11/15 Anesthesia and the Rise of Surgery Puzzles from History of Psychiatric Surgery Rise and fall of lobotomy Lobotomy often done without general anesthesia Risk vs. Benefit? Expediency? Punishment? Origins of Surgery Trephining Prohibitions in the Hippocratic Oath, vs. success of Galen Early modern surgery: Royal College of Barber-Surgeons, 1540 Louis XIV, Francois Felix, and anal fistulae Warfare and surgery: amputations Surgery c. 1800 clip from Master and Commander Violent, gruesome, often deadly: 30-50% operative mortality Mix of practitioners, common and elite Pain and the culture of surgery: masculinity Surprising Histories of Anesthesia Discovery and priority: Wells, Morton, and Long Delayed adoption of anesthesia: calculus of suffering Anesthesia and dentistry Anesthesia in the marketplace: making treatment more appealing Mesmerism as precedent and threat Disparities: women more like, blacks less likely, to receive anesthesia Surgery after Anesthesia Initial increase in mortality: longer operations, more infections Laudable pus Lister, antisepsis, and asepsis Surgical successes in 1880s and 1890s Improving prestige of doctors and hospitals Persistence of a masculine culture