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Ancient Surgery - Modern Yardstick

Trepanation - crude form of surgery


When Phineas Gage’s skull got badly pierced in a railroad accident in 1848, many, including surgeons, had enough of evidence that his end was near. But Gage survived and lived happily thereafter. Was it an accidental case of trepanation? Trepanation could be called as a crude form of surgery, which involves drilling holes into the skull for the sake of cranial correction or treatment.

This was an ancient practice; and if medical history is anything to go by, it worked well without high risk factors involved. Trepanation has now given way to cranial surgery, which, on account of high precision involved, remains to be a highly specialized job of highly specialized people. Evidence again states that most of the surgical techniques that we call as modern now actually owe their roots to the ancient times.

According to archaeologists who have found skulls with carefully carved, man-made holes in them, the art of cranial surgery was practiced up to 5,000 years ago in Europe, and until a few centuries ago on many other continents. “Evidence of healing and bony scar tissue around the holes shows that many of these people lived long lives after going under the knife,” says Willow Lawson, a researcher.

“If you cut a hole in someoneís head, as it heals, the edges smooth out,” says John Verano, an archaeologist at Tulane University who is writing a book on the surgery. “A spongy kind of bone will grow between the gaps.”

Archaeologists think most of these ancient operations were performed to treat individuals who had suffered massive head trauma, most likely in combat. Early surgeons probably performed trepanation to remove splinters of skull bone and relieve pressure from blood clots that formed when blood vessels were broken. It was surgery at work in ancient times.

Ancient Nose Job

Other, so to say, non-invasive techniques were used for beautification than healing purposes. For example, correction of nose, which we call as rhinoplasty now, was practiced in the Ayurvedic era some 5000 years back. So was plastic surgery, which was normally employed in instances of battle wounds or animal attacks.

“Although Egyptians performed plastic surgery as early as 3400 B.C., but it was actually in India, sometime between the sixth century B.C. and the sixth century A.D. when the ancient Ayurvedic compendium Susruta Samhita was written, that the skill evolved.” says Thomas V. DiBacco, a historian at American University.

Indian surgeons devised what came to be known as the attached-flap method of plastic surgery as a solution for the punishment for adultery -- the cutting off of the nose. In the procedure, skin transplanted to the nose area was kept alive by remaining attached to healthy tissue, as the Susruta Samhita explained:

When Christopher Columbus set sail in 1492, the procedure began to be revived in Europe. Around the same time Italian surgeons used skin from both the cheek and arm to replace noses. Nearly a century later, Gasparo Tagliacozzi, professor of surgery at Bologna, employed upper-arm skin grafts on individuals whose noses had been destroyed by syphilis. The graft at one end remained attached to the arm, to be nourished by the body's blood.

The procedure finally made headway into northern Europe finally in the 18th century when British surgeons in India were witness the attached-flap surgery performed. Then came the practice of free-tissue grafts, a procedure in which tissue was completely cut away from original site and planted elsewhere. This was the beginning of modernization of techniques that bore ancient roots.

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