Surgery (cheirourgia, from the Greek
"cheir" meaning "hand" + "ergon" meaning
"work") is the branch of medicine that deals with the physical
manipulation of a bodily structure to diagnose, prevent, or cure an ailment.
Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery
is, "To eliminate that which is superfluous, restore that which has been
dislocated, separate that which has been united, join that which has been
divided and repair the defects of nature."
Since humans first learned to make and
handle tools, they have employed their talents to develop surgical techniques,
each time more sophisticated than the last; however, until the industrial
revolution, surgeons were incapable of overcoming the three principal obstacles
which had plagued the medical profession from its infancy — bleeding, pain and
infection. Advances in these fields have transformed surgery from a risky
"art" into a scientific discipline capable of treating many diseases
and conditions.
Origins
The first surgical techniques were
developed to treat injuries and traumas. A combination of archaeological and
anthropological studies offer insight into man's early techniques for suturing
lacerations, amputating unsalvageable limbs, and draining and cauterizing open
wounds. Many examples exist: some Asian tribes used a mix of saltpeter and
sulfur that was placed onto wounds and lit on fire to cauterize wounds; the
Dakota people used the quill of a feather attached to an animal bladder to suck
out purulent material; the discovery of needles from the stone age seem to
suggest they were used in the suturing of cuts (the Maasai used needles of
acacia for the same purpose); and tribes in India and South America developed
an ingenious method of sealing minor injuries by applying termites or scarabs
who ate around the edges of the wound and then twisted the insects' neck,
leaving their heads rigidly attached like staples.
Trepanation
The oldest operation for which evidence
exists is trepanation (also known as trepanning, trephination, trephining or
burr hole from Greek τρύπανον and τρυπανισμός), in which a hole is drilled or
scraped into the skull for exposing the dura mater to treat health problems
related to intracranial pressure and other diseases. In the case of head
wounds, surgical intervention was implemented for investigating and diagnosing
the nature of the wound and the extent of the impact while bone splinters were
removed preferably by scraping followed by post operation procedures and treatments
for avoiding infection and aiding in the healing process. Evidence has been
found in prehistoric human remains from Proto-Neolithic and Neolithic times, in
cave paintings, and the procedure continued in use well into recorded history
(being described by ancient Greek writers such as Hippocrates among others).
Out of 120 prehistoric skulls found at one burial site in France dated to 6500
BCE, 40 had trepanation holes. Folke Henschen, a Swedish doctor and historian,
asserts that Soviet excavations of the banks of the Dnieper River in the 1970s
show the existence of trepanation in Mesolithic times dated to approximately
12000 BCE. The remains suggest a belief that trepanning could cure epileptic
seizures, migraines, and mental disorders.
Many prehistoric and premodern patients
had signs of their skull structure healing, suggesting that many of those that
proceeded with the surgery survived their operation. In some studies, the rate
of survival surpassed 50%.
