The first record of a surgery was during the Neolithic Age, through a process called trepanation. While this was most likely done to drive evil spirits away, Neolithic "surgeons" were thought to have unknowingly cured things like headaches and insanity.
"Trepanation is the process of creating an opening in the skull, either by drilling or sawing. "
-Michelle Powell-Smith (History Collection)
More than 1500 skulls found dating to the Neolithic period show evidence of trepanation, with, in some cases, multiple holes in the skull. [History Collection]
"In Egypt, about 3000 BC, surgeons were immobilizing fractures, excising tumours and suturing wounds with linen thread. But what is most significant in the development of surgery, Friedenberg notes, was how the mummification of bodies taught surgeons about anatomy, improving their diagnosis and treatment of the living."
-Canadian Medical Research Journal
"Indian surgery (circa 400 BC) expanded the scope of the discipline by reconstructing body parts, missing because of the judicial practice of removing the nose and parts of the ear as punishment, Friedenberg writes. Surgeons rebuilt the nose, for example, by inserting two small pipes to create nostrils, then suturing skin from the cheek, in the shape of a leaf."
-Canadian Medical Research Journal
Eventually, in the late 1740s, renowned surgeon John Hunter developed new surgical procedures by observing organs in the body, fixing previous incorrect theories.
John Hunter (1728–1793) attributed to Johan Zoffany
"Hunter transformed surgery from an empirical craft to a science.”
-Zachary Friedenberg (Prof. of Orthopedic Surgery)
This book, first published in 1771, details the form and structure of the dentition, jaws, and related muscles, how the teeth develop, their customary appearance when healthy as well as their presentations when diseased or pathological, and assorted other information that Hunter deemed important and necessary to a proper comprehension of oral anatomy and the treatments available at the time for its maladies. [John Hunter, courtesy of NYU Dentistry]
Before the 1846 Ether Dome demonstration, the biggest barrier to surgical success was pain management. Techniques like alcohol or opium inhalation and herbal remedies were used to subdue patients, but seldom nullified pain effectively. Squirming patients had to be restrained and operations were lighting fast, raising the risk of accidental death.
Portable version of an apothecary cabinet, containing herbal and chemical preparations which would have been administered by a doctor on visits to patients. [courtesy of The Russell Museum]
Without anaesthesia, patients had to be held down as they were subjected to agonising pain [Charles Bell]
"During the 17th and 18th centuries, surgeries were often performed without anaesthesia. Surgeons relied on alcohol, something for patients to bite down on, or simply the patient’s ability to withstand pain."
-European Society of Anaesthesiology and Intensive Care
“Often people would not have operations until they were absolutely at death's door or living in excruciating pain.”
-Sally Frampton (Medical Historian)
Even with several people holding them down, thrashing patients were hard to restrain. [Stefan de Hert].
Due to the inability to manage pain, many considered surgery as a last resort.