The History of Surgery:

A brief account of how an

esteemed art and science came to
be what it is today.
 Chirurgery =
Latin, chirurgia, from the
Greek, cheir = hand and
ergon = work…
anglicized to Surgery.
• Shoulder dislocation
• Arterial ligation
• Hereditary nature of
hemophilia
• Dental devices
• Ectopic pregnancy (lethal)
• Inspection of the uterus, ear,
throat

Abul Qasim Khalaf

ibn al-Abbas al-Zahrawi
or Albucalsis (993- 1064)
Dominique
Larrey
“Studied
medicine and
then trained in
surgery…”
Napoleon’s
Surgeon-in-Chief
by 1805.
“There is no
more science
in surgery
than in
butchering,”
- Lord Thurlow
Parliamentary debate on the
establishment of a Royal College of
Surgeons in 1811
 16 October 1846

Massachusetts Hospital
Boston
John Collins Warren
1778- 1856
Manassas, Virginia
July 21, 1861
France

1864
 Scotland 1869
antisepsis, asepsis
and man

Lord Joseph Lister

1827-1912
 Glossary of the unfamiliar
in 1870:

• Antibiotics • Transfusion
• Anesthesiologist
• Sterile field
• NG suction
• Rubber gloves
• Chest X-ray
• Appendicitis
• Endotracheal tube
• Bovie • Cardiac
operations
Rochester, Minnesota
1864 through 1889:
The Rise of the
Hospital
Unregulated,
proprietary medical
schools, followed by
occasional
internships,
supplemented with
elective peripatetic
observational
education mostly
founded on
experiences from
those in need…
Baltimore, Maryland

1889
 QuickTime™ and a
Photo - JPEG decompressor
are needed to see this picture.
September 23, 1852 to September 7, 1922
The Flexner Report and Reforms
1910
1909: Thyroid function and operations
1912: Vascular anastomoses
1921: Toronto
1923: Discovery of insulin
“There is no more science in
surgery than in butchering”
Franklin H. Martin, MD, FACS 1857-1935
Evarts A. Graham
Germany 1929
1956: Cardiac catheterization and circulatory physiology
 University of Chicago
1941

1966: Specific hormonal influence on cancer cells

Johns Hopkins Hospital
1940
Boston - 1942
 World War II
demanded
advances in :

• wound management
• antibiotic use
• blood transfusions
• organization of field hospitals
 Philadelphia
1953

John H. Gibbon
Boston 1954
1990: Successful Organ Transplantation
 C. Rollins Hanlon
Chair at Saint Louis University from 1950 - 1969

St. Louis - 1950

St. Louis - 1969
Denver 1963
California 1961
Houston 1963
Cleveland 1969
 Norman Shumway
Stanford

Jonathan Rhoads
U of Pennsylvania

1970’s to 80’s

Stanley Dudrick
U of Pennsylvania
& UT Houston
From the ancient Inca’s,
through medieval surgery,
and
the application of the art
of surgery…
…to the marriage of
science and surgery
in the past century…
the thrust has been
how we can do more
and more,
safely and effectively,
to extend the quantity
and quality of life?
…but in the past two decades the
emphasis has shifted to how
much less can we do to achieve
our goal of treatment.
 Less can be More
So long as the results are the
same or better:
• Shorter hospital stay, earlier return to
work, fewer transfusions
• Sometimes lower costs
• Recurrence or cure rate equivalent or
better
• Complication rate equivalent or better
 And that is the story of
surgery from the Inca’s to
the present

Now you know

• Why is surgery like getting a hair cut?
• What was Napoleon’s contribution to
modern surgery?
• How did a dentist change surgery ever?
• What is the difference between antisepsis
and asepsis?
• What is the difference between a
physician and a surgeon?
• Give examples of the history of surgery’s
alteration by non-surgeons.
• Give an example of a discovery or
knowledge advancing inefficiently to
practice.
• Name a surgical Nobel prize winner.
Blalock