Long before there were humans, there
was illness and injury, and long after we’re gone, illness and injury will
persist wherever there is life. Yet archaeological evidence has shown that we
have combatted these ills as best we could, given the knowledge we had, for
millennia. As far back as the Stone Age, surgical procedures were performed in
order to alleviate pain and illness. You might be surprised by how long our
earliest medical practices persisted before science transformed the way
medicine is practiced today.
Yet as medicine and surgery has
evolved, one thing has remained common: proper surgery, the kind that helps and
heals, cannot be performed without the right tools. A good surgeon is
important, of course, but without the right tools for the job a surgeon can
actually cause more harm than good – as has happened again and again throughout
history, until recent advancements in surgical techniques. Of course, by
‘recent’ we mean developments in the last 150 years. None of those discoveries
in surgical technique could have been possible without the earliest surgeons
working to heal others, however.
Ancient Surgery: I Need Surgery Like a Hole in the Head
As far back as the Stone Age, our ancestors
practiced trepanation. Trepanation is the practice of cutting open a hole in
the skull in order to alleviate pressure on the brain. Blood and/or swelling in
the brain can cause massive amounts of pain and even serious and lasting
injury. This kind of swelling could be the result of any number of injuries or
illnesses, but it is most often a blow to the head that would cause the need
for trepanation. Surprisingly, evidence – i.e., the unearthed bodies of ancient
man – has shown that some people even survived this procedure, as the bone grew
back over the hole in the skull.
The Egyptians displayed detailed
knowledge of human anatomy and surgical techniques for the time. You are
probably familiar with the mummified remains their civilization left behind; in
order to embalm those bodies, principal organs were removed and preserved using
embalming tools, such as a three-inch stick used to remove the brain. Probes,
saws, forceps, scalpels, and surgical scissors also
saw use in the embalming process, as well as in normal surgical procedures.
That’s right, the Egyptians also had
some knowledge of how to treat the human body before it died – revolutionary! Clamps, sutures, and cauterization
techniques were commonly used, as was honey and willow bark – natural
antiseptics. Similarly, the ancient Greeks used wine to bathe wounds, as the
alcohol acted to prevent infection.
While the dissection of human bodies
was outlawed in ancient Rome, there were nevertheless several surgical
instruments developed that continue to be used today, such as the vaginal speculum,
which Greek and Roman gynecologists and obstetricians used to diagnose and
treat vaginal and uterine disorders. There are records of rectal speculums used
in ancient Rome as well, with Hippocrates writing of “… laying the patient on
his back and examining the ulcerated part of the bowel by means of the rectal
speculum.”
Medieval Surgery: Just How It Sounds
While much of the middle ages saw basic
surgery performed by barber-surgeons, who also acted as dentists, the 16th
century saw a revolution in surgery as knowledge of anatomy became more
advanced, specifically with the publishing of The Fabric of the Human body in
1543 by Andreas Vesalius. With humanity’s improved knowledge of anatomy,
surgical techniques advanced considerably.
Subsequently, the development of
substantively functional surgical tools became paramount. A flurry of surgical
inventions were invented in the following centuries, such as development of
sutures and ligatures to stop bleeding, as developed by Ambroise Paré. The discovery of microbes as responsible for
infection and disease by Louis Pasteur also led to more sanitary surgical
practices throughout the medical world as doctors were encouraged to wash their
hands between patients.
Modern Surgery: Oldies But Goodies
Subsequently, Joseph
Lister (after whom Listerine is named!) developed carbolic acid as a cleansing
and disinfecting agent used to reduce infection by treating instruments and
other objects that make contact with the patient. Ernst von Bergmann’s steam
sterilization for instruments was a later improvement on this revolution in
surgical cleanliness. In the 19th century, methods of anesthesia
were developed – such as the discovery of ether – which have helped patients
around the world. Meanwhile, surgical instruments themselves continued to
evolve, with the advent of more delicate and precise tools like the needle
holder.
Today, surgical tools
are incredibly advanced, with a range of computerized and robotic tools aiding
the surgeon. However, some of the oldest tools at the surgeon’s disposal – the
scalpel, the forceps, and so on – continue to be used by surgeons today. As
surgical technology continues to evolve and advance, there’s no telling what
changes we will see, but one thing is for certain: none of these advances were
possible without ancient surgeons laying the groundwork, making mistakes,
learning, passing on their expertise to others, and developing new tools to
help them solve the surgical problems of their time.
