Friday, November 6, 2015

Crucial Interventions: An Illustrated Treatise on the Principles and Practice of Surgery is a book that sums up every terror about surgery and medicine you ever had.

Surgery to correct strabismus (abnormal alignment of the eyes) which involved the division of the internal muscles of the eyeball so the eye would point in the right direction.

Surgery to correct strabismus (abnormal alignment of the eyes) which involved the division of the internal muscles of the eyeball so the eye would point in the right direction.

The Wellcome Collection 2015

A follow-up to the award-winning The Sick Rose, Richard Barnett's latest book is a medical history of the 19th century, a time that saw a complete revolution of the practice and reputation of surgery.

Removal (or "resection") of the lower jaw.

Removal (or "resection") of the lower jaw.

The Wellcome Collection 2015

Or as he put it: “The blood and the bawling, the last-ditch butchery, and the pervasive threat of death.”

Compression of arteries in the arm and leg to reduce blood loss during surgery.

Compression of arteries in the arm and leg to reduce blood loss during surgery.

The Wellcome Collection 2015

It was the century that anaesthesia and antisepsis were introduced.

It was when surgery stopped being a job carried out by local barbers.

A painting depicting one of the first British operations carried out with anaesthesia by pioneering Scottish surgeon Robert Liston. He operated with a knife gripped between his teeth, and could amputate a leg in under three minutes.

A painting depicting one of the first British operations carried out with anaesthesia by pioneering Scottish surgeon Robert Liston. He operated with a knife gripped between his teeth, and could amputate a leg in under three minutes.

The Wellcome Collection 2015

Prior to this, operations were carried out as fast as possible in the hopes of minimising pain, shock, and blood loss. Mortality rates were high.

Two kinds of caesarian section.

Two kinds of caesarian section.

The Wellcome Collection 2015

You had pretty good reasons to be scared of the doctor.

Surgical saws, knives and shears for operations on bone.

Surgical saws, knives and shears for operations on bone.

The Wellcome Collection 2015

Before antisepsis, a medical intervention could be worse than just living with whatever it was you had. The surgical instruments could be crawling with infectious bacteria.

Anatomy of the armpit, and the ligature (clamping by string to stop the blood flow) of a blood vessel near it.

Anatomy of the armpit, and the ligature (clamping by string to stop the blood flow) of a blood vessel near it.

The Wellcome Collection 2015

So even if you made it through the screaming pain of surgery, there could be more horrors to come — sometimes fatal.

Amputation of various toes.

Amputation of various toes.

The Wellcome Collection 2015

Well into the 1840s, operating theatres were noisy, dirty, and crowded.

Surgeons and their assistants were dressed in street clothes, and patients were awake for their ordeal.

Sites for ligature of arteries in the lower arm and elbow joint.

Sites for ligature of arteries in the lower arm and elbow joint.

The Wellcome Collection 2015

But within two generations, operating theatres came to resemble laboratories.

Sterile, safer.

Surgery for cancer of the tongue.

Surgery for cancer of the tongue.

The Wellcome Collection 2015

Through medical images from the Wellcome Library – textbooks, treatises of anatomy, atlases of the body – Crucial Interventions tells the story of how surgeons started to get to grips with the human body.

Ligature of an artery in the inguinal region, using sutures and a suture hook, with compression of the abdomen to reduce aortic blood flow.

Ligature of an artery in the inguinal region, using sutures and a suture hook, with compression of the abdomen to reduce aortic blood flow.

The Wellcome Collection 2015

It’s partly a story about new technologies, like anaesthesia and antisepsis, but it’s also a cultural and political story about the transformation in the status of surgeons.

Where once surgery was a job shared by the guys on the high street who cut your hair, now surgeons were medical men, welcomed members of the aristocracy.

Cross section of the human brain.

Cross section of the human brain.

The Wellcome Collection 2015

These beautiful, morbid, and sometimes wildly gross images show surgeons putting new knowledge into practice: a top-to-toe atlas of the human body and the ways in which surgeons believed it could go wrong.

Musculature and blood supply of the wrist and hand.

Musculature and blood supply of the wrist and hand.

The Wellcome Collection 2015

They're crucial to the history of where we ended up.

Dissection showing the aorta and the major arteries of the thorax (the bit inside the ribcage) and abdomen.

Dissection showing the aorta and the major arteries of the thorax (the bit inside the ribcage) and abdomen.

The Wellcome Collection 2015

They show surgeons figuring out the complexities of the human body.

Anatomy of the large intestine, front and back.

Anatomy of the large intestine, front and back.

The Wellcome Collection 2015

They show surgeons thinking about how they can improve the lives of their patients.

But also, at the same time, how they can save them.

Dissection of the thorax, showing the relative positions of the lungs, heart, and primary blood vessels.

Dissection of the thorax, showing the relative positions of the lungs, heart, and primary blood vessels.

The Wellcome Collection 2015

Crucial Interventions or, An Illustrated Treatise on the Principles & Practice of Nineteenth-Century Surgery by Richard Barnett is published by Thames & Hudson in association with the Wellcome Collection.

Crucial Interventions or, An Illustrated Treatise on the Principles & Practice of Nineteenth-Century Surgery by Richard Barnett is published by Thames & Hudson in association with the Wellcome Collection.

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