by John R. Mangiadi, MD FACS

Before the Operating Room: Magicians, Priests and Physicians

The development of surgery occurred in different regions at different times, in China, India, South America, Mesopotamia, Persia, Arabia and finally Europe. The early surgeons were either priests, magicians, physicians or barber-tradesmen who understood anatomy and were comfortable with the common practices of amputation and trephination.

Trephination is perhaps the oldest of surgeries that we know of.  Because it involved cutting or grinding a hole in the skull, remnants are plentiful, as human skull bones have lasted for as many as 12,000 years intact. Neolithic evidence of trephination has been found in many disparate civilizations, from the pre-Incas in South America (2000 BC), to the early Europeans in France (5100 BC), to the Egyptians extending back as far back as 8,000 BC. The practice was probably originally performed for spiritual and magical reasons, and was performed by kings, priests and magician-physicians. It later was used to relieve pressure for head injuries, seizures and mental disorders such as psychosis.

During these times, the most common practitioner was the battlefield surgeon, who removed arrows, applied bandages, performed amputations and dispensed rugged hope to both the wounded and those who continued to fight. He was, at times, highly valued by both the men and their officers. A surgeon “who knows how to cut out darts and relieve the smarting of wounds by soothing unguents was to armies more in value than many other heroes.” (Iliad, Book XI)

The word ‘physician’ was probably coined by Homer. The name derives from the Ionian dialect spoken in the Greek colonies of the eastern Aegean meaning  “Extractor of arrows.”