From C-sections performed to help delivery of a baby, to organ transplants and cosmetic surgery, surgeries certainly are lifesaving marvels in this day and age. However, surgeries used to be a last resort, characterised by great risk, pain and blood, as surgeons had to contend with the three principal obstacles plaguing the medical profession since its infancy – bleeding, pain and infections.

By the Classical Age, ancient Greek physician Dioscorides (the first person known to have used the word "anaesthesia") used potions made from mandrakes and wine. In later times some doctors even experimented with hypnotism. The really unlucky patients had to make do with folk-anaesthetics like mulberry and lettuce. None of these numbed completely, and few improvements were made during the Middle Ages.

In fact, in 1750, the anatomist, John Hunter, colourfully described surgery as ‘a humiliating spectacle of the futility of science’ and the surgeon as ‘a savage armed with a knife.’ Unfortunately, he was not far from the truth, as illustrated here with five facts about pre-anaesthetic surgery.

1. Pain was believed to be vital to keep the patient alive

In the pre-anaesthetic era, pain was treated not just as an unavoidable side-effect of surgery. In fact, sometimes it was believed that the loss of consciousness in a patient was dangerous, so pain-alleviators like opiates and alcohol were used sparingly, and typically administered shortly before a procedure.

2. Surgeons took an odd pride in being as bloody and messy as possible

Before the mid-1860s, the existence of microbes and their connection to disease was still being debated. Earlier attempts to sanitise the practice of medicine by those like Hungarian physician Ignaz Semmelweis were swiftly mocked even by scientists of the highest authority in that time, and largely forgotten – he was more often cited than understood. It was not unusual then for surgeons to reuse bandages and dressings already stiff with blood.

3. Surgeries become safer through the popularisation of hygienic practices

Starting in the mid-1860s, a Scottish surgeon named Joseph Lister would revolutionise the surgical field. Although Lister erroneously identified the air as the cause of surgical infections, he popularised the use of antiseptics to clean wounds and instruments prior to surgery, and the adoption of hygiene practices like washing his hands before surgery. Only 15% of Lister’s surgical patients died between 1867 to 1870.

4. Doctors tried interesting things to alleviate the pain

Doctors, dentists, and patients would try almost anything to reduce the pain of surgery. Chinese and Indian doctors used hallucinogenic drugs like marijuana and hashish, while the Incas managed to drill holes in the heads of patients with relatively little pain by chewing coca leaves and spitting into the wounds. In the West, patients got through the procedure with sparing amounts of opium and alcohol, both substances that were also widely used in various parts of the world.

In addition to the use of substances to reduce patients’ pain, doctors also used techniques to numb limbs, including compression to cut off blood flow and sensation in Assyria and Egypt during the Classical Age. Some surgeons were even known to straight up knock patients unconscious with a hit to the head, or by strangulation.

5. Speed was valued over precision

In the Western world, prior to the use of anaesthetics, the sounds of patients thrashing and screaming filled operating rooms. Before the latter half of the 19th century, patients were often sat upright in an elevated chair, so that they would be prevented from bracing when the surgeon’s knife began to cut into their flesh. They were often restrained, sometimes with leather flaps.

So as to minimise the duration of excruciating pain felt by the patient, surgeons did their jobs as quick as possible. The role of surgeons was regarded as a sort of cross between showman and butcher, with famous surgeons like Robert Liston - “fastest knife in the West End” - being known for their lightning-quick and bloody methods.

Surgeries were performed in a matter of minutes, even seconds – including amputations. Spectators in the operating-theater gallery would get out their pocket watches to time him. Liston operated so fast that he once accidentally amputated an assistant's fingers along with a patient's leg. The patient and the assistant both died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300% mortality. MIMS

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