Thomas Franco

Mr. Palcsey

Honors English 10

April 30, 2018

Franco’s Anatomy: The Advancements of Surgery Across Time

Surgery and medicine has changed life for people in every era. The capability of

physicians has grown over the centuries, and safety in surgery has been improved as well,

making this era the best in medical history, thanks to technology. The advancements of

technology across the Middle Ages changed drastically from the time of Christ and continues to

improve to be better in the present day, and the projected path in the future continues to present

new opportunities for medicine to improve.

Medicine and surgery date back hundreds of years, like to ancient Egypt back between

2000 and 1200 B.C. The Egyptians tied their medicine and surgical practices to the gods. “The

practice of medicine was still mainly magico-religious in character, but much of it was rational

and there was a good deal of accumulated knowledge about disease,” (Bishop 30). Egypt loved

their gods and religion, as it was the most important lifestyle to Egyptian culture. They

cherished their gods so much that each god in their culture was paired with a disease or illness,

and also different parts of the body. Archaeologists have discovered ancient texts and objects

from excavations that shows insight ancient Egyptian surgery (Bishop 30). Ancient Egypt

lacked educated doctors, as those who performed surgeries were Egyptian priests. Priests being

the most qualified for medicinal and surgical purposes correlated with their deep faith in

worshipping gods (Bishop 31). Because of warfare, Egyptians learned about the human body

through having to suture and bandage deep stab wounds. The ancient Egyptians could set broken
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bones, so they could heal properly (Bishop 35). The Egyptian knowledge with little known

background information to base their studies on is spectacular. “Hippocratic texts precluded

significant influence on western medical thought,” (Barr 263). The knowledge the Egyptians

created and studied was a building block for the future and many generations after they passed.

They presented a platform for other cultures and eras to continue research where the Egyptian

era of medicine ended.

The Greeks had their pinnacle moment in the world of medicine and surgery around the

first century (Bishop 50. This was because of their massive growth in anatomical and

physiological knowledge. The Greeks did not rely on their faith and the gods when it came to

medicine and surgery like the Egyptians did. A strong foundation was formed on science and

principles to allow more information to be learned regarding disease and illness. (Bishop 46, 57)

Before this foundation was implemented, about 400 years earlier surgeons were expected to be

of focused on completing the procedure as quick as possible, ignoring screams of a patient in

pain, as more time meant more blood was being lost (Murdoch 10). With extensive

documentation about patient’s cases, this opened up for books to be written and to be learned,

and normal check-ups of patients were improved as well. Surgeons were expected to always be

able to attend to a patient at any given hour. This is very similar to the modern era’s version of

doctors being on-call, as the transition to modern day surgery slowly begins to form (Bishop 48).

Surgery at the beginning of the Middle Ages was practically nonexistent, as the fall of the

Roman Empire, was the fall of medicine too. Until the 11th and 12th century, medical schools

were not common in Europe, as medicine was not seen as worth being studied (Bishop 58).

Physicians were rare to come across, as members of the church were among those who studied

medicine. The Church had strict laws in place about the clergy being involved in medicine, as
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the body was seen as a holy place that should not be opened no matter what. Even when medical

schools came to fruition, what the schools were able to do was limited. Without detailed books

of the body, the only way to learn about the body was through dissection, which impacted the

growth and prosperity that could have been obtained at this time (Bishop 58). Surgery was kept

simple; fractures, dislocations, and wound treatments. These were basic injuries that did not

conflict with the Church’s beliefs. The borders the Church put up on the clergy on how much

they could do in the world of medicine meant that barbers and other men who lacked the

knowledge needed were those who became the ones to perform surgeries (Bishop 58-59).

Surgeons gained much knowledge and experience on the battlefield. Granted, it was only basic

treatment that could be carried out, but it was still valuable knowledge that was able to help

reignite the study of medicine in the Middle Ages (Bishop 60). As time progressed, medicine

became more and more popular with many great physicians such as Ambroise Pare and Guy de

Chauliac. According to Chauliac, a surgeon should be confident when preparing to perform a

surgery, but to also remember the possibility of things that can go wrong. He also talks about

how a surgeon should be a honorable man when charging patients for the surgery, and not taking

too much from the poor. (Murdoch 9-10) This begins to show the transformation of patient

care, compared to the view of it back roughly 1,000 years.

The Middle Ages possibly saw the use of anesthesia during surgery for the benefit of the

patient, as the first documentation of anesthesia usage was in the 19th century (Bishop 60). The

purpose of anesthesia was so the patient would feel less pain and be able to recover faster from a

surgery than without anesthesia. If anesthesia was used at this time, it would have been very

beneficial when removing arrows or bullets, as well as aiding burn treatments (Bishop 60).

Arrows had multiple ways of being removed. First, the wound would be cleansed with leaf
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juice. Then a hot spear would enter the cut to stop the excess bleeding and burn away unhealthy

tissue (Bishop 15-16). Burn treatments were cured with various herbs and oils to soothe the area

in pain. On Page 17, W.J. Bishop says treated with honey and a paste to allow the wound to

heal. By the end of the Middle Ages, the world of medicine had vastly opened up for even more

research for the future generations to build off of.

