The Horrors of Amputation, the Liston Knife, and the Silvester Method

During the grisly scene at the hospital in Episode 5, “A Second Death,” Elise is mistaken for a nurse and forced to witness a critically injured patient undergoing an amputation. This is just one more example of how Borrowed Lives takes listeners back in time to real places and circumstances that were part of life in 1870s Chicago. Although medical science had already made many advances, treatments were still far more barbaric than they are now.

The Liston Knife, used by the doctor to amputate the injured man’s arm, was invented by Robert Liston. He was a Scottish surgeon known for his speed and skill, which made a significant difference in terms of pain and survival before the invention of anesthesia. The knife was 6–8 inches long and made out of high-quality metal.

Medical amputations were common despite being risky because not all doctors understood the importance of sterilization. Even after anesthesia was available, blood poisoning or sepsis was a major threat, leading to high mortality rates. But amputation was often the best option to prevent death from infection.

Lucky for us, anesthesia was invented. An early version was first used at Massachusetts General Hospital in Boston by dentist William T.G. Morton and surgeon John Warren on October 16, 1846. In Borrowed Lives, the doctor uses Ether, but in 1871, some doctors might have also used chloroform or nitrous oxide mixed with oxygen (the use of this new anesthetic blend was proposed by Dr. Edmund Andrews in Chicago in 1856).

During the scene, when the patient goes into cardiac arrest, the doctor says they must use the Silvester method to revive him. This method was an early form of CPR, developed by Henry Silvester in 1858. A person is placed on their back and their arms are raised above their head to expand the chest and draw air into the lungs. Then, the arms are pressed against the chest to force exhalation. The process would be repeated rhythmically until the patient is revived or declared dead.

Of course, we now use much more effective methods for resuscitation, mouth-to-mouth and chest compressions. I think everyone would agree that we are lucky to live in modern times for many reasons, but especially if we have to undergo surgery.

Sources:

Henry Silvester

https://en.wikipedia.org/wiki/Liston_knife
https://www.umhs-sk.org/blog/medical-milestones-discovery-anesthesia-timeline