By Tim Lambert
Surgery was invented in 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 gained their knowledge of anatomy by making mummies. To embalm a dead body they first removed the principal organs, which would otherwise rot.
In Ancient Egypt surgeons treated wounds and broken bones and dealt with boils and abscesses. Egyptian surgeons used clamps, sutures, and cauterization. They had surgical instruments like probes, saws, forceps, scalpels, and scissors.
They also knew that honey helped to prevent wounds from becoming infected. (It is a natural antiseptic). They also dressed wounds with willow bark, which has the same effect.
The Ancient Greeks also helped to advance surgery. Greek surgeons bathed wounds with wine. (The alcohol helped to prevent infection). A Greek named Herophilus (c. 335-280 BC) carried out dissections of human bodies in public. He is sometimes called the Father of Anatomy. Erasistratus (c. 304-250 BC) was also a great anatomist.
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, surgery continued in the Byzantine Empire and in the Islamic World, and in the 12th and 13th centuries it returned to Western Europe.
Meanwhile in India surgeons were highly skilled. They were pioneers of plastic surgery. They performed an operation to reconstruct the nose (rhinoplasty). There were hospitals in India and Sri Lanka before 200 BC.
Medieval and Renaissance Surgery
In Western Europe, in the 13th century, a new type of craftsman 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.
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 Tudor greatest surgeon was Andreas Vesalius (1514-1564). He did many dissections and realized 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 into 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. n 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.
In the 19th century surgery was greatly improved by the discovery of anesthetics. As early as 1799 the inventor Humphry Davy (1778-1829) realized that inhaling ether relieved pain. Unfortunately decades passed before it was actually used as an anesthetic by Crawford Long in an operation in 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 anesthetic. 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 surgeon’s hands and clothes were sterilized before the operation and surgical instruments were sterilized with superheated steam. Rubber gloves were first used in surgery in 1890. Anesthetics 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.
Ludwig Rehn performed the first heart surgery in 1896.
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 heart transplant was performed in 1967 by Christiaan Barnard. The first artificial heart was installed in 1982. The first heart and lung transplant was performed in 1987.
Meanwhile, the first kidney transplant was performed in 1950 by Richard Lawler.
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 time a limb was successfully reattached.
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.
In the 21st-century surgery continued to advance. 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.
Last revised 2021