The Ancient and Surprising History of Surgery
Written by Ren on Wednesday January 30, 2019
While it may seem intuitive to describe surgery as a ‘modern’ medical practice, its origins in fact can be traced back thousands of years, deep into the Pre-Classical and even Neolithic era.
The earliest recorded archaeological evidence for surgical practice is an astounding 12000 BCE. To put a time frame like this in perspective, writing wasn’t developed until 2600 BCE in Egypt. Early people were practicing rudimentary surgery before recorded history!
Prehistoric surgery focused around a practice called trepanation, which involves scooping or drilling a hole into the skull of the patient. This ancient practice was used as a panacea for everything from relieving migraine or intracranial swelling, cleaning out fractured skull fragments from a war injury, and even as a means of managing misunderstood mental health conditions that were viewed as a malignant spirit trapped within the patient’s cranial cavity.
In 500 BCE, the first example of plastic surgery sprung up in India. Having one’s nose cut off was a common punishment for a past crime, and so reformed felons would have their noses reconstructed via early rhinoplasty to avoid the social stigma. Surgery in Ancient Greece included a variety of makeshift surgical work including the setting of broken bones, bloodletting, the draining of lungs from patients suffering from pneumonia, and the severing of gangrenous limbs. The Mayans were really at the forefront of global surgical practice at this time and performed routine dentistry, filling in cavities with flecks of jade, turquoise, quartz, or hematite. The Incas had master surgeons specializing in head injuries and cranial surgery, and records show they had substantially better success rates than surgeons during the American Civil War, nearly 500 years later.
Another major leap forward was in 900 AD, with the highly esteemed ‘father of surgery’ Al-Zahrawi, and his all-encompassing surgical text Kitab al-Tasrif. It was a cutting-edge compendium on every known practice and procedure, including orthopedics, military surgery, and ear, nose, and throat surgery. A combination of Al-Zahrawi’s collected knowledge and local folk remedies remained the go-to surgical manual for nearly eight hundred years. Up until the 18th century, there was no formal medical training in Europe, and so most surgeons learned their trade through apprenticeship, much like one might learn blacksmithing or another artisan skill. In fact, because surgeons were seen as ‘lesser’ physicians during this period of time, many women were trained and practiced as surgeons. It wasn’t until the 1700s, with the development of medical colleges and academic institutions, that women were then excluded from practicing.
As far as patient care was concerned, it really wasn’t until modernity that a surgical procedure became anything short of horrific to experience. With little regard for infection control, pain management, bodily fluid contamination, or proper wound maintenance, being a patient before modern anesthetic was akin to torture. Many physicians believed it was important to keep patients alert and awake during surgery, and would periodically rouse the patient if it appeared they were in danger of losing consciousness. Opium and alcohol were used as analgesics only sparingly, and never in quantities large enough to diminish patient consciousness. Japanese surgeons were the first to implement true general anesthetic in the early 1800s, at which point ether, chloroform, and locally-administered cocaine became more commonplace globally as anesthetic for patients in the operating room.
While far from a modern practice, surgery has grown and developed to be a vastly safer and more pleasant patient experience over the millennia, all thanks to talented medical pioneers and advocates all over the world.