Editing Surgery (section)

===Modern surgery===
The discipline of surgery was put on a sound, scientific footing during the [[Age of Enlightenment]] in Europe. An important figure in this regard was the Scottish surgical scientist, [[John Hunter (surgeon)|John Hunter]], generally regarded as the father of modern scientific surgery.<ref>{{cite book|url=https://books.google.com/books?id=BFAsAAAAYAAJ|title=The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery| vauthors = Moore W |year=2005|publisher=Crown Publishing Group|access-date=7 February 2013|isbn=978-0-7679-1652-3}}</ref> He brought an [[empiricism|empirical]] and [[experiment]]al approach to the science and was renowned around Europe for the quality of his research and his written works. Hunter reconstructed surgical knowledge from scratch; refusing to rely on the testimonies of others, he conducted his own surgical experiments to determine the truth of the matter. To aid comparative analysis, he built up a collection of over 13,000 specimens of separate organ systems, from the simplest plants and animals to humans.{{citation needed|date=May 2023}}

He greatly advanced knowledge of [[venereal disease]] and introduced many new techniques of surgery, including new methods for repairing damage to the [[Achilles tendon]] and a more effective method for applying ligature of the [[arteries]] in case of an [[aneurysm]].<ref>{{Cite web|url=http://library.uthscsa.edu/2010/12/john-hunter-%E2%80%9Cthe-father-of-scientific-surgery%E2%80%9D-resources-from-the-collection-of-the-p-i-nixon-library/ |title=John Hunter: "the father of scientific surgery": Resources from the collection of the P.I. Nixon Library |access-date=17 December 2012 |url-status=dead |archive-url=https://web.archive.org/web/20131026210110/http://library.uthscsa.edu/2010/12/john-hunter-%E2%80%9Cthe-father-of-scientific-surgery%E2%80%9D-resources-from-the-collection-of-the-p-i-nixon-library/ |archive-date=26 October 2013 }}</ref> He was also one of the first to understand the importance of [[pathology]], the danger of the spread of [[infection]] and how the problem of [[inflammation]] of the wound, bone [[lesion]]s and even [[tuberculosis]] often undid any benefit that was gained from the intervention. He consequently adopted the position that all surgical procedures should be used only as a last resort.<ref>{{Cite web |url=http://www.healio.com/hematology-oncology/news/print/hematology-oncology/%7BC9A8CA57-FA27-4432-AADF-D8EE0671428F%7D/John-Hunter-Founder-of-Scientific-Surgery |title=John Hunter: 'Founder of Scientific Surgery' |access-date=17 December 2012 |url-status=live |archive-url=https://web.archive.org/web/20131214210131/http://www.healio.com/hematology-oncology/news/print/hematology-oncology/%7Bc9a8ca57-fa27-4432-aadf-d8ee0671428f%7D/john-hunter-founder-of-scientific-surgery |archive-date=14 December 2013 |df=dmy-all }}</ref>

Other important 18th- and early 19th-century surgeons included [[Percival Pott]] (1713–1788) who described [[Pott disease|tuberculosis on the spine]] and first demonstrated that a cancer may be caused by an environmental [[carcinogen]] (he noticed a connection between [[chimney sweep]]'s exposure to soot and their high incidence of [[Chimney sweeps' carcinoma|scrotal cancer]]). [[Astley Paston Cooper]] (1768–1841) first performed a successful ligation of the abdominal aorta, and [[James Syme]] (1799–1870) pioneered the Symes Amputation for the [[ankle joint]] and successfully carried out the first [[Hemipelvectomy|hip disarticulation]].

Modern [[pain]] control through [[anesthesia]] was discovered in the mid-19th century. Before the advent of [[anesthesia]], surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient [[suffering]].  This also meant that operations were largely restricted to [[amputation]]s and external growth removals. Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as [[diethyl ether|ether]], first used by the American surgeon [[Crawford Long]], and [[chloroform]], discovered by Scottish obstetrician [[James Young Simpson]] and later pioneered by [[John Snow (physician)|John Snow]], physician to [[Queen Victoria]].<ref>{{cite book| vauthors = Gordon ML |title=Sir James Young Simpson and Chloroform (1811–1870) |url=https://books.google.com/books?id=pYer05UwKBYC|access-date=11 November 2011|year=2002|publisher=The Minerva Group, Inc. |isbn=978-1-4102-0291-8 |page=108}}</ref> In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body.  In addition, the discovery of [[muscle relaxant]]s such as [[curare]] allowed for safer applications.{{citation needed|date=May 2023}}

