A Brief History Of Surgery

A Brief History of Surgery Nick Harvey MemorableMedicine.com

Chirurgery
Latin: chirurgia
Greek: cheir = hand
ergon = work
anglicized to Surgery

Trephanation
Neolithic
6500 BC France
New World
1500 BC Inca

Dentistry
7000 BC Mehgarh, Pakistan
2650 BC Egypt

Ancient Egypt
2000-2500 BC
Religious reasons?

Ancient Egypt

Ancient Egypt
Trephination
Draining dental abscesses
Circumcision
Castration
Amputation
Lithotomy
Opiates
…

Ancient India
600 BC – Sushruta
Sushruta Samhita
120 surgical instruments
300 surgical procedures
I&D
Rhinoplasty
Bowel anastmosis
Cataract removal
Prostatectomy
Tonsillectomy
Leeches
Ethical code
Technical skills lab!

Ancient Greece
460-370 BC – Hippocrates
Disliked opening the body
Knowledge from the battlefield

Ancient Greece
“ cutting persons labouring under the stone should be left to such persons as practice it”

Ancient Greece

Ancient Greece
Kritodemos & Alexander the Great
Operated with a spoon!

Ancient Greece
3 rd Century BC
Herophilus: allowed to dissect
Arcagathus: famous for enthusiastic use of
knife & cautery
130 AD – 200 AD
Claudius Galen – Gladiator’s surgeon, advanced practice

Ancient China
200 BC - Hua Tuo
Physician & surgeon
Executed & scripts burnt

Middle Ages
5 th – 14 th Century AD
Practice of surgery declines
Left to barbers

Modern Surgery
“ There is no more science in surgery than in butchering”
Lord Thurlow

Modern Surgery
Bleeding
Infection
Anaesthesia
Transplants
Minimal invasion

Bleeding
10 th Century Ligatures
Abulcasis
16 th Century Ligatures over cautery
Ambroise Par é
20 th /21 st Century ABO system (1901 - Karl Landsteiner) Diathermy
Harmonic scalpel

Infection
1847 Hand washing
Ignaz Semmelweis
1860 Germ theory
Louis Pasteur
1867 Cleanliness & gloves
Joseph Lister
1928 Penicillin
Alexander Fleming

Anaesthesia
200 Hua Tuo
1842 Ether
Crawford Long
1844 Nitrous oxide
Horace Wells
1846 Ether
William Morton
1847 Ether
John Snow
1596-1942 Curare
Walter Raleigh - Harold Griffith

Modern Surgery
Other big names
1316 - Guy de Chauliac
Chirurgia magna
1616 - William Harvey
An Anatomical Exercise on the Motion of the Heart and Blood in Animals
1651 - Richard Wiseman
Several Chirurgical Treatises
1661 - Marcello Malpighi
Describes capillaries
18 th C - John Hunter
Anatomist & Surgeon
1895 - Wilhelm Conrad Röntgen
X-rays
1953 - John Gibbon
Heart/Lung bypass machine

Allografts
1905 Cornea (Eduard Zirm)
1954 Kidney (Joseph Murray)
1959 Azathioprine
1963 Lung (James Hardy)
1964 Heart - chimpanzee (James Hardy)
1966 Pancreas (Richard Lillehei & William Kelly)
1967 Heart (Christiaan Barnard)
1967 Liver (Thomas Starzl)
1968 Heart & Lung - failed (Denton Cooley)
1970 Cyclosporine
1981 Heart & Lung (Bruce Reitz)
1987 Lung (Joel Cooper)
1998 Hand (Jean-Michel Dubernard)
2005 Face (Bernard Devauchelle)
2006 Penis (Hu Weilie)

Modern Laparoscopy
1901 Cystoscope, Kelling
1911 Proctoscope, Bernheim
1918 Pneumoperitoneum, Goetze
1929 135 o scope, Kalk
1934 Forceps & cautery, Ruddock
1936 Sterilization, Boesch
1938 Veress needle
1977 Assisted appendicectomy, Dekok
1983 Appendicectomy, Semm
1985 Cholecystectomy, Mühe
1996 Robotic telesurgery

Sushruta’s general advice to physicians
“A physician who has set out on this path should have witnessed operations. He must be licensed by the king. He should be clean and keep his nails and hair short. He should be cheerful, well-spoken and honest.”

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A Brief History Of Surgery

by Nick Harvey on Jul 01, 2008

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