Cutting Time: A Brief History of Surgery

By: Jeongmin Lee

We are walking works of art. From the delicate brain to the flow of blood in our veins, the human body is a dense complex system. The surgeon is expected to cautiously open this living system to mend his or her patient before patching the patient up so that the machination of the body can resume its work. This delicate task has been handled quite differently over the ages, and currently, we are in yet another period of change due to technological advancements. Visiting previous procedures can elicit an appreciation of the surgical methods that we have in this present day.

Even in prehistoric times, people have recognized that there are situations when one must intrude a patient’s body to treat them. Archaeologists have found evidence of trephination, the practice of drilling a hole into the skull in hopes of treating mental diseases, in remains of humans dating back to 6500 BCE (1). Evidence suggests that trephination was practiced throughout the world. The people who were treated with trephination appear to have survived the procedure, as many of the skulls seem to have started healing after the perforation. A possible reason behind this procedure may be related to humoralism from ancient Western medicine.

As time passed, records describe more detailed procedures that revolve around the idea of humors. Hippocrates initiated historical medicine in ancient Greece, according to his disciples who made records under him. A common theme in his lectures was humors, four types of liquids that can affect one’s personality and well-being: blood, phlegm, yellow bile, and black bile (2). It was believed that when the humors were imbalanced, the patient was ill, so medicine was diagnosed to balance the liquids by letting out one of them. Trephination, according to Galen from the Roman Empire, had many risks. So instead, those civilizations practiced bloodletting where a hot patient with too much blood had to lose some blood to balance his or her humors. This practice remained popular throughout the Middle Ages as people believed that diseases could be washed out of the body if the blood containing the disease was drained (3). There were other surgical procedures by the sixteenth century such as amputations, which removed infected parts of the body before the infection spread. However, patients would die in pain or from further complications if the amputations were not quick enough.

Before the advent of anesthetics, amputations and other surgeries could cause the patient to die in pain, and sooner than if the patient had been left unoperated. “Time me, gentlemen” is the most recognized quote by Robert Liston, who practiced completing surgeries in record time (4). However, the quick job often left patients dying on the table or soon after. It took until 1846 before William Morton from America demonstrated how the anesthetic properties of ether can be used to complete a dental procedure painlessly.5 Anesthetics allowed surgeons to take their time when operating, greatly increasing survival rate. Anesthesia is commonly used in surgeries today.

The evolution of surgery continues as surgeons use cutting edge technology to make their incisions. To reduce exposing the body’s interiors as much as possible, some medical centers are employing technology to aid the surgeon’s accuracy and efficiency. The Robotic Surgery Center in New York has a machine that magnifies the point of interest and allows the surgeon to control a small but accurate knife to make the least invasive maneuvers.6 Overall, the history of surgery depicts stories of how procedures become overturned with new discoveries. Akin to how Liston’s quick sutures were not as important once anesthetics increased the time a surgeon could spend operating or how trephination discontinued once Western civilizations reasoned different alternatives, automated machines can find and make ideal cuts that a skilled human hand would not reliably accomplish. Currently, the machines are yet another tool a surgeon can use to minimize risks for the patient. Surgery’s history of constant innovation is what many fields strive to have.

 

Jeongmin Lee ’19 is a junior in Lowell House concentrating in Chemistry.

WORKS CITED

[1] Irving, J. Trephination. https://www. ancient.eu/Trephination/ (accessed Sept. 23, 2017).

[2] Osborn, D. The Four Humors. http:// http://www.greekmedicine.net/b_p/Four_ Humors.html (accessed Oct. 15, 2017).

[3] Clunie, A. Surgery…a Violent Profession. https://www.hartfordstage.org/ stagenotes/ether-dome/history-of-surgery (accessed Sept. 4, 2017).

[4] Jones, A. et al. Time me, gentlemen! The bravado and bravery of Robert Liston. https://www.facs.org/~/media/files/archives/05_liston.ashx (accessed Sept. 23, 2017).

[5] Markel, H. The painful story behind modern anesthesia. PBS [Online], http://www.pbs.org/newshour/rundown/the-painful-story-behind-modern-anesthesia/ (accessed Oct. 15, 2017).

[6] NYU Langone Health. What is Robotic Surgery? https://med.nyu.edu/robotic-surgery/physicians/what-robotic-surgery (accessed Sept. 23, 2017).