The history of surgery dates back to prehistoric times, with earliest written accounts of its practice dating from Mesopotamia and Egypt. It then moved into the Ancient Greek and Roman worlds and then on to the Dark Ages and Renaissance. The history of surgery is full of gruesome vignettes and dramatic tales of early discoveries, such as trepanning and stone cutting, but also includes key developments, such as the discovery of anaesthesia and antisepsis.
Hunter’s fundamental pathologic studies were first detailed in A Treatise on the Blood, Inflammation, and Gun-Shot Wounds (1794). His collection of more than 13,000 surgical specimens represented an unprecedented warehousing of organ systems and the interaction between structure and function. These advances greatly increased the knowledge of surgery, and the history of surgery is one of the most comprehensive and detailed of all. This history is essential reading for any surgeon.
Halsted was an early pioneer of medical education at Johns Hopkins, establishing the first formal surgical residency training program in the United States. His system centered on European concepts, and established a two-year house surgeon training program. In the process, he created role models for future generations of surgeons, including Harvey Williams Cushing and Walter Dandy. He also pioneered the use of local anesthetics and aseptic techniques, and introduced the use of rubber gloves in operating rooms.
By the mid-19th century, surgeons were widely respected, viewed as highly skilled clinical physicians. However, until this time, the field of surgery had only a modest scope. It consisted of treating simple fractures, dislocations, abscesses, and amputations. Surgical skills were viewed as an art form, and it was associated with religious overtones. Some patients chose to die of their disease rather than undergo the procedure, despite the fact that surgery has been around for thousands of years.
Galen’s ideas dominated surgical thought for about 1,300 years. Galen’s ideas were based on animal dissections, which could have been put to better use. It also fueled massive misconceptions in the minds of generations of physicians. During the Medieval Age, surgeons became craftsmen who often wore barbers’ clothing. During the Crusades, an English surgeon treated Prince Edward. He did not understand that the same theories applied to humans and were not universally applicable.
The practice of surgery in India dates back to at least 400 BC, when barbers traveled the world performing minor surgeries. They removed organs to perform mummification and used alcohol and herb mixtures to alleviate pain during the operation. They used saws, forceps, and scalpels to treat abscesses. Before the 1700s, women were not allowed to become physicians, but they practiced surgery, and reconstructive rhinoplasty was common in India.
Andreas Vesalius was a professor in the 16th century in Padua, Italy. In those days, many of the anatomical knowledge was based on animal dissection and servants. Vesalius proposed a hands-on approach for physicians and corrected the many misconceptions based on animal dissections. His work De Humani Corporis Fabrica Libri Septem was published in 1543 and became the most comprehensive anatomy text of its day. Despite its short lifespan, it has become the basis for two centuries of anatomical study.
