The history of surgery is a fascinating collection of
knowledge from various civilizations dating back up to four thousand years.
Some of the oldest writings on surgery and surgeons’ duties date back to the
Hammurabi code and Egyptian papyri. The role of the surgeon, particularly, has
always had a somewhat peculiar distinction from that of other physicians.
In
reality, the physician sphere rarely interacted or overlapped with the surgeon
sphere of practice, and responsibilities and rewards assigned to the two
groups were frequently completely different. We sought to examine and compare
the scope of practice, risks, rewards, and punishments of surgeons in Ancient
Assyria and Ancient Egyptian times.
The responsibilities of the surgeon were, interestingly,
somewhat similar to those of surgeons now. Surgeons were responsible for
evaluation of ailments that were considered mechanical in nature.
Ophthalmologic surgeries are noted as being done as early as 3500 BC for 10
shekels, whereas members of the ruling class would frequently pay significantly
reduced, and sometimes almost none, of the ordained fees. Other
responsibilities for Assyrian surgeons included management of bowel
obstructions.
Descriptions of surgeons “opening the bowels” to let impacted
contents spew out are described in these texts. While it is unclear whether
these were enterotomies or early ostomies, the concept of decompression is
delineated. Conservative management of bowel obstructions and impactions is
also described by what appears to be orogastric lavage with ointments and oils,
and later, enemas as well. Keeping patients nil per os (NPO) is also described,
with various medicinal shrubs and herbs provided “without food”.
