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Prehistoric Surgery
Types of Surgery
- Trepanning (Trephination) Hole in skull for spiritual reasons
- Dental Surgery
- Setting broken bones
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents while hunting / fighting
Spiritual – release of evil spirits from body
Key People?
None
Specialist Surgeons?
No
Key Events?
No
Equipment? Tools?
No
Anaesthetics? No
Antiseptics? No
Factors?
Religion
Egyptian Surgery
Types of Surgery
- Trepanning (Trephination) Hole in skull for spiritual reasons
- Dental Surgery
- Setting broken bones
- Circumcision
- Caesareans
- Removing cysts / boils
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents
Key People?
None
Specialist Surgeons?
No – operations done by doctors who were trained
Key Events?
No
Equipment? Tools?
Books of Thoth and Papyrus Ebers gave advice
Anaesthetics? Not effective – only alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Factors?
Religion (circumcision)
Communication (medical books)
Overall?
Some progress from Prehistoric – eg. Books of Thoth
Lots of continuity – types and techniques
Greek Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents
Key People?
None
Specialist Surgeons?
No – operations done by doctors who were trained at Alexandria
Key Events?
No
Equipment? Tools?
Medical books in library at Alexandria
Anaesthetics? Not effective – only alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Large empire led to better materials and metals to make surgical tools which were
very good – scalpels, saws.
Factors?
Communication
Technology (a little bit better tools)
Overall?
Some progress from Egyptian period eg. Better tools
Lots of continuity – types and techniques
Roman Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Gladiator surgery – cauterising
Levels of Surgery
Simple
Basic
Last resort
Army had hospitals with surgical operating theatres
Reasons for Surgery
Accidents / Warfare
Key People?
None
Specialist Surgeons?
Operations done by doctors who were trained at Alexandria
Army had army surgeons
Key Events?
No
Equipment? Tools?
Medical books in library at Alexandria
Anaesthetics? Not effective – only alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Large empire led to better materials and metals to make surgical tools which were
very good – scalpels, saws – similar to Greeks
Factors?
Communication
Technology (a little bit better tools)
War – (a little bit)
Overall?
Some progress from Greeks, operating theatres in hospitals
Lots of continuity – tools, types and techniques
Dark Ages Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents / Warfare
Key People?
None
Specialist Surgeons?
No trained doctors
Key Events?
Collapse of Roman empire
Equipment? Tools?
Anaesthetics? Not effective – only alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Factors?
No
Overall?
Regress – ideas and developments from Ancient World lost and destroyed – no
hospitals, specialist surgeons
Islamic World Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents / Warfare
Key People?
None
Specialist Surgeons?
No but had trained doctors
Key Events?
No
Equipment? Tools?
Anaesthetics? Yes – opium and alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Medical books
Hospitals
Factors?
Communication
Overall?
Continuity from Romans, hospitals, specialist tools
Middle Ages Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
- War surgery
Levels of Surgery
Simple
Basic
Last resort
Reasons for Surgery
Accidents / Warfare
Key People?
None
Specialist Surgeons?
No but had trained doctors
Key Events?
No
Equipment? Tools?
Anaesthetics? Yes – opium and alcohol
Antiseptics? Limited eg. Honey / herbs eg. Garlic and thyme
Medical books
Factors?
Communication
Overall?
Progress from dark ages, some specialist tools
Renaissance Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
- Ligatures to stitch wounds
- Amputation
Levels of Surgery
Last resort, but developing skills throughout the time period
Reasons for Surgery
Accidents / Warfare
Key People?
Pare
Specialist Surgeons?
Yes – barber surgeons treated ordinary people – not real qualifications
Army surgeons
Key Events?
No
Equipment? Tools?
Anaesthetics? Yes – opium and alcohol, but pain huge problem
Antiseptics? Limited eg. herbs eg. Garlic and thyme, turpentine but infection huge
problem
Blood loss huge problem
Medical books – eg. Pare
Factors?
Communication – Pare’s books
War – discovery of alternative to cauterising / boiling oil
Individual Brilliance (Pare)
Chance (Pare running out of oil)
Overall?
Progress was significant – ligatures, better tools and less cauterisation
Industrial Revolution Surgery
Types of Surgery
- Dental Surgery
- Setting broken bones
- Caesareans
- Removing cysts / boils
- Cauterising
- Ligatures to stitch wounds
- Amputation (Blood loss = massive problem)
Levels of Surgery
Last resort, but developing skills throughout the time period – very dangerous
Reasons for Surgery
Accidents / Warfare
Key People?
Simpson – Anaesthetics - Chloroform (1847) (stopped pain but resisted at first by
army, (pain = manly), church, (pain = God’s punishment for sin of Eve) and people who
did not trust surgeons
Lister – Antiseptics Carbolic Acid (1867) (killed germs – stopped a lot of infection)
Halstead Aseptic surgery, (hats, gloves, masks, protective clothing) 1889 (stopped
germs being in surgery)
(Pasteur – Germ Theory)
Specialist Surgeons?
Yes
Key Events?
Black Period – 1847 – 1867 – after chloroform sent people to sleep
surgeons could operate more deeply in body but didn’t know
about infection so sealed infection deeper in the body. Operation
survival rates = better, post operation 40% more people died.
Germ Theory – ended Black Period
Factors?
Individual Brilliance (Simpson, Lister, Halstead)
Science and Technology
Overall?
Progress was significant, dealt with pain and infection but blood loss = still a problem
Modern World Surgery
Types of Surgery
- High tech – brain surgery, heart surgery, plastic surgery
- Invasive (deep in body)
- Highly skilled
Reasons for Surgery
Accidents
Cosmetic
Treatment for disease
Key People?
McIndoe (WW2 – plastic surgery for fighter pilots who had been burned)
Barnard – Heart surgery 1967 – first successful heart transplant
Specialist Surgeons?
Yes – specific to types of operations – highly skilled and trained
Anaesthetists
Factors?
Individual Brilliance (McIndoe, Barnard)
Science and Technology – high tech machinery – x-rays (WW1), heart – lung machines,
ultrasound – blood transfusions
Chance (cyclosporine for organ transplants)
Overall?
Progress was significant and continues to be, but MRSA = problem