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Ira Rutkow

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Empire of the Scalpel: The History of Surgery
Ira Rutkow, Mar 2022, Scribner, an imprint of Simon & Schuster
Themes: Medical, History
Tracing the fascinating story of surgery through global history, EMPIRE OF THE SCALPEL shares the key people and breakthroughs that established the foundations for today’s life-saving medical practices.
Take-aways: Educators will find useful examples of how the science of surgery evolved over time. Use these people and practices to demonstrate the importance of ongoing research and perseverance.… (lisätietoja)
 
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eduscapes | 1 muu arvostelu | Dec 14, 2022 |
Much better at describing the foundations of surgery than later years (say, 1960+), and poor information on 21st century surgical developments. Therefore a lot of the ground covered was familiar. Still, Rutkow tells the story in his own way, and I certainly learned from it.

> The original [Hippocratic] Oath specifically forbade cutting: “I will not use the knife; not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.” The proscription established an unmistakable division between Hippocratic-influenced physicians and the class of individuals who performed surgical operations. Like that of their Babylonian predecessors, who consigned surgery to a lesser standing within Medicine, the Greeks left the craft and its work of the hand to itinerant craftsmen and roustabouts

> As the first major medical author writing in Latin, Celsus translated hundreds of Greek medical terms into the language of ancient Rome. Many of these words remain in modern professional usage. I recall, fifty years ago as a freshman medical student, memorizing the four cardinal signs of inflammation enunciated by Celsus, ones that he urged every surgeon to be on the lookout for: “calor, dolor, rubor, tumor; calor, dolor, rubor, tumor.” This assonant phrase, with its English rendition—“heat, pain, redness, swelling”—is tattooed onto every surgeon’s psyche.

> In the sixteenth century, Vesalius and Paré created a revolution in anatomy and surgery: the former, by demonstrating that knowledge of human anatomy can only be gained through the hands-on dissection of cadavers; the latter, by showing how to control bleeding during an operative procedure.

> "All his profession would allow him to be an excellent anatomist, but I never heard of any that admired his therapeutique ways. I knew severall practisers in London that would not have given 3 ducats for one of his bills." Favoritism or not, Harvey’s middling work as a physician should not be conflated with his astounding accomplishments as a researcher. During Harvey’s early years of practice, no one knew that he was investigating the action of the heart and the movement of blood. … What Harvey could not explain was how the arteries and veins were connected to one another to complete the circular pathway. He was unable to visualize the capillaries, the arterial-venous go-betweens, because they were microscopic sized. Proof of their existence would wait several decades until the microscope was invented

> In early 1865, his approach changed when he read a newspaper account of how engineers at a nearby sewage plant used carbolic acid (aka phenol, a derivative of coal tar) to reduce the smell of cesspits. Lister deduced that the carbolic acid killed the microorganisms in the refuse … Joseph Lister joins the elite list because of his notable efforts to introduce systematic, scientifically based antisepsis in the treatment of wounds and the performance of surgical operations.

> In 1686, the surgical treatment of Louis XIV’s anal fistula required construction of a handmade, three-pronged, metal retractor that allowed his surgeon to adequately view the king’s anal canal. The success of the operation demonstrated the curative powers of a knife bearer’s scalpel and brought about a key shift in how the public viewed the craft of surgery.

> Railway accidents in the nineteenth century were so common and catastrophic they brought about the long forgotten specialty of railway surgery. It was America’s earliest large surgical specialty with its own journals, textbooks, and local, state, and national societies. However, railway surgery ultimately failed to gain recognition within mainstream Medicine and suffered a precipitous decline.

> Charles Drew was a celebrated African-American scientist and surgeon. His research in the area of blood banks and techniques for blood storage led to the large-scale use of blood transfusions during World War II.

> Surgeons could not repair major cardiac defects without a way to stop the heart from beating while ensuring that the patient’s blood was still oxygenated. John Gibbon, with the assistance of his wife, Mary, developed the heart-lung machine and their success meant that heart surgery, an elusive vision in 1950, became practical and routine by 1960.

> In 1954, the world’s first successful transplant of an organ, a kidney, changed surgery in profound ways. It broke a psychological, perhaps spiritual, barrier that viewed the human body as a sacrosanct object able to receive care but not designed to provide it. An individual’s body could now provide a cure, along with drugs, minerals, and plants.
… (lisätietoja)
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breic | 1 muu arvostelu | Apr 17, 2022 |
Although Rutkow's depiction of Civil War medicine does not focus on nurses, he does make some valuable points about Civil War nurses. On page 168 he reminds the reader that no programs in nursing education existed in the country at the time, and although some Catholic orders did train nuns as nurses, the training was not of the "Nightingale School" ie cleanliness, diet, drainage, light, quite and warmth and adequate ventilation; but rather caring for patient's emotional needs, providing clean clothing and linen and regulating what the patient could eat. This is the first book I've read that discusses in detail the type of training received by nursing sisters. It also discusses the Catholic church's initial reaction to the nun's nursing for the Army which was unfavorable. The book also contains an excellent discussion of why Victorians found the idea of women nurses so unpleasant, and discusses the contributions of such nurses as Hannah Ropes and Lousia May Alcott. The author explains more about the background and character of Hannah Ropes than one can get from her diary (which we have) and also does a great job explaining the motivations of Dorothea Dix. The story of Dix's attempts to hire only middle-aged, plain women is well known, what is not known was why. Initially Army doctors objected strenuously to almost all the women nurses, criticizing some for laziness and other for working too hard and insisting on cleanliness. The real problem of course was that few doctors wanted the women there at all! The only women, Dix believed, who could get along with doctors were "women of bad character" because these became the doctor's mistresses! Thus she began to insist on plain women...… (lisätietoja)
 
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MWMLibrary | 1 muu arvostelu | Jan 14, 2022 |
The first half of this book offers a short biography of the little-remembered President, and the second half is made up of a detailed account of the shoddy medical care which he received after his shooting. This portion of the book incorporates a digression into the state-of-the-art of American medicine at the time, with emphases on the slow and grudging acceptance of Lister's sepsis discoveries, the absence of a nursing profession, and the rivalry between homeopaths and allopaths to become the prevailing approach for American clinicians. The author is hardly the first individual to state that physicians killed Garfield, not an assassin--indeed, assassin Chas. Guiteau said as much in his courtroom defense, but he does deploy some truly excruciating examples of poor practice to strengthen his case. Unfortunately, his antipathy toward the physicians in charge leads him into expressing a rather odd sympathy for homeopathy. A fascinating epilogue sketches the medical care and overnight stay in the hospital Garfield would have received had he been shot a century later when Dutch Reagan was shot. The book is unspectacular but consistently interesting and informative.… (lisätietoja)
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Big_Bang_Gorilla | 4 muuta kirja-arvostelua | Sep 28, 2018 |

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Teokset
8
Jäseniä
348
Suosituimmuussija
#68,679
Arvio (tähdet)
½ 3.5
Kirja-arvosteluja
9
ISBN:t
17

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