Surgery Past Questions and Model Answers
1. James Simpson and Joseph Lister both made important contributions to the
development of surgery.
A) Explain what problems faced surgeons in the early nineteenth century [5]
B) Was Lister’s work more important than Simpson’s in the development of
surgery? Explain your answer [7]
C) ‘After the work of Simpson and Lister there was little left to do in the
development of surgery.’ How far do you agree with this statement? Explain
your answer [8]
Ideas for a model answer to question 1 (this is suggested content only- you
would need to write these ideas in full sentences):
A)
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Explain what problems faced surgeons in the early nineteenth century [5]
Surgeons had to work quickly to minimise pain.
Many patients too frightened to undergo operations.
Problem of ‘shock’ (bloodloss).
Many patients died of postoperative infection.
Because of the problem of infection, amputation of limbs was a frequent
method of treatment (problem of gangrene).
Ignorance of germs.
B) Was Lister’s work more important than Simpson’s in the
development of
surgery? Explain your answer [7]
 Simpson as Professor of Midwifery had used ether as a means of reducing
pain in childbirth.
 Experimented to find better anaesthetics- discovered chloroform- much more
effective anaesthetic and endorsed by Queen Victoria!
 Use of anaesthetics meant that operations could be longer and more
complicated- this also increased chance of infection though.
 Lister heard of Pasteur’s work- insisted that equipment and people in
operating theatres should be kept clean.
 Then read that carbolic acid was used to treat sewage- developed spray- this
led to antiseptic surgery.
 Used in operation on a boy with broken leg- leg was saved and patient
survived.
C) ‘After the work of Simpson and Lister there was little left to do in the
development of surgery.’ How far do you agree with this statement? Explain your
answer [8]
 One big problem remained- bloodloss.
 Blood transfusions had been carried out since the 17th century- needed to
discover about blood groups to make it more effective.
 Needed to be able to store blood in large quantities.
 Complex operations done in aseptic conditions (germ free)
 Better technology needed for more complicated operations.
 Better training for surgeons and nursing staff.
2. Some developments connected with surgery were not fully exploited straight
away. Choose one on the following and complete the questions on this:
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Harvey and the circulation of blood.
Lister and antiseptics.
a) Briefly explain your chosen development [5]
b) Explain why it did not lead to immediate improvement in the success
rate of operations [7]
c) This development did not lead to immediate improvement in the success
rate of operations. Why, then, is it important in the development of
surgery? [8]
Ideas for a model answer to question 2 (this is suggested content only- you
would need to write these ideas in full sentences):
a) Briefly explain your chosen development [5]
Harvey and the circulation of blood:
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Harvey studied at Padua- many new theories on circulation of blood.
Harvey measured flow of blood- found that large amounts flowed through
veins.
Concluded that blood HAD to circulate.
Theory proved by careful measurement and recording.
Lister and antiseptics:
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Lister was aware of problems of postoperative infection and wanted to
overcome them.
Work of Lister- Germ Theory replaced spontaneous Generation.
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Colleague told him of use of carbolic acid in treating sewerage.
Through experimentation showed that use of carbolic as disinfectant
prevented infection.
b) Explain why it did not lead to immediate improvement in the success rate of
operations [7]
Harvey and the circulation of blood:
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Few doctors could understand the thinking behind Harvey’s work.
No immediate applications were obvious.
No understanding of microbes- Germ Theory unknown.
Surgeons did not really understand the function of blood.
Lister and antiseptics:
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Much opposition from nursing staff and surgeons because procedures caused
more work.
Many doctors and surgeons did not understand or believe in the Germ Theory.
Many problems of infection overcome but did not combat the problem of
bloodloss.
Early methods of application (eg spray) were crude and caused patients to
suffer burns.
c) This development did not lead to immediate improvement in the success rate
of operations. Why, then, is it important in the development of surgery? [8]
Harvey and the circulation of blood:
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His work increased knowledge of anatomy.
Basis for future research on blood and anatomy.
Work later helped developments in prevention of bleeding, blood groups and
blood disorders.
His scientific methods were a good example to others.
Compare with ideas on blood before Harvey.
Lister and antiseptics:
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Work was the basis for aseptic surgery.
Allowed for development of complicated surgery (alongside anaesthesia and
transfusions).
Compare conditions in surgery before his work!
NB A good answer here would say that the work is important because of
the change it allowed in the future as well as pointing out how it
improved the situation in the past.
3. Before the nineteenth century there was little progress in the development of
surgery.
a) Describe briefly the problems which held back the development of surgery
before the nineteenth century [5]
b) Explain how surgeons had tried to overcome these problems before the
nineteenth century [7]
c) Explain why surgeons were able to overcome many of these problems during
the nineteenth century [8]
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a) Describe briefly the problems which held back the development of surgery
before the nineteenth century [5]
Restrictions on dissection- poor understanding of the human body so complex
operations eg stomach were not attempted as a result.
Lack of anaesthetics- great suffering for patients as a result.
Bloodloss (shock)- no understanding of the importance of blood (NB bleeding
was a favourite cure-all!)
The Church discouraged operations- pain was seen as intended by God.
b) Explain how surgeons had tried to overcome these problems before the
nineteenth century [7]
Use of laudanum / opium / alcohol to dull pain.
Wine used by some surgeons in the 14th century as a disinfectant to clean
wounds.
Cautery used to reduce / stop bleeding and combat infection.
Speed used to reduce suffering eg in amputations (Lister could remove a leg in
under 30 seconds)
Work done by Vesalius- ‘Fabric of the Human Body’- new knowledge.
Experiments by the Royal Society eg blood transfusions.
c) Explain why surgeons were able to overcome many of these problems during
the nineteenth century [8]
More knowledge eg Germ Theory developed by Pasteur and circulation of
blood (Harvey).
Lister developed antiseptics.
Anaesthetics developed by people like Davy and Simpson.
Use of anaesthetics endorsed by Queen Victoria- this led to widespread
acceptance.
Better communications spread ideas eg Lister aware of work of Pasteur.
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Improved technology eg X-rays and better instruments.
Work of individuals like Pasteur, Lister, Semmelweis, Simpson- all faced
opposition yet continued with work.
Most important was the development of anaesthetics and antiseptics. The
former made possible more complex operations although the death rate from
postoperative infection increased.