Much of medicines great accomplishments have come in the last 150 to 200 years.

Modern era of surgery really turned and came about in the mid to late 19th century making

modern surgery a rather recent technological advancement. Anesthesia was a huge advancement

that lead surgery into the modern era (Bishop 9). The study of medicine and surgery is

continuous, it is always being researched and developed, looking for refinement. Doctors always

look for new ways to learn about cases and procedures to see if there is any place to learn from

past procedures to improve upon. The technology doctors have the capability of using has

massively assisted in the progression of medicine, and new discoveries for doctors to learn about.

Some ways technology has greatly improved the world of medicine are CT Scans, Ultrasounds,

and Coronary Artery Bypass Grafting, or robotics in CABG (Diodato and Chedrawy 4). CT

Scans and Ultrasounds are used frequently by millions of people, as they give doctors different

ways to image the body in events such as pregnancy, or scanning a bone in a body to see if there

is a fracture or not.

CABG is more complex, as it only came about in the 1950’s and has been greatly refined

in the following decades (Diodato and Chedrawy 1). It is known as open-heart surgery as the

body circulates blood as it bypasses the heart. The past 100 years have seen a massive step up in

open heart surgery. From being an abstract, and to some possibly irrational, idea to a life-

changing operation that is widely-accepted, which has gone through multiple refinement stages
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to increase safety condition of the patient. Multiple variations of the operation are still being

researched to open up different approaches to surgery. This opens up more alternate starts that

better suit each patient’s state and condition with different method options (Diodato and

Chedrawy 4).

The process to become a doctor has changed drastically from the common era to the past.

Nowadays, being a doctor is a practice, unlike from before surgeons did not need a medical

background to perform surgery. Medical school in the Middle Ages lasted over 5 years, with an

exam that was a pass or fail, and those who passed got the title Doctor (Bishop 61). Over time, a

ranking system was implemented, and higher ranks meant more but could only be achieved

through more classes and exams. This hierarchy is quite similar to today, as going to medical

school longer allows for physicians to achieve much more than someone who does not. Starting

off a doctor earns a Bachelor's Degree, which is four years. Then, doctors take the Medical

College Admissions Test. After that, doctors earn a Medical Degree which takes 4 years as well.

Doctors then start their residency, lasting from 3-7 years, before receiving their licensure.

Finally, the doctor is certified to begin practicing as a career. This process can take up to 15

years. The Middle Ages had an apprenticeship, similar to residency, that lasted seven years

(Bishop 87).

With the growth of medicine, there are many different fields that were unknown to those

in ancient times, and even the Middle Ages. Surgeons back then only knew so much and were

only capable of doing basic procedures from today’s standards (Bishop 59). There are lots of

fields for students to look into to shown interest in doing as a career. A major shift from the past

to the common era is the focus on the patient’s condition. Over time, the doctors have paid more

attention to the needs of the patient rather than the completion of the surgery (Murdoch 14). If a
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procedure is too risky for a patient nowadays, the patient will not undergo the treatment as their

life is more valuable. Risk of death coming out of surgery is greatly reduced now with all the

checks and precautions doctors go through. Safety was to a priority to surgeons in the past

(Murdoch 15). Computers have helped doctors find diseases that have saved lives, as well as

aiding them in surgery. New technology is being tested to help doctors with various types of

procedures. Robotics is an up and coming phenomenon that will change the world of medicine

forever. Prototypes have been made to help with needle placement in CT-guided procedures

(Ray Jr. 419). With this technology still in a very early stage, there are lots of problems to be

addressed that hopefully will be upgraded to be even more beneficial in the surgical room. All

the great technological advancements accomplished in such a short amount of time makes the

future of medicine a spectacle to watch.

The present day is the pinnacle of medicine, and the future can only grow more on what

the world of medicine is now, and it is only where it is now because of the progress made in the

past and how it has changed. Without the technology available, the rapid development medicine

has made since the 19th century would not have been possible. The future of medicine depends

on this technology to continue its great expansion in the lives of future generations.

Works Cited Page

Barr, Justin. “Vascular Medicine and Surgery in ancient Egypt.” Journal of Vascular Surgery.

Section Edited by Norman M. Rich. Vol. 60, no. 1, Official Publication of Society of

Vascular Surgery, July 2014, pages 260-263.

Bishop, W.J. The Early History of Surgery. New York. 1995, pages 9-87
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Diodato, Michael and Edgar. G. Chedrawy. “Coronary Artery Bypass Graft Surgery: The Past,

Present, and Future of Myocardial Revascularisation.” Academic Editors C. F.

Bianchi, H. Hirose, and V. Vecsei. Vol. 2014, Hindawi, pages 1-6.

Murdoch, G. “Amputation Revisited.” Department of Orthopedic and Traumatic Surgery,

University of Dundee, Scotland. 1984, pages 8-15.

Ray Jr, Charles E. “Seminars in Interventional Radiology.” Thieme. Guest editor Hector Ferral.

Vol. 32 no 4, 2015, pages 333-454.