EARLY SURGERY

Press, Volume C, Issue 29436, 11 February 1961, Page 3

EARLY SURGERY

The Early History of Surgery. By W. J. Bishop. Robert Hale. 192 pp.

The title of this book is rather misleading for. although the author (who. after long experience in medical libraries, is now editor of "Medical History") begins at the beginning and tells of trephination in the New Stone Age. he takes the story of surgery to the days of Lister and beyond. His final chapter is an account of the great surgical advances made since the discovery of anaesthesia and asepsis. The book is a wide survey, compressed into a relatively small volume, from which the layman may learn a great deal as he reads of ancient Egypt. Babylon. Assyria. India. China. Japan. Greece and Rome and on to tne Middle Ages. From there we move to the Renaissance which, with its new interest in the structure and function of the human body, saw some profound changes in medicine and surgery. To this period belongs the great surgeon Ambrose Pare. who. among other things, reintroduced the ligat on of blood vessels, a delightful and humble tnan"l dressed him and God healed him.” Mr Bishop tells us that nowhere was there a greater flowering of surgical talent in this period than in England, and he has some interesting things to say about the Bar-ber-Surgeons’ Company, later dissolved in 1745. the surgeons becoming the Royal College of Surgeons in 1843 Although the early *ev“’ teenth century saw nc> g.eat advance in surgery. Harvey discovered cireulMion of the blood in 1628. it was one cf the results of this> was now a rational basis for blood transfusion, of which we hear more later on. inc uding the book written by interval of a century which Mr Bishop sons) the work of James Blundell and later still l*ndsteiner and Jansky early in the present century. In the eighteenth century the French surgeons are .man! the British was the great John Hunter the master of Jenner. Abernethy and As-

ley Cooper. Mr Bishop regards Hunter as the founder of modern surgery and the man who elevated it to the rank of a science. In the early nineteenth century there is a long list of great surgeons, including the brothers John and Charles Bell, the discoverer of distinct sensory and motor nerves.

The layman puts this book down feeling a tremendous admiration for the essential courage and toughness of our ancestors who in the davs before general anaesthetics and the work of Pasteur survived shock and sepsis under the surgeon’s knife.

The Chinese Hua To is generally supposed to have discovered surgical anaesthesia in the second century. but apparently he did not alwavs use it. as on one occasion he operated on a general for a poisoned arrow wound and a game of chess was played to distract the patient’s attention from his pain. The mediaeval Dominican Theodoric of Cervia described the use of the soporific sponge, and Mr Bishop calls him a pioneer of antiseptic and anaesthesia, but there was no surgical operation under a general anaesthetic until ether was used in 1846. This was a very great advance as more operations* became possible, but the mortality rate was higher than it had ever been Medical men had been slow to accept the theory of infection by micro-organisms. i.nd even in the early nineteenth century, we are told, surgeons often washed their hands after rather than before operating. This underlines the importance of Pasteur’s work in elucidating the true nature of infection, and of its application in practice by Lister in 1865.

The reader feels profound thankfulness for the progress of modern surgical science in alleviating human suffering. The reader may also be grateful to Mr Bishop whose purnose. he says, is “to tell something of the giants who paved the way for the triumphs of modem surgery and of the conditions under which they worked.” The book has 21 illustrations, beginning with a pre-Columbian skull from Peru and ending with Lister’s carbolic spary in action. Each chapter is followed by a list of books for further reading.