One the most valuable medical legacies of Dr. J.S. Helmcken, was that he wrote about his medical experiences and preserved, in order, all the medical instruments he used in his long career.
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19TH CENTURY MEDICAL HISTORY
During Dr. John Sebastian Helmcken's lifetime, the course of medicine changed completely, and laid the groundwork for medical care as we know it today.
When he began his studies at Guy's hospital in 1844, anesthetics were not in use, and germ theory was unknown. As a result, surgery was a last resort and, of necessity, a quick one the surgeon had only three minutes in which to do his work, before the patient went into shock. Those who survived the agony of an operation often developed infections from the lack of sterile conditions, and these were sometimes fatal.
Under these conditions, operations consisted of basic routines, carried out when all else had failed. Some of the many instruments in the Helmcken Medical Collection are shown here, and were used for such surgical procedures.
Amputation:
Amputation was used to remove the diseased or wounded parts of the body, to halt the spread of gangrene and, hopefully, prevent death. In the box of instruments awarded to Dr. Helmcken at Guy's hospital is the saw, double-bladed knives, tourniquet, suturing needles and silk that were used in amputations.
Trepanation:
Trepanation involved the removal of a small piece of bone from the skull. This was the only way to relieve pressure caused by a head injury, and was an ancient operation, going back to the Neolithic Period (6000 - 3000 BC). In the same set of instruments, there is a Hey's saw, a trepanning saw, and an elevator, all used in trepanation.
Phlebotomy:
Phlebotomy, or bloodletting, was engaged to relieve the patient of what was thought to be an overabundance of blood, causing disease or poor health. This was in accordance with medical thinking of the earlier centuries, which carried over into the beginning years of the 1800's.
This belief held that symptoms were caused by too much blood, phlegm, yellow bile or black bile, known as the "four bodily humours". The scalpels, scarificators, pump-syringe, vacuum-glasses, and sets of glass cups in graduated sizes (in chamois covers, to avoid chipping) were all used in this practice.
With the gradual acceptance of the use of anesthetics, the course of surgery changed. The three which were all discovered by 1831 - ether, nitrous oxide gas, and chloroform - had been slow to gain acceptance, although several doctors had experimented with them. In 1846, a dentist, Dr. W.T.C. Morton, gave a demonstration of the use of ether to a class at Harvard, which marked a turning point in medicine. From then on, surgeons were able to operate on relaxed and unconscious patients.
The use of anaesthetic and the discovery that bacteria was the origin of disease were the two major medical discoveries of the 19th Century. From theories pioneered by doctors such as Oliver Wendell Holmes (Boston, 1843), Ignaz Semmelweis (Vienna,1851), Louis Pasteur (France,1860), and Joseph Lister (Glasgow, 1867), the realization that infection was caused by germs was gradually admitted. It was not until the 1880's, however, that the whole medical community accepted this fact, and adopted procedures to contend with it.
By the time Dr. John Sebastian Helmcken retired from his medical Practice, he had witnessed a complete change in the treatment of diseases and injuries. From the early years, with all of the frustrations and unknowns, to the later ones, with some of the hindrances removed, it was an incredible period in the history of medicine.
New Doctor in a New LandView the Helmcken House Collection
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