Surgery has continued to evolve since the first time it came into practice. It is an ancient branch of medical specializations. It deals with the manipulation of physical body structures with an aim of diagnosing, preventing, or curing a disease. It has evolved from the surgery in the ancient ages where some adults would have holes cut in their skulls. It was the operation at those times though nobody knows its purpose.      Surgery continued to evolve to the time of Egyptians and preservation of the mummies. They would embalm the body by removing the organs that would make the mummies rot. However, their surgery would get used to treating wounds and broken bones. Ancient surgery also comprises of the Greeks, the Romans, and the Indians. All the individual communities had different processes of performing surgery.      Surgery in the middle ages is surgery in Europe. It started in the 13th Century after the emergence of new craftsmen in towns. The craftsmen were the barber-surgeon. They would shave and pull teeth. They would also conduct simple surgical operations such as setting broken bones and amputations. Surgery started to take shape in the 14th Century when the church allowed dissection of human bodies.      Surgery evolved into what it is today in the 16th Century through Leonardo Da Vinci. He would dissect human body and draw accurate diagrams of the same. Other surgeons that came after Leonardo Da Vinci were Andreas Vesalius, who published a book with accurate drawings of the human body. Surgery has continued to evolve and advance until in the 21st Century where surgeons are performing a successful organ transplant.

 

Early History of Surgery

Essay

Surgery in the world has undergone significant evolution in history. Right from the

ancient time when some adults would have holes cut in their skulls in an operation that rarely

anyone understood its purpose, to the present day where there are astonishing surgical

breakthroughs that allow limb or even face transplants. Each development made in the field of

surgery has resulted in a unique capability that promotes not only increased rates of successful

operations but also the undertaking of amazing medical surgeries. These developments are core

in saving lives in the modern world, where humankind gets faced by new complex and

complicated diseases such as cancer, cardiovascular diseases, and brain diseases. It is important

to understand the history of surgery for the young surgeon, so as to appreciate what they learn

within the context of past and present cultural, political, economic, and social institutions.

The word surgery got derived from a Greek word meaning hand work, and in the ancient

age of the Homo sapiens, it applied to the manual manipulations that got conducted by a surgical

practitioner in the attempt to assuage the people’s injuries and diseases. Apart from treating

wounds and fractures, the early surgeons also dealt with three other kinds of operative

procedures that are cutting for the bladder stone, circumcision, and trephination of the skull.

(Ellis, 2002)

2400 and 3000 BC – Circumcision

Circumcision is the most ancient elective operation that got practiced in the Ancient

Egypt by assistants to the priests and gone done to priests and the Royal family members. This

surgical story gets supported by evidence carved on the tomb of a high-ranking official of the

royal family that got discovered in the Sakkara Cemetery in Memphis and dated back to between

the 2400 and 3000 BC. It is a representation of two boys getting circumcised. The instrument

that got employed was a crude stone instrument. The patient had both arms held by an assistant

though another merely braced his left arm on the head of the assistant. The ancient Jews had

learned much about circumcision during the bondage in Egypt, and indeed there is the

mentioning of circumcision in the Old Testament getting attributed to Abraham (Ellis, 2002).

According to early ethnological investigations, circumcision got practiced broadly among most

primitive communities such as the Bantus, those in the equatorial Africa, traditional Jews, and

those of South America and Australian Aborigines.

10 000 BC - Trephination of skull

This procedure is one of the oldest surgical stories, dating back to 10 000BC when the

ancient man could not read and write. Early surgeons undertook the several successful operations

of trephination or trepanning that is the cutting or boring out rings or squares of bones from the

skull. Various techniques got employed in trepanation in the ancient times. In the recent

primitive communities, it entailed the scrapping away the bone, the making of a circular bone to

loosen a central core of bone, the cutting and boring away the bone, or the making of rectangular

intersecting incisions in the skull. Evidence of these ancient surgical stories got discovered in the

prehistoric stone tomb in the Central France where in 1865; Dr. Prunires an amateur archeologist

and a general practitioner discovered a skull that had gore bore a large artificial opening on its

posterior aspect.(Ellis, 2002) However, the question still exists of what was the main reason for

conducting the operation, and the specific procedure followed by the early surgeons. Evidence

showed that patients who underwent the process completely recovered, as there was evidence of

healed fractures and the edges of the trephined effect. The operation got undertaken in the

absence of anesthesia, although authorities surmise that an extract of coca plant got applied by

the ancient South American practitioners. The instrument that got used was a sharpened flint or

piece of obsidian, fastened with a cord to a wooden handle. Later these got replaced by the

copper and bronze blades.

17th Century - Dealing with blood loss

Blood loss was a crucial challenge to surgeons in the early medical world. Heavy

bleeding often makes it challenging for doctors to see what they are doing and if the patient loses

much blood, their blood pressure reduces impacting the heart and body functioning consequently

the patient dies. Anesthetics and antiseptics allowed the performing of complicated surgical

operations, as there was effective blood loss control and transfusions could get conducted

successfully.

1846 - Anesthesia

The inability of early surgeons to undertake complete pain-free operations was one of the

terrifying surgical challenges. During this era, surgeons focused more on the surgery speed rather

than the clinical efficacy of their dissection. Similarly, patients had long been unwilling to

undergo surgical procedures. The breakthrough came in 1846 when William Morton a Boston

Dentist, persuaded John Warren a professor of surgery to allow him to administer sulfuric ether

to a surgical patient. The result was a painless removal of a small, congenital vascular tumor of

the neck (Taylor & Johnson, 2014).

