Surgery Practice Paper How to win at this paper Yellow booklet practice paper two

What can you learn from Source A about how operations were carried out before anaesthetics

Q1: Learning from the source (6 marks) Label the source (just as we did) At least 2 x ‘SUGGEST’ e.g. There are lots of men holding down the patient, this suggests that patient was in an extreme amount of pain Use your own knowledge to expand the points ‘There are lots of men holding down the patient, this suggests that patient was in an extreme amount of pain. From my own knowledge I know that during this period, the only real form of pain relief was alcohol, which would not have been sufficient to numb the pain in this type of operation.’ = 3 marks!

Study source B and your own knowledge What was the purpose of this representation? (8 marks) A painting about the first use of ether as an anaesthetic. It shows an operation carried out in the USA by Dr Warren and Dr Morton in 1846.

Q2: Purpose (8 marks) Label the source (just as we did) and the text! 3 paragraph points: ‘The purpose of the painting is to show the calmness of the use of ether, this is shown by the fact that the clean, white light is on the patient and its almost heavenly. This allows the author to show that the patient is calm and safe. The purpose could also be to show how new this anaesthetic is as the author shows lots of people watching in a theatre. From my own knowledge I know that when Ether was first used there were lots of problems with it, as it was highly flammable and quite dangerous as it was such a new substance.’ THIS WOULD GET YOU 5 MARKS

Q3 Why was the discovery of ether so important? (10)

From the Boston Daily Evening newspaper, 1st October 1846 ‘Dr Morton has discovered something which can reduce sufferings of those who need painful operations in dentistry and surgery and make the operation easier for the surgeon to carry out. He can make the patient unconscious and any operation can then be performed without causing pain. We are told by a gentlemen of the highest respectability that he witnessed an experiment carried out by Dr Morton last week. A bad tooth was taken out without giving the patient the slightest pain. He was put into a kind of sleep by inhaling this preparation. The sleep lasted less than a minute, just long enough to extract the tooth. This discovery is destined to make great revolution in surgery and dentistry.’

3. Why was…so successful/important (10 marks) Label the source (just as we did) QUOTE, OWN KNOWLEDGE, KEY WORD FROM THE QUESTION 3 paragraph points ‘The discovery of ether and its importance is shown throughout the source, but its importance is different for a number of reasons. Firstly it is important due to the fact it ‘can reduce sufferings of those who need painful operations’. From my own knowledge I know ether to be a stronger anaesthetic than previous anaesthetics, such as Humphrey Davy’s laughing gas, which made you less aware of pain, but didn’t ‘into a kind of sleep’ like Ether. It numbed the senses for longer and allowed the patient be free from pain for longer than ever before, showing why it is important. Secondly ether is important because it can ‘make the operation easier for the surgeon to carry out’. Before anaesthetics I know from my own knowledge that surgeons had great difficulty performing operations as the patient often had to be held down due to the pain of performing surgery without the use of anaesthesia. Laughing gas made the patient more comfortable, but ether produced a very deep sleep which, from my own knowledge, could last for days! This is important because it allowed the surgeons longer to perform intricate surgery as the patient was not thrashing around, or the surgeon worried the pain relief would run out.’

Study sources D, E and use your own knowledge HOW RELIABLE ARE THEY OF THE SUCCESS OF CONQUERING PAIN IN THE 19TH CENTURY?

Use three of these to evaluate the source Miss H would probably use: 4. Reliability (10 marks) Use three of these to evaluate the source Miss H would probably use: Who What When Who wrote it? What is it? Where was it written? When was it written? Why was it written? ALSO OWN KNOWLEDGE ALSO A JUDGEMENT

Source D: a brief history of medicine by Paul Strathern, 2005 Source D: a brief history of medicine by Paul Strathern, 2005. Here he is writing about the introduction of anaesthetics ‘A newspaper headline announced ‘We have conquered pain!’ but people remained unconvinced. There was widespread speculation on religious grounds especially about the use of anaesthetics during childbirth. According to the bible, God had said childbirth would be accompanied by pain. More serious objections came from the medical opposition to ether. It found that this could damage the lungs and occasionally cause vomiting which, if happened during an operation, could lead to the death of a patient.’

How would I use it? Source D shows that anaesthetics were not completely successful in conquering pain. Source D is written by a historian, Paul Strathern, in a book A Brief History of Medicine, in 2005. I know a source of this kind would have meant the author would have had to do a lot of research, and would want to try to produce an accurate account of conquering pain, therefore we can see that it is fairly reliable. Strathern shows ether was not dangerous and from my knowledge I know some of the evidence to be reliable, for example ether ‘could cause vomiting’. I also know it was very flammable, which was really dangerous as most light was from candles or gas lights in this time. I also know Strathern’s work to be quite reliable, as I know there was ‘widespread opposition on religious grounds’, but also because ether was difficult for surgeons to carry around as it had to be carried in large glass bottles. Most surgery was still done at home, so this was another reason why people opposed it. Overall Strathern’s source is reliable and shows that although they managed to conquer pain, it was not completely successful because of opposition and danger to the patient, particularly with Ether.

Source E: From Queen Victoria’s journal 1853, describing her reaction when she was given chloroform for the birth of her 8th child. ‘Dr Snow gave me the blessed chloroform and the effect was mild, calming and beautiful beyond belief.’

How would I use it? Source E is a source from Queen Victoria’s journal, who actually experienced pain relief, so this makes her journal source quite reliable. She describes it as ‘blessed…mild, calming and beautiful beyond relief’, this shows us that conquering pain was extremely successful. However, the reliability of this source is not complete. Queen Victoria is just one person who experienced chloroform, not everyone had the same experience. From my own knowledge I know Hannah Greener died after having her toenail removed under the influence of chloroform in 1848. Queen Victoria would have also had the highest form of medical care, not everyone would have had the same experience as her, so the source is not completely reliable. Overall the source shows there was success in pain relief, however this is only one persons experience so can’t be completely reliable/

Judgement! Overall, I think source D is more reliable as evidence of success in conquering pain. It shows that although there were some successes, methods to overcome pain were still dangerous and also opposed. Although source E shows it as a success, it is only one account and cannot be completely relied upon as evidence of the success of pain in the 19th century.

Study Sources A, D and G and use your own knowledge ‘Surgery has improved significantly with the use of anaesthetics in the 19th century.’ Key points: Both sides of the argument ALL the sources: A, D and G What do they show? Do they support the argument in the question? What don’t they show? Do they disagree with the argument in the question? Own knowledge Judgement/conclusion

‘Surgery has improved significantly with the use of anaesthetics in the 19th century.’ Agree disagree Anaesthetics were a major step forward eliminating the pain suffered in operations. John Snow carried out thousands of operations using the anaesthetic Chloroform and his inhaler without a single overdose. Surgeons could carry out operations without the danger of the patient moving about due to the extreme pain they were experiencing. Ether made the patient cough and vomit and was flammable. Simpson’s discovery of Chloroform was followed by the ‘Black Period’ in which many patients died of overdoses. The use of anaesthetics did not overcome the problems of infection and blood loss. ‘Fearful and feeble’ patients were likely die from an overdose until Snow’s inhaler became widely used. Surgeons became over-confident and carried out lengthy operations which increased deaths from infection.