The Evolution of Surgery: From Primitive Practices to Modern Innovations

The term "surgery" finds its roots in the Greek words cheiros (hand) and ergon (work), aptly encapsulating the manual manipulations performed by surgical practitioners to alleviate injuries and diseases. The history of surgery is as ancient as humanity itself, with evidence suggesting that our ancestors possessed a natural inclination to treat physical ailments, driven by the universal instinct for self-preservation.

Since the emergence of Homo sapiens approximately 300,000 years ago, individuals with a particular aptitude for healing have likely existed. This is not surprising, given that self-preservation is a fundamental instinct shared by all mammals. For instance, a wounded dog instinctively licks its wounds, limps on three legs if injured, seeks shelter when ill, and even consumes specific grasses or herbs to induce vomiting when feeling unwell. Similarly, early humans would have sought to heal themselves and others, developing rudimentary methods to treat injuries and diseases.

Palaeopathologists, scientists who study ancient diseases through skeletal remains, have uncovered abundant evidence that our prehistoric ancestors were plagued by various ailments. Excavations of ancient skeletons reveal fractures, bone diseases, and dental decay, indicating that even in the earliest human societies, injuries and illnesses were common. Notably, evidence of bone tumors has been found in the fossilized remains of dinosaurs, such as a bony tumor on the tail vertebrae of a dinosaur that lived millions of years ago in what is now Wyoming.

Injuries inflicted by falls, crushing incidents, wild animals, and human conflicts necessitated treatment. Among primitive tribes, open wounds were typically covered with dressings made from natural materials such as leaves, plants, cobwebs, ashes, natural balsams, or even cow dung. The use of cow dung as a dressing for the umbilical cord was still practiced in some West African villages in recent times, leading to cases of neonatal tetanus due to the presence of tetanus spores in feces.

Remarkably, primitive surgical techniques often displayed a high degree of ingenuity. Among the Masai of East Africa, deep wounds were stitched together using acacia thorns, which were plaited against each other with plant fiber to hold the edges of the cut together. In both India and South America, insects such as termites or beetles were used to bite across the edges of a wound, with the insect's body twisted off, leaving the jaws to hold the wound closed. This method bears a striking resemblance to the metal skin clips used in modern surgical procedures. Splints made of bark or soft clay were also employed to immobilize fractured limbs, and similar splints have been discovered in ancient Egyptian burial sites.

Beyond treating wounds and fractures, early surgeons performed three main types of operative procedures: cutting for bladder stones, circumcision, and trephination of the skull. Trephination, the practice of drilling or scraping a hole into the skull, was believed to release evil spirits or relieve pressure from head injuries. Evidence of trephination has been found in ancient cultures worldwide, from Europe to South America, indicating that early surgeons possessed a deep understanding of the human body and its ailments.

In conclusion, the history of surgery is a testament to the ingenuity and adaptability of the human spirit. From the use of primitive tools and natural materials to the development of sophisticated surgical techniques, the evolution of surgery reflects humanity's enduring quest to heal and preserve life. Today, modern surgery continues to build on this ancient legacy, employing advanced technology and medical knowledge to save lives and alleviate suffering.
The Evolution of Surgery: From Primitive Practices to Modern Innovations