1865 - Antisepsis, Asepsis, and understanding the nature of an infection

The recognition of antisepsis and asepsis in the evolution of surgical history was a

significant event. Early surgeons had little understanding of infection and germs; hence most of

the patients recovered from the operation, however, died several days later from sepsis, which is

infection and decay with a strong smell of rotting flesh getting produced. It was evident that the

deadening of pain allowed a surgical operation to get undertaken in a more efficacious way.

Speed was no longer the primary concern in surgeries. However, a surgical procedure could still

get conducted but with the great challenge if a patient conceived anesthesia. The lack of

antisepsis and asepsis led to deaths rather than the just pain in surgical operations.

1895 - X-rays

Among the most notable researchers conducted in the 19th century that have significantly

impacted the field of medicine, was the one undertaken by Wilhelm Roentgen resulting in his

1895 elucidation of X-rays. X-rays have broad applications in the area of medicine that include

diagnosis and location of fractures and dislocations, as well as the removal of foreign bodies

(Rutkow, 1988).

20th Century

In the 20th century, sterilization and surgeons wearing antiseptic-looking white coats

become a reality. Many of the surgical evolutions in the 20th century also get attributed to the

prestige received by surgeons who showcased their new surgery accomplishments and

development.

Present Day Brain Surgery

The present day neurosurgery got pioneered in the early 20th century by American

surgeon Harvey Williams Cushing. Brain surgery has undergone numerous advances.

Trepanning is the earliest form of Stone Age surgery. The first skull that got discovered as

having got trepanned was in Inca cemetery in Peru during the 1830’s (Wickens, 2014). Less

invasive brain surgeries get performed by neurosurgeons using an endoscope to remove pituitary

gland tumors, as well as draining the blood that had pooled in the brain referred to as the

hematoma. The endoscope is a device that consists of a long and flexible tube attached to a light

and camera that enables the neurosurgeon to see inside a tissue only by making a small incision.

Anesthesia that got discovered in 1846 is critical because it has enabled patients to undergo brain

surgeries, although procedures for certain brain tumors or forms of epilepsy the patient gets

treated while awake. Brain surgery also includes radiosurgery, where the surgeon does not cut

the patient, rather focuses a high-dose beam of radiation at a tumor or lesion in the brain to

destroy it.

Factors that have influenced the advancements in surgery

War

Conflicts and wars in the pre-history necessitated for developments in dealing with the

high cases of bone fractures and injuries (Moulin, 2012). The early surgeons developed

trephining and setting of broken bones. Wars and animal-human conflicts in the Roman Empire

improved the expertise of surgeons, due to the presence of different injuries. Early experiments

on blood transfusion got initiated in the war zones.

Technology

Through the use of technology, specialist craftsmen in Ancient Egypt made fine bronze

instruments that aided surgeons. In the Roman Empire, surgery got enhanced through the use of

iron bladed scalpels, artery forceps, and saws. Innovation and technology have resulted in the

development of x-rays, microscopes, and other equipment that have assisted in the surgical field.

Science

Science enabled surgeons in the pre-history to understand that the removal of some bone

from the skull leads to pressure release, thus frequently conducted the operation for severe head

injuries to the skull. In Ancient Greece in the 250 BC, science allowed Herophilus’ dissections to

understand that the brain controlled the body and that there was a difference between nerves and

arteries. He also identified several parts of the stomach including duodenum and the prostate.

Communication

The lack of written evidence to prove any theories in the pre-history was a significant

challenge to understanding the purpose of some early surgical procedures. Many people have

become surgeons because of communication of medical ideas through medical books. The

transfer of surgical ideas has also resulted in the advancements in surgery. Medical writings in

different parts of the world including India, China, Greece, Egypt, and Mesopotamia in the

ancient period greatly led to numerous surgical developments (Majno, 1991).

Religion

Religion played a vital role in promoting trephining in the pre-historic era since some

religions believed that the boring of holes in the skull resulted in the release of evil spirits hence

purifying self. Also, the beliefs that in the afterlife resulted in embalming caused the growth in

exploring internal organs.

Government

In the Ancient Egypt, the evolution of surgery was enormous in the time of Pharaoh as

his doctors spent a lot of time attempting to improve various medical ideas. The acceptance of

Queen Victoria to use chloroform during the delivery of her eight in 1857 resulted in

considerable acceptance and doomed any opposition that was available to anesthetics.

 

References

Ellis, H. 2002 A History of Surgery: Cambridge University Press

Majno, G. (1991). The healing hand: man and wound in the ancient world. Harvard University

Press

Moulin, D. 2012 A history of surgery: with emphasis on the Netherlands: Springer Science &

Business Media

Rutkow, I. M. 1988 The History of Surgery in the United States, 1775-1900: Textbooks,

monographs, and treatiesIssue 2 of Bibliography and Surgery Series: Norman Publishing

Taylor, I. & Johnson, C. D. 2014 Recent Advances in Surgery 36, Volume 36 Recent Advances

in Surgery: JP Medical Ltd

Wickens, A. P. 2014 A History of the Brain: From Stone Age Surgery to Modern Neuroscience:

Psychology Press