10,000 BC

• Tigress-Euphrates valley, Mediterranean & Meso-Amerca – Trephination

17th century BC

• Ancient Egypt (Source: Edwin Smith papyrus) –  Scientific approach. Examination, diagnosis, and treatment headings for their cases.
• Ancient Greece (Source – Homer’s Iliad). Use of Klisiai – wounded soldiers cared for separately in the barracks

5-6th century BC

• Hippocrates (460 – 377BC) – debridement of necrosis, wine/vinegar for washing, avoiding bandages to prevent gangrene.
• Sushruta 600BC – First to talk about Haemorrhage control with ligation and cautery. Described 6 types of dislocations and 12 factures. Remove foreign bodies

1-2nd century AD

• Roman empire – Valetudinaria – 25 in total. 11 in Britain
• Celsus (25BC – 50AD) – primary suture of fresh wounds, advice on abdominal stab wounds – suture large bowel, small bowel hopeless

5-6th century AD

• Aetius of Amida (Byzantine) – brachial arter aneurysm
• Paul of Aegina – tracheostomy

Medieval ages

• NOTHING

10th century AD

• al-Zahrawi – immobilise fractures, similar method to Kocher’s for shoulder relocation

12th Century – Salerno, Italy

• Roger Frugard – skull fractures, contrecoup
• Roland – extradural haematoma (stone thrown, no problems, then died next day, black haematoma seen on opening cranium), described aseptic techniques

13th century

Guy de Chauliac – inhalational anaesthesia, cleanliness of surgeon and hospital

15-16th century

Ambroise Pare – royal surgeon. Used turpentine instead of boiling oil. Used ligatures instead of cautery. Described phantom limb and used prosthesis

18th century

• John Hunter – Infection and Necrosis relationship, Advocated surgery for abdominal wounds
• James Simpson – use of chloroform in surgery. Queen Vic used it in childbirth in 1853
• Joseph Lister (also Semmelweis 50y previously) – carbolic acid for wounds. Treated 11yo boy with open fracture which went on to unite without infection