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Foundations
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(A) (B)
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2 Kinds of holes
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Fig 21 Trephination (trephination) among the ancient Peruvian Indians
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(A) Preoperative anethesia is induced by narcotics (B) Trephination/ trephination: A scalpel (surgical knife) is used to make a hole in the skull (C) Postoperatively, the wound was covered by a shell or gourd to assist healing
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employed The rst of these knives was used to incise (in-SIZE) or cut into the scalp, which was then drawn back by a crude retractor (ree-TRAKT-er) After the initial incision (in-SIZH-un) ( process of cutting into ) was made, special trepanation scalpels carved a variety of openings into the skull, itself The scalpel-cut openings were usually fairly square Other instruments drilled rounded holes within the top of the cranium (KRAY-nee-um) or skull The accumulated uid lying inferior (in-FEAR-ee-or) to that is, below the skull surface, was then released When the operation was over, the head wound was covered with a shell or gourd to protect it during healing (Figure 21, C) This was part of the postop or postoperative (pohst-AHP-er-ah-tiv) healing regimen, which literally occurred after (post-) the operation An extremely large number of fossil skulls have been found with trephination holes that were at least partially lled in with new bone tissue Thus, we can conclude that this dramatic operation had a high success rate, even in ancient times In other words, the Peruvian Indians were very skilled in the practice of hole-istic medicine!
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Anatomy, Anesthesia
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SUMMARY TABLE 21
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Consult Summary Table 21 for a quick review of some important words and word parts
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Summary Table 21 Words and Word Parts Write in the exact meaning (literal English translation) for up to 10 key terms selected from the preceding block of text After you are done, check your word meanings with the correct answers, which are given at the end of this chapter
Key Terms operative Pre xes (none) Roots operat work surgic hand work crani skull trephin, trepan boring superi above sedat quieting operat Suf xes -ive pertaining to -al pertaining to -al pertaining to -tion the process of -or one which -ion Exact Meanings 1
surgical
(none)
cranial
(none)
trephination, trepanation
(none)
superior
(none)
sedation
(none)
preoperative
pre before an without (none)
-ive
anesthesia
esthes feeling narc benumbing
-ia condition -osis abnormal condition of -ive
narcosis
postoperative
post after
operat
PART 1
Foundations
JOHN HUNTER: THE FATHER OF SCIENTIFIC SURGERY HAD NIGHT VISITS FROM GRAVE ROBBERS!
Of great value in performing surgery is a correct knowledge of anatomy Far too often in ancient times, surgery (especially of the thorax and abdomen) led to a quick death for the unfortunate patient, because his surgeon would accidentally hit a major blood vessel or other vital body part! Eventually, ligatures (LIG-uhchurs) were developed Ligatures consist of thread or wire that is tied (ligat) tightly around a cut blood vessel, thereby stopping heavy bleeding In addition, the technique of suturing (SOO-chur-ing) was perfected, in which seam -like sutures (SOO-churs) were created by stitching two cut surfaces back together However, ligation (lie-GAY-shun) the process of (-ion) tying (ligat) and narrowing a blood vessel or other structure and suturing (creating stitched seams ) simply cannot substitute for advanced anatomical knowledge! Vesalius (whom we introduced in 1) began the thorough dissection of human cadavers in the 1500s, but this beginning of precise anatomical knowledge had to be greatly expanded before surgery could become scienti c By scienti c, we literally mean pertaining to (-ic) making knowledge (scientif ) Speci cally, this is the anatomical type of scienti c knowledge, which is best gained by cutting (tom) the body up or apart (ana-) With precise anatomical knowledge, obviously, the surgeon knows exactly where to cut (or where not to cut) during an operation! John Hunter, for instance, was a Scottish-born surgeon and anatomist (ahNAT-oh-mist) one who specializes in (-ist) cutting (tom) the body up or apart (ana-) Working in England during the mid-1700s, Hunter helped make surgery scienti c (hence more respectable and reliable) by basing it upon careful autopsies (AW-tahp-sees) An autopsy is the process of (-y) seeing (ops) a dead body personally, for your own self (auto-) Hunter carried out more than 2,000 autopsies on corpses, thereby seeing for himself the exact anatomical changes that were behind many diseases Most unfortunately, however, Hunter was so eager to carry out autopsies that he utilized the services of grave robbers, who visited cemeteries by night and dug up the corpses of the recently buried! Hunter also carried out dissections on living animals, using no anesthesia, while he took numerous biopsies (BUY-ahp-sees)! A biopsy is the process of (-y) seeing (ops) the tissues of a living (bi) thing After a scalpel is used to make an incision into an area of living tissue, a pair of forceps (FOR-seps) or tongs is employed to grab the edge of cut tissue The isolated tissue is then excised (ek-SIZED) cut (cis) out of (ex) the body To prevent heavy bleeding, the cut vessels left behind after tissue excision are often cauterized (KAW-ter-eyezd), that is, burned and sealed off Originally this was done with a hot burner or burning iron Cauterization
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