A Brief History of Surgery

For this History of Science class, our final exam can take the form of a research project/experiment. For mine, I am planning on delving into a research project with one of the pediatric urology surgeons I work with at U of M's hospital.

I have always been fascinated by the history of surgery, and how it has evolved over the years, so I thought I would share some of the more interesting parts with the readers of this blog.

Surgeons and doctors were considered very different in the Middle Ages: doctors went to university and got a degree to practice medicine, while surgeons were apprentices, and learned their trade through practice. Surgeons were called Mr. _______ instead of Dr. _________. One of the surgeons I work with practiced in England, and still has his nameplate that says Mr. _________.

Surgeons' primary responsibilities were pulling teeth and setting broken/dislocated bones.

Aseptic techniques for surgery were developed by Joseph Lister in 1867 with his book Antiseptic Principle of the Practice of Surgery.


Surgery is often advanced during war, when desperate times call for desperate measures. For example, amputations were experimented with during wartime, especially in the Civil War.

There are many others to check out if you are left curious by this post. Surgery is a fascinating field, and advancements are constantly being made to make surgeries safer and more comfortable for patients.

Stumbling upon science...

Can you believe that one of the greatest drugs discovered in history was found by accident?  In 1928 Alexander Fleming noticed in his lab that there was mold on one of his plates of bacteria, and around the mold there was an absence of bacteria (http://www.historylearningsite.co.uk/alexander_fleming_and_penicillin.htm).  I have been taught throughout my life that Fleming had discovered penicillin, the wonder drug, but I did not know that he discovered it by accident.  It is truly amazing to me is that Fleming was not actively testing mold as an agent to kill bacteria.  He merely discovered it due to his lab being messy.  Based on this one observation, the bacteria free ring around the mold, he was able to make one of the most important scientific discoveries in history.  Many lives would be saved because of Fleming's accidental discovery.  It just goes to show that sometimes the best science can come from making observations of mistakes or accidents.

Internists versus Surgeons

In class, we talked about the fact that physicians we completely different than surgeons in the Medieval times, and a question was asked as to what caused these differences. I stated that in a paper that I read by Dr. David A. Bloom of the University of Michigan, he emphasized that in the Hippocratic Oath, physicians were not allowed to wield a knife to cure their patients. A translation of the Oath reveals this statement:

“I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.”

The people trained in this craft were surgeons, those who used implements to cut a human’s body in order to heal. I spoke with Dr. Bloom last week, and he said that in England, where he worked for some time, physicians and surgeons are still somewhat separate entities. For example, internal medicine practitioners are referred to as “Doctor”, while surgeons are referred to as “Mister”. Dr. Bloom showed me his name plate from England which had “Mr. Bloom” inscribed in it.

Today in America, doctors and surgeons are usually thought of as very similar. Both must go to undergrad and medical school, and both must complete residencies, which are at least 4 years. In most cases today, surgeons receive more formal training than internal medicine practitioners.

A brief history of surgery can be found on this website:

http://www.localhistories.org/surgery.html

Some information on the life of a surgeon/internist can be found at this website.

http://www.bls.gov/oco/ocos074.htm

Physicians, Surgeons, and Apothecaries

In the eighteenth century, there were three types of professions that were considered to be medical professions: physician, surgeon, and apothecary. Only physicians needed any sort of training in higher education, as surgeons and apothecaries were often simply apprenticed into their position.

All of this made me wonder just how effective medicine of this century was. I think everyone has their preconceptions about what it would have been at this time, perhaps with surgeons haphazardly taking saws to patients and apothecaries giving mystery drugs to customers, but maybe medicine was a tad more advanced than that even three hundred or so years ago. I would think that, perhaps, people knew enough about human anatomy to at least have effective surgeries, even if they were conducted without anesthesia, and I think that the majority of "surgeries" really involved sawing a person's mangled limb off, but that may be another misconception. I have less confidence in the apothecaries' drugs, as chemistry wasn't really a flourishing field yet during the eighteenth century, but perhaps, just by experimentation, these apothecaries did manage to find some effective medicine. In any case, it adds to my intrigue as to why physicians, of all of them, were the only ones that needed formal training when the other two seem to be more precarious and advanced.

Again, most of this was merely speculative, and typing this has actually inspired me to look more into this, so I can put aside my misconceptions and learn about the quality of eighteenth-century medicine as it actually was.

-Christopher Hoef