Surgery

Surgery is concerned with the diagnosis, treatment, and prevention of pathological conditions through operative procedures, while its counterpart, medicine, uses medications, behavioral modification, and a host of other nonsurgical means. The history of surgery entails the transition from primitive rituals based in spirituality to a highly innovative and specialized field driven by breakthroughs in science and technology, and the inventiveness of those who practice it. Modern surgery is performed by physicians known as surgeons, who undergo rigorous training, and usually specialize in the surgical management of a specific organ system or systems. A surgery is a complicated endeavor requiring pre-, intra-, and postoperative regimens, and a cohesive team of medical professionals with a wide array of skills. Surgery is currently at a pinnacle of technological innovation, and its future is limitless.

The earliest archaeological evidence of surgery dates to the Neolithic era (around 10000 to 6000 bce) with a procedure known as trepanation. Trepanation was originally conducted to release spirits or evils from individuals suffering from headache, seizures, and other ailments by using a primitive instrument to cut a small hole in an afflicted person's skull. Later civilizations used it for its benefits in relieving intracranial pressure.

The Edwin Smith surgical papyrus, named after the American trader who bought the papyrus, is an ancient Egyptian trauma surgery textbook and the world's oldest medical document. Written over 4,000 years ago, it gave a detailed account of the examination, diagnosis, and treatment of various injuries, and some of the first descriptions of neuroanatomy. Carvings also depicted procedures such as circumcision (the removal of the foreskin of the penis or the female clitoris), amputations (the removal of limbs), fracture repair, and lithotomy (the removal of bladder stones).

Around 3,000 years ago on the banks of the river Ganges, the ancient Indian surgeon Sushruta authored the Sushruta Samhita describing over 300 procedures and 121 surgical instruments, some of which are strikingly similar to what is used today. He created the field of plastic surgery while healing those who had their noses cut off as punishment. The procedure involved carving a flap from the patient's forehead and securing it over the missing portion of the nose.

Ancient Greeks and Romans (1000 b.c.e. to 100 c.e.), including Hippocrates and Galen, furthered surgical knowledge through advances in anatomy and physiology, and with the development of novel instrumentation.

During the Middle Ages (500 to 1400 c.e.), surgery suffered a regression. It was considered inferior to medicine and relegated to traveling surgeon-bar-bers. These men were identified by the striped white and red pole representing blood and bandages still in use today. They traveled from city to city cutting hair along with pulling teeth, amputating limbs, and tending wounds with high rates of infection and mortality. They were also purveyors of bloodletting, the act of draining blood, which was at the time thought to cure disease. In modern England, New Zealand, Australia, and South Africa, surgeons are distinguished from medical doctors by the title and badge of honor “Mr., Miss, or Mrs.” as opposed to “Dr.” as a vestige of the time of the barber-surgeon.

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