An Introduction to Surgery

By Ambrose Parey, Father of Surgery, 1510-1590

Book 1

II. Of Surgical Operations.

Five things are proper to the duties of a surgeon:
1. Growth Removal
2. Restoring Dislocations
3. Separating body parts joined together
4. Joining separated body parts
5. Devising prosthetics and orthotics


The best way to learn these things is from hands-on experience, not from reading books or listening to teachers every day. Speech, no matter how eloquent or detailed, will never adequately describe procedures you can only learn from your own eyes and handiwork. 

Growth Removal Examples:

Examples of Dislocated Joints:

Separation examples:

  • Fingers growing together, either by some chance, as burning, or from birth
  • Hymenectomy
  • Frenectomy – separating the ligament of the tongue, which hinders children from sucking and speaking, 
  • Frenulectomy – which hinders the glans of the penis from being uncovered of the foreskin
  • Venous ablation
  • Tenodesis – cutting a tendon
  • Rhizotomycutting a nerve to stop convulsions 
  • Anotia/microtia – babies born without an ear passage, (or perhaps he’s talking about ear wax being a membrane that needs separating)
  • Bosma syndrome – cutting nostrils in babies born without a nose
  • Imperforate anus
  • Division of membrane stopping the passage in the mouth
  • or the stubborn sticking together of the hairs of the eye-lids. 
  • Refer to this place all the works done by Causticks, the Saw, Trepan, Lancet, Cupping glasses, Incision Knife, Leeches, either for evacuation, derivation or revulsion sake.

Joining examples:

  • Stitches
  • Bolstering
  • Binding
  • Repairing fractures
  • Restoring luxated parts
  • Binding vessels to stop bleeding
  • Cleft lip surgery
  • Filling in cavities caused by ulcers and fistulas

Prosthetics/Orthotics examples:

  • Setting an eye, ear, nose, or teeth
  • Filling the hollowness of the palate eaten by the pox with a thin plate of gold or silver, etc.
  • Creating a tongue extension 
  • Arm prosthetic
  • Leg prosthetic
  • A vest with iron plates to make the body straight
  • Putting cork in a shoe to fill it out
  • Fastening stockings to a man’s girdle to help his gait

In performing these things with the hands, we cannot but cause pain. Who can cut off a leg, tear apart the bladder, restore dislocated bones, open ulcers, bind wounds, or apply cauteries without causing pain? But unless we do it, the patients will either die or lead the remnant of their lives in perpetual misery. Who can accuse a surgeon of cruelty? Who could want surgeons to be punished the same way the ancient surgeon Archagatus of Rome was? He was a good surgeon, but because his methods were painful, the people dragged him from his house into the Campus Martius and there stoned him to death, according to Sextus Cheroneus of Plutarche’s niece. It was truly an inhumane ingratitude to cruelly murder a man intent on doing such a necessary job. The Senate disapproved of what the people did to him, so they made a statue of him in gold and placed it in Aesculapius, dedicated to his perpetual memory. 

 

I like what Celsus said: a surgeon must have a strong, stable, and intrepid hand, and a mind resolute and merciless, so that to heal him he takes in hand, he be not moved to make more haste than the thing requires; nor to cut less than is needed; but which does all things as if he were nothing affected with their cries; not giving heed to the judgment of the vain common people, who speak ill of surgeons because of their ignorance.