====Infection and antisepsis====
The introduction of anesthetics encouraged more surgery, which inadvertently caused more dangerous patient post-operative infections. The concept of infection was unknown until relatively modern times. The first progress in combating infection was made in 1847 by the [[Hungarian people|Hungarian]] doctor [[Ignaz Semmelweis]] who noticed that medical students fresh from the dissecting room were causing excess maternal death compared to midwives. Semmelweis, despite ridicule and opposition, introduced compulsory handwashing for everyone entering the maternal wards and was rewarded with a plunge in maternal and fetal deaths; however, the [[Royal Society]] dismissed his advice.{{citation needed|date=May 2023}}
[[File:Joseph Lister2.jpg|thumb|upright|[[Joseph Lister, 1st Baron Lister|Joseph Lister]], pioneer of [[Antiseptic#Usage in surgery|antiseptic surgery]]]]
Until the pioneering work of British surgeon [[Joseph Lister, 1st Baron Lister|Joseph Lister]] in the 1860s, most medical men believed that chemical damage from exposures to bad air (see "[[Miasma theory of disease|miasma]]") was responsible for [[infections]] in wounds, and facilities for washing hands or a patient's [[wound]]s were not available.<ref name="storyof medicine">{{cite book | url=https://books.google.com/books?id=WKkCwqDEI9QC&q=%22good+old+surgical+stink%22&pg=PA420 | title=The Story of Medicine | publisher=Kessinger Publishing | vauthors=Robinson V | page=420 | isbn=978-1-4191-5431-7 | year=2005 }}{{Dead link|date=April 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> Lister became aware of the work of French [[chemist]] [[Louis Pasteur]], who showed that rotting and [[fermentation (food)|fermentation]] could occur under [[Anaerobic infection|anaerobic conditions]] if [[micro-organisms]] were present.  Pasteur suggested three methods to eliminate the [[micro-organisms]] responsible for [[gangrene]]: filtration, exposure to heat, or exposure to [[chemical solutions]]. Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop [[antiseptic]] techniques for wounds.  As the first two methods suggested by Pasteur were inappropriate for the treatment of human tissue, Lister experimented with the third, spraying [[carbolic acid]] on his instruments. He found that this remarkably reduced the incidence of gangrene and he published his results in ''[[The Lancet]]''.<ref>{{cite journal | vauthors = Lister J | title = On a new method of treating compound fracture, abscess, etc.: with observations on the conditions of suppuration. | journal = The Lancet | date = March 1867 | volume = 89 | issue = 2272 | pages = 326–329 | doi = 10.1016/S0140-6736(02)51192-2 }}<br>Five articles running from:<br>Volume 89, Issue 2272, 16 March 1867, pp. 326–29 (Originally published as Volume 1, Issue 2272)<br>
to:<br>Volume 90, Issue 2291, 27 July 1867, pp. 95–96 Originally published as Volume 2, Issue 2291</ref> Later, on 9 August 1867, he read a paper before the British Medical Association in Dublin, on the ''[[Antiseptic Principle of the Practice of Surgery]]'', which was reprinted in the ''British Medical Journal''.<ref>{{cite journal | vauthors = Lister J | title = On the Antiseptic Principle in the Practice of Surgery | journal = British Medical Journal | volume = 2 | issue = 351 | pages = 246–248 | date = September 1867 | pmid = 20744875 | pmc = 2310614 | doi = 10.1136/bmj.2.351.246 }}. Reprinted in {{cite journal | vauthors = Lister BJ | title = The classic: On the antiseptic principle in the practice of surgery. 1867 | journal = Clinical Orthopaedics and Related Research | volume = 468 | issue = 8 | pages = 2012–2016 | date = August 2010 | pmid = 20361283 | pmc = 2895849 | doi = 10.1007/s11999-010-1320-x }}</ref><ref name=FUSourcebook>{{cite web| vauthors = Lister J |title=Modern History Sourcebook: Joseph Lister (1827–1912): Antiseptic Principle Of The Practice Of Surgery, 1867|url=http://www.fordham.edu/halsall/mod/1867lister.asp|publisher=Fordham University|access-date=2 September 2011|url-status=live|archive-url=https://web.archive.org/web/20111107163352/http://www.fordham.edu/halsall/mod/1867lister.asp|archive-date=7 November 2011|df=dmy-all}}Modernized version of text</ref><ref name=PG-JL>{{Cite book| vauthors = Lister J |title=On the Antiseptic Principle of the Practice of Surgery by Baron Joseph Lister|url=http://www.gutenberg.org/ebooks/23968|publisher=Project Gutenberg|access-date=2 September 2011|url-status=live|archive-url=https://web.archive.org/web/20111009065204/http://www.gutenberg.org/ebooks/23968|archive-date=9 October 2011|df=dmy-all|date=December 2007}} E-text, audio at Project Gutenberg.</ref> His work was groundbreaking and laid the foundations for a rapid advance in infection control that saw modern antiseptic operating theatres widely used within 50 years.{{citation needed|date=May 2023}}

Lister continued to develop improved methods of [[antisepsis]] and [[asepsis]] when he realised that infection could be better avoided by preventing bacteria from getting into wounds in the first place. This led to the rise of sterile surgery. Lister introduced the Steam Steriliser to [[sterilization (microbiology)|sterilize]] equipment, instituted rigorous hand washing and later implemented the wearing of rubber gloves. These three crucial advances – the adoption of a scientific methodology toward surgical operations, the use of anaesthetic and the introduction of sterilised equipment – laid the groundwork for the modern invasive surgical techniques of today.

The use of [[X-rays]] as an important medical diagnostic tool began with their discovery in 1895 by German [[physicist]] [[Wilhelm Röntgen]]. He noticed that these rays could penetrate the skin, allowing the skeletal structure to be captured on a specially treated [[photographic plate]].

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Image:Acquapendente - Operationes chirurgicae, 1685 - 2984755.tif|[[Hieronymus Fabricius]], ''Operationes chirurgicae'', 1685
File:John Syng Dorsey.jpg|John Syng Dorsey wrote the first American textbook on surgery
File:1753 Traversi Operation anagoria.JPG| An operation in 1753, painted by [[Gaspare Traversi]].
</gallery>