The Early Roots of Surgery

The first recorded cases of cancer show how the Ancient Egyptians used cauterisation (using red-hot instruments to burn off tissue and seal off wounds) to destroy tumours and to treat a variety of infections, diseases and bleeding lesions. Until the mid-18th century, surgery was the only effective option for addressing several conditions. But it was difficult and painful, as shown by the case of Madame Frances d’Arblay, an English novelist living in Paris.

Before operating in 1811, d’Arblay’s doctor didn’t shield her from the gruelling pain she would encounter during the treatment for her advanced breast cancer – a mastectomy, without anaesthetic. “You must expect to suffer, I do not want to deceive you—you will suffer—you will suffer very much!” d’Arblay later wrote that “when the dreadful steel was plunged into the breast—cutting through veins, arteries, flesh, nerves—I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly the whole time of the incision… the air felt like a mass of minute but sharp and forked poniards [daggers] that were tearing the edges of the wound.” Yet the operation was a success, and d’Arblay lived for another 29 years.

In 1846, the introduction of ether as an anaesthetic eliminated the pain. Such was its impact that the next hundred years became known as ‘the century of the surgeon’. Yet, even in the 21st century, a neurosurgeon removing a tumour still relies largely on just his eyes and touch to guide him.

Alex O’Brien writing in Mosaic about the difficulty of visually distinguishing cancerous cells from non-cancerous cells in the brain. His piece explores how scorpions, Amazon.com, and the legacy of a dying girl are helping provide new tools for brain surgery.

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