ABSTRACT

Surgery has evolved from one of the most despised branches of medicine into one of the most respected, most powerful, and best compensated areas of medical specialization. A closer examination of the evolution of surgery suggests a more complex explanation for the changes that occurred in the nineteenth century. The art of surgery gained much from studies of anatomy, physiology, pathology, and even chemistry, but it also contributed an empirical, anatomically based point of view that was to have important ramifications for medicine as a whole. The remarkable products of the eighteenth-century chemical revolution transformed the search for surgical anesthetics and replaced anodynes from nature's medical garden. The introduction of anesthesia might have given surgeons the opportunity to carry out more complex operations, but postsurgical infections seemed to become an even more frequent menace. Nineteenth-century surgery is so inextricably associated with "hospitalism" that modern surgery seems to be a direct product of the introduction of Joseph Lister's antiseptic system.