History of Modern Surgery

History of Modern Surgery

Thomas Schlich

This project aimed to understand how surgery has transformed from a last resort measure into a routinely used body technology, arguably the most important but one of the least questioned technologies of body manipulation today. Any valid explanation for this shift addresses surgery’s technical effectiveness and, connected to this, its safety—an aspect that has been treated either simplistically, by invoking milestone innovations such as antisepsis and anesthesia, or by ignoring the problem altogether. By contrast, the research project examined the radical changes in surgical technology and knowledge in a key period of modern surgery, not in terms of individual innovations, but as the development of a whole ensemble of interdependent technologies and knowledge.

The emergence of aseptic surgery in the late nineteenth century represents a crucial stage in the history of modern surgery. The introduction of an ensemble of new technologies led to a new style of surgery and facilitated an unprecedented extension of the range and number of surgical interventions. At the same time, aseptic surgery entailed a new degree of interaction between surgical practice and laboratory science. In the emergence of the new type of surgery, the centers of surgical innovation moved from Great Britain to the German-speaking countries, and finally to North America. Based on preliminary theoretical work (published in peer reviewed journals), this research combined approaches from the social history of medicine, the history of technology, and science and technology studies, and looked at knowledge, practices, and objects (such as instruments and spaces), as well as different historical actors (surgeons, scientists, patients) in different countries. With its inclusion of the history of practices and objects, the chosen framework helped to explain how surgery became technologically effective and socially accepted. Source material consists in textbooks, scientific articles, published autobiographical material, archival material (e.g., surgeons’ correspondence with each other, with scientists, and manufacturers) and objects (in the sense of material culture, e.g., instruments, machines, etc.), from the UK, Germany, Switzerland, Austria, the US, and Canada. With its broad thematic and geographic range and its combination of approaches from various disciplines, the proposed research project provided a better understanding of the new technological, scientific, and social dynamics of surgery between 1870 and 1920 and provided a new perspective on the rise of modern surgery.

This research addressed a wide community of scholars because it dealt with one of the great unanswered questions in the history of medicine—namely how surgery became the most important but least questioned technology of body manipulation. It helped to understand how surgery gained the effectiveness and safety it has today, and thus how it became such a ubiquitous and seemingly self-evident solution to a wide range of problems. On a more general level, it looked to elucidate the role of technology in the context of societal and cultural factors in the development and diffusion of new treatment methods in medicine. In its attention to the complexity involved in the creation of modern surgery, this historical work contributed to policy debates regarding scientific research, technological innovation, and medical practice. It also deepened understanding of how knowledge is transferred between fields (such as surgery and fundamental science) and across different national contexts.

  • Thomas Schlich, “Surgery, Science and Modernity: Operating Rooms and Laboratories as Spaces of Control,” History of Science 45 (2007), pp. 231-256.
  • Thomas Schlich: “The Art and Science of Surgery: Innovation and Concepts of Medical Practice in Operative Fracture Care, 1960s-1970s,” Science, Technology and Human Values 32 (2007), pp. 65-87.
  • Thomas Schlich: “Nobel prizes for surgeons: In Recognition of the surgical healing strategy,” International Journal of Surgery 5 (2007), issue 2, pp. 129-133.
  • Annmarie Adams and Thomas Schlich: "Design for Control: Surgery, Science, and Space at the Royal Victoria Hospital, Montreal, 1893-1956," Medical History (2006), pp. 73-94.
  • Thomas Schlich: “Ein Netzwerk von Kontrolltechnologien: Eine neue Perspektive auf die Entstehung der modernen Chirurgie,” NTM Journal of the History of Science, Technology and Medicine 16 (2008), pp. 333-361.
  • Thomas Schlich: “The Emergence of Modern Surgery,” in: Deborah Brunton (ed.): Medicine Transformed: Health, Disease and Society in Europe, 1800-1939, Manchester University Press, Manchester 2004, pp. 61-91.