A BRIEF HISTORY OF SURGERY
By Tim Lambert
The first evidence of surgery is trepanned skulls from the stone age. Some adults had holes cut in their skulls. At least sometimes people survived the 'operation' because the bone grew back. We do not know the purpose of the 'operation'. Perhaps it was performed on people with head injuries to release pressure on the brain.
The Egyptians did have some knowledge of anatomy from making mummies. To embalm a dead body they first removed the principal organs, which would otherwise rot.
However Egyptian surgery was limited to such things as treating wounds and broken bones and dealing with boils and abscesses. The Egyptians used clamps, sutures and cauterisation. They had surgical instruments like probes, saws, forceps, scalpels and scissors.
They also knew that honey helped to prevent wounds becoming infected. (It is a natural antiseptic). They also dressed wounds with willow bark, which has the same effect.
The Ancient Greeks bathed wounds with wine. (The alcohol helped to prevent infection).
In the Roman Empire techniques of surgery were dominated by the ideas of Galen. He was interested in anatomy. Unfortunately by his time dissecting human bodies was forbidden. So Galen had to dissect animal bodies including apes. However animal bodies are not the same as human bodies and so some of Galen's ideas were quite wrong.
Unfortunately Galen was a very influential writer. For centuries his writings dominated medicine.
After the fall of the Roman Empire in the West surgery, along with other crafts, declined in Western Europe. However ideas about anatomy and techniques of surgery were kept alive by the Arabs and in the 12th and 13th centuries they returned to Europe.
Meanwhile in India surgeons were highly skilled. They were pioneers of plastic surgery. Because people were often punished by having their nose cut off an operation to reconstruct the nose (rhinoplasty) was common.
Surgery in the Middle Ages
In Europe in the 13th century a new type of craftsmen emerged in towns. He (or she because not all were male) was the barber-surgeon. They cut hair, they pulled teeth and they performed simple operations such as amputations and setting broken bones.
From the mid-14th century the church allowed some dissections of human bodies at medical schools. However Galen's ideas continued to dominate medicine and surgery.
Surgery in the 16th Century
In the 16th century surgery did become a little more advanced. Leonardo Da Vinci (1452-1519) dissected some human bodies and made accurate drawings of what he saw.
However the greatest surgeon of the age was Andreas Vesalius (1514-1564). He did many dissections and realised that many of Galen's ideas were wrong. In 1543 he published a book called The Fabric of the Human Body. It contained accurate diagrams of a human body.
Vesalius's great contribution was to base anatomy on observation not on the authority of writers like Galen.
Another great surgeon was Ambroise Pare. In the 16th century surgeons poured hot oil onto wounds. However in 1536 during the siege of Turin pare ran out of oil. He made a mixture of egg yolk, rose oil and turpentine and discovered it worked better than oil. Pare also designed artificial limbs.
In the 16th century syringes were used to irrigate wounds with wine.
In the 18th century surgery did make some progress. The famous 18th century surgeon John Hunter (1728-1793) is sometimes called the Father of Modern Surgery. He invented new procedures such as tracheotomy.
In 1792 a Frenchman named Dominique-Jean Larrey created the first ambulance service for wounded men.
Surgery in the 19th Century
In the 19th century surgery was greatly improved by the discovery of anaesthetics. As early as 1799 the inventor Humphrey Davy (1778-1829) realised that inhaling ether relieved pain. Unfortunately decades passed before it was actually used as an anaesthetic in an operation 1842.
James Simpson(1811-1870), who was Professor of Midwifery at Edinburgh University, began using chloroform for operations in 1847.
In 1884 cocaine was used as a local anaesthetic. From 1905 Novocain was used.
Surgery became much more advanced in the 19th century. In 1865 Joseph Lister (1827-1912) discovered antiseptic surgery, which enabled surgeons to perform many more complicated operations. Lister prevented infection by spraying carbolic acid over the patient during surgery. German surgeons developed a better method. The surgeons hands and clothes were sterilised before the operation and surgical instruments were sterilised with super heated steam. Rubber gloves were first used in surgery in 1890. Anaesthetics and antiseptics made surgery much safer. They allowed far more complicated operations.
In 1883 Robert Lawson Tait removed the fallopian tube of a woman suffering an ectopic pregnancy saving her life.
In 1895 Wilhelm Roentgen discovered x-rays. That brought great benefits to surgery.
Surgery in the 20th Century
In the 20th century surgery made great advances. The most difficult surgery was on the brain and the heart. Both of these developed rapidly in the 20th century. The first pacemaker was made in 1958. The first heart transplant was performed in 1967. The first artificial heart was installed in 1982. The first heart and lung transplant was performed in 1987.
The laser was invented in 1960. In 1964 it was used in eye surgery for the first time.
Meanwhile in 1960 the first hip replacement surgery was performed. In 1962 a boy had his arm severed but surgeons managed to reattach it. That was the first successful reattachment surgery.
In the late 20th century one of the most exciting developments in surgery was keyhole surgery. In 2008 a laser was used in keyhole surgery to treat brain cancer.
A modern hospital in Portsmouth
Surgery in the 21st Century
In 2005 the first face transplant was performed. The first leg transplant took place in 2011 and the first womb transplant was carried out in 2012.
A timeline of Surgery
A brief history of Dentistry
A brief history of Medicine
A brief history of Public Health
A brief history of Cosmetics
Last revised 2013