The Wound Man ( or Man of Wounds , depending on how you translate it in Fasciculus medicinae , the 1491 aesculapian treatise in which his imagefirst appear ) is one of the most well - known knightly surgical diagrams going . It ’s up there with da Vinci ’s Vitruvian Man ( né 1490 ) but is far less esthetically pleasing than what everyone ’s favourite Renaissance Man had cooked up . Rather , the Wound Man — his poor mangled physical structure decorate with pungency and pustule , smashed by rocks , and pierce with various virulent implement — fag out a look of serene surrender that belies the infinite violent indignities that have been visited upon him .
This macabre teaching assist vividly demonstrates the various wound that a person may receive through war , chance event , or disease . It also hammers home the the incontrovertible fact that — no matter how regal , fight - hardened , or beautiful we may image ourselves to be — the human body is essentially a meat sacque full of goo that is constantly on the brink of ca-ca out on us .
That corporeal fragility and the distance to which intrepid ( and otherwise ) surgeon throughout human history have gone to direct it via novel , nonsensical , and often downright terrifying surgical interventions is the subject of Dutch surgeon Arnold van der Laar ’s young Word of God , Under the tongue : A History of Surgery in 28 Remarkable Operations . The Wound Man appear therein , alongside a coloured casting of characters hovering on and around the operating board . We see wiz surgeon Robert Liston at workplace , and get wind about the medical troubles of Queen Victoria , Harry Houdini , Vladimir Lenin , a smattering of popes , and the Sun King himself , Louis XIV , who became the proud ( and very public ) recipient of France ’s first successful anal retentive fistula remotion .
caravan der Laar outlines legion crashing miracles and missteps while also taking care to explain the science and methodology behind the military operation themselves ; he is a operating surgeon , after all , and attention to item is kind of their matter today . He scoured the archive of the Nederlands Tijdschrift voor Heelkunde , the daybook of the Dutch Surgical Association , and plucked out 28 model of famed operating room — many of them the first of their sort — that range from the exhilarating to the tragical . He even takes the lector back to the Biblical epoch , and excuse the case of Abraham ’s alleged invention of January 1 to fighting phimosis , a common penial ailment that bedeviled desert - populate folk in those days ( open flowing robe , sand , detritus , a lack of piss for washing , and a pronounced want of underclothing was a recipe for catastrophe ) .
He also generate more existential , tackling questions like , “ What kind of citizenry are surgeons ? What on Earth makes you want to trend into someone ’s body , even if they ca n’t sense it ? ” from his own perspective as an established expert in his discipline . He is frank about the immense pressure and sense of responsibleness he and his fellow surgeon palpate as they use their paw to stress and heal patients , and about the agony of self - dubiousness , and of see a affected role conk out in your concern . The people behind the masquerade party may seem like heroes or magicians to those of us looking up from the operating table — but they are still fallible , and mussy , and above all , human . Being a surgeon has never been an prosperous job , and while the creature and circumstance have changed , this ramification of healing remain a unceasing struggle .
“ Throughout the book I express my utmost surprise about how small the old surgeons seemed to have been be active emotionally with the distress they imposed on their patients , ” he told Gizmodo via email . “ Reading old reports on operation without anesthesia , I repeatedly think , how was this potential ? modernistic surgeons would never dare to inflict such pain to their patient , or such terrible peril of kill them with their operation . ”
sawbones are now hailed for their preciseness , knowledge , and dedication to the healing artistic creation , but well into the eighteenth century , they were regarded as little more than butchers . Prior to the borrowing of construct like introductory hygiene ( to say nothing of anaesthesia ) , they did petty to disabuse their patients of this impression . As van der Laar enjoin , “ Most affected role had a cicatrix for life , not only on their skin , but also on their minds . ”
The betting odds of surviving a surgical operation were appallingly slim , and even if you did make it through , betting odds are that an infection ( or worse ) would finish you off later . Surgery was a last resort for the despairing and the doom .
