Otolaryngology, or the study of diseases of the ear, nose, and throat, became a recognized branch of medicine at the end of the nineteenth century with the discovery of anesthesia though physicians had always been called upon to do their share of surgery on the head and neck because of trauma that had accompanied ongoing conflicts throughout history.
The removal of cataracts was popular in sixth century India and continued by barber-surgeons as they traveled throughout Europe, remaining the only procedure routinely performed on the eye prior to the nineteenth century.
Because of the high mortality of surgical intervention, all sought a simple medical cure for urinary tract obstruction.
For centuries the practice of removing stones, or lithotomy, was looked down upon by the medical profession as a trade best left to traveling barber-surgeons, who included in their resume other minor surgical procedures such as dental extractions, bloodletting, abscess drainage, and fracture repair. Death was certain without intervention and the chance of survival from lithotomy was about 10 per cent, so physicians avoided taking on this challenge. Dr. Sydenham commented, “The patient suffers until he is finally consumed by both age and illness, and the poor man is happy to die.”
Beautiful anatomic representations of the female anatomy well preceded the attention that physicians paid to the diagnosis and treatment of women's diseases.
The Civil War was a seminal event in American history as combatants decided whether or not the United States would ultimately become a great nation. The death and destruction was horrific, a large part of the problem being that very few physicians had any surgical training at the beginning of the war. The Union had only 30 surgeons and 83 assistant surgeons, and when the war started, 3 surgeons and 21 assistants resigned to join the South.
Prehistoric skeletons have commonly demonstrated evidence of healed fractures, and certainly physicians have always been faced with the need to address broken bones and displaced joints. Some of the finest early illustrations were those of the skeletal system, and orthopedic repair was a subject of some of the earliest medical texts.
Head trauma resulting in the development of a subdural hematoma, or a blood clot around the brain, was not an uncommon medical problem faced by physicians after large confrontations. These clots needed to be removed and made trepanning (the excision of a section of skull) a fairly common practice throughout early medical history.
The most dangerous peri-operative complication related to surgery was uncontrolled bleeding, so that hemostasis has always been an critical and challenging problem. There were a number of inventive ways in which surgeons attempted to control the loss of blood.
The manufacture of surgical instruments was primarily left to tradesmen prior to the eighteenth century. Armourers, blacksmiths, and cutlers made instruments that were used for crude surgery, and later, silversmiths were responsible for finer work. A dramatic increase in the complexity of surgical procedures occurred in the nineteenth century as the development of technology provided physicians with a new class of therapeutic instrumentation.