers who needed to have bullets or shrapnel removed from their bodies. X‐rays proved very useful in allowing surgeons to accurately locate the metal objects inside the body. During the war the first mobile x‐ray machines were invented.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none">

<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">The Twentieth Century 

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:14.0pt;mso-bidi-font-size:12.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">  

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The speed of advances in surgery increased dramatically in the 20 <span style="font-size:9.0pt;mso-bidi-font-size: 7.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family: Calibri">th <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt; mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family: Calibri">century, for example:

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Plastic Surgery

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The solution to the problem of storing blood for blood transfusions happened during the First World War (1914‐18) which was in the 20 <span style="font-size:9.0pt;mso-bidi-font-size:7.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">th <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">century. Another advance which was speeded up by the First <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> World War was the development of plastic surgery. Harold Gillies set up the first dedicated centre <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> for plastic surgery in England in 1917. Gillies’ cousin – <span style="font-size:13.0pt;mso-bidi-font-size: 11.0pt;font-family:"Calibri-Bold","sans-serif";mso-bidi-font-family:Calibri-Bold">Archibald McIndoe <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt; mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family: Calibri">– continued his work in <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> the 1930s. In 1938, McIndoe was appointed as Consultant in Plastic Surgery to the R.A.F.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">During the <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Second World War (1939 '<span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math"">‐ '<span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">45), <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Archibald McIndoe operated on many badly burned aircrew. He reconstructed their faces but also recognised that they would need psychological <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> support in order to recover. He called the airmen his ‘Guinea Pigs’ and the Guinea Pig Club still <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> meets today to honour him.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">The First Transplants

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">In 1954, the first successful kidney transplant was carried out. It was between two twin brothers so they matched perfectly and the transplanted kidney was not rejected. In 1959, doctors discovered <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> the drug imuran which could suppress the immune system and prevent transplanted kidneys being <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> attacked by the patient’s immune system.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">By 1967, the technology existed for the first successful heart transplant to take place. This was carried out by <span style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Christian Barnard <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">. He was able to carry this out due to a number of factors:

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He led a team of highly trained anaesthetists and nurses.

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">He used X‐rays to monitor the lungs.

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-US" style="font-size:13.0pt;mso-bidi-font-size:11.0pt;font-family:SymbolMT; mso-hansi-font-family:Calibri;mso-bidi-font-family:SymbolMT"> <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri; mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri">Blood chemistry and urine were analysed in a laboratory.

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<h2 class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Surgery in the Present Day

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">

<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">Two significant advances which have been made in recent years are:

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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">(i) <span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Keyhole surgery  <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">– this is where a very small incision in the patient’s body is made and the surgeon uses fibre‐optic cables to look inside the body and an endoscope which has tiny tools for performing the operations. The advantage of keyhole surgery is <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri"> that it does not leave a serious wound for the patient to recover from.

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<p class="MsoNormal"><span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">(ii)  <span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold">Micro surgery '<span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math"">‐ '<span style="font-size: 13.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri-Bold","sans-serif"; mso-bidi-font-family:Calibri-Bold"> <span style="font-size: 14.0pt;mso-bidi-font-size:11.0pt;mso-ascii-font-family:Calibri;mso-hansi-font-family: Calibri;mso-bidi-font-family:Calibri">By magnifying the area a surgeon is working on it is now possible to perform operations on tiny nerves and blood vessels. For example, severed limbs or <span style="font-size:14.0pt;mso-bidi-font-size:11.0pt; line-height:115%;mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri; mso-bidi-font-family:Calibri"> hands can be sewn back on and the feeling restored.