Surgery in the Modern Period

Period of time: 1700-1900

The period is characterized by a development in surgery, medicine, and science as a result of stronger national states, international exchange of knowledge combined with continuous warfare. People live significantly longer compared to the middle ages.

1721: Lady Mary Wortley Montagu (1689 – 1762), wife of the English ambassador in Turkey. Introduced the Ottoman practice of inoculation to England using live smallpox virus taken from a smallpox blister in a mild case – inducing immunization.¹

1735: First documented successful appendectomy. Performed by Claudius Amyand (1660 – 1740), a French surgeon who had fled to England. Served as war surgeon and later became master of the Company of Barber-Surgeons. In 1722 he inoculated the three child princess of Wales against smallpox.²

1745: The formation of the “Company of Surgeons”. The professionalisation of surgeons leads to the break away of surgeons from the “Company of Barber-Surgeons”.³

1764: John Hunter (1728 – 1793), Scottish surgeon, founded his own anatomy school in London. Hunter introduced the experimental method of science with systematic animal experiments. In 1776 he was appointed surgeon to King George III.^4,5

1800: The Company of Surgeons in England is granted a royal charter to found “The Royal College of Surgeons” (RCS). When addressing a member of the company you should use the title Mr., Miss, Mrs. or Ms. – not doctor (Dr.). To become a member you must have studied medicine, receive the title Doctor and afterward pass the diploma MRCS. Today enrollment is both international and in England⁶.

1768 – 1841: Sir Astley Cooper, English Surgepn, who pioneered in ligation of arteries. Documentation for ligation of carotic arteries (1805), iliac artery (1808) and abdominal aneurism (1817).⁷ Named after him are Coopers fascia covering the spermatic cord; Coopers ligaments: The suspensory ligaments of the breasts; Coopers disease: Benign cysts of the breast.⁸

1822 – 1895: Louis Pasteur. French microbiologist and chemist. Father of microbiology. Discovered the principles of microbiological fermentation, vaccination, and pasteurization (named after him). The Pasteur Pipette is also named after him.⁹

1827-1912: Joseph Lister, 1^st Baron. British surgeon and professor of Glasgow. The father of modern surgery. Pioneered in sterilization after reading the publications of Louis Pasteur. Lister successfully used phenol (carbolic acid) to sterilize surgical instruments and clean wounds. His work reduced postoperative infections significantly.¹⁰

1842: Crawford Williamson Long (1815 – 1878). American surgeon and pharmacist. Used inhaled sulfuric ether as an anesthetic when removing a tumor from a patients neck. A towel was administered with sulfuric ether through which the patient inhaled, allowing surgery to be performed with less pain.¹

1848: First Danish documented nose reconstruction by Søren Eskildsen Larsen, Professor at the General Hospital.¹²

1861: Leopold Ollier showed that autogenous bone chips, rib cartilage graft, and temporal fascia could be used covering craniotomy defects and for reconstruction.¹³

1879: First successful brain tumor removal. Diagnosed by Sir William Macewen (1848 – 1924), Scottish surgeon. He based the location of the brain tumor in the frontal lobe of a teenage girl on neurological findings alone.¹⁴ He also pioneered in anesthesia, using endotracheal intubation.¹⁴

1880: The first thyroidectomy performed by Ludwig Rehn (1849 – 1930), German surgeon, later professor in Franfurt, served in World War 1 as surgeon general.¹⁵

1890: Rubber gloves were introduced to the Operating theatre by Caroline Hampton Halsted (Married to William Halsted).¹⁶ Caroline was a scrub nurse, had dermatitis and let the rubber gloves produced by ‘Goodyear Rubber Company’. The rubber gloves were soon acquired by other surgeons.¹⁶

1895: Discovery of X-rays by Wilhelm Roentgen (1845 – 1923). German mechanical engineer and physicist.¹⁷

1896: The first successful heart surgery by Ludwig Rehn (1849 – 1930, also mentioned above). He repaired a stab wound to a 22-year-old gardener, saving his life. The procedure led to the ethical discussions of heart surgery.^15,18