Van der Laar kicks off the book with the story of Ambroise Pare , a sixteenth century French army - surgeon who find out that most operative interventions do more harm than good . “ At this compass point the modulation from the craftsman - surgeon to the scientist - surgeon started , ” he explained . “ This transition is fill in only now , with evidence based surgical operation gaining power over the previous expert belief surgery . ”
The next case van der Laar distinguish fear one Jan de Doot , a Dutch Adam Smith who underwent two unsuccessful surgeries to remove an extremely painful bladder stone , and then determine to take matters into his own hands — literally . While his married woman was at the market , de Doot took a curving tongue and made three crossways cuts to his perineum , then used his index fingers to deplume the wounding astray enough for the Harlan F. Stone — which was “ larger than a chicken ’s egg and weighed four ounces”—to fall out . He survive this primitive lithotomy ( and must have felt at least a piddling smug about the whole matter ) but was left with a huge , festering injury between his legs for the residual of his animation .
Frau Therese Heller was a bit luckier , though only just . In 1881 , she underwent the first successful distal gastrectomy in 1881 , and manage to survive for a good four month after the fact ( three month longer than the first manlike patient to give it a spin ) . Viennese surgeon Theodor Billroth polish off a monolithic neoplasm from the 43 - year - quondam mother of eight ’s venter ; prior to that , Billroth performed the first successful esophagectomy on a dog in 1870 , the first successful laryngectomy on a human being in 1873 , and also found sentence to key out the streptococcus bacteria in 1874 .
Then as now , surgeons and medical folk in general were a curious clump , and some especially lionize surgeon like Billroth , Lister , and wit sawbones Harvey Cushing pioneered multiple technique and notched various vital discoveries . Harvery Williams Cushing was one of the most influential neurosurgeons of his time , and his list of professional achievement is pall , to say the least . In 1926 , he introduced a novel raw invention — locomotive engineer William Bovie ’s electrosurgical source — into the operating dramaturgy in hopes of finding a novel style to halt bleeding during surgery .
His use of electrocoagulation ( a process by which heat energy is used to stem the flow of blood by converting the protein in stemma and the surround tissue from liquid to solid ) to cauterize a tumour kept a brain tumor patient from bleed out during a prolonged operation . It also turned Cushing into something of an evangelist for the applied science , and allowed him to successfully complete previously unthinkable surgical intervention . Almost a one C later , Bovie ’s electrocoagulation equipment has stay on almost unaltered , and is used in operating elbow room across the world .
Some other things have n’t shift , either . The full-bodied and royal have always had access code to the well medical care usable , and that stay as true today as it was in 1853 , when a fraught Queen Victoria gingerly availed herself of a cutting - edge new anaesthetic : chloroform . At the time , anesthesia was known as “ Yankee humbug ” in England and dismissed as a scam used only by surgeons who lack the speed and acquisition to operate quick . However , the Queen — who excellently dreaded childbirth and suffered from severe post - natal depressive disorder following the nativity of each baby — was do-or-die for relief , and opt to sample the experimental raw method .
Fifteen drop and a handkerchief to the nose later , she awaken raving about “ that blessed chloroform , soothing and delicious beyond beat ” that had been administered by ( a very anxious ) Dr. John Snow . News of the female monarch ’s experience , spread across Europe , and woman began demand the same treatment — know as anesthésie à la reine , the Queen ’s anaesthesia .
This marked the commencement of a gradual sea modification in the recitation of OR as a whole . The Second Advent and widespread acceptation of anaesthesia meant that operating surgeon no longer had to race against the clock , and were now capable to take their clip while address patients . The heroics of early operating surgeon who sliced and diced as needed while their patients had only whisky ( if that ) to benumb the pain were rendered unneeded , and submit to the annals of historical barbarism . Thanks to the exploit and sacrifices of these people and so many others left nameless , the butchering artistry tardily but definitely became a precision skill .
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