Book Review

Surgery: An Illustrated History

N Engl J Med 1993; 329:1899-1900December 16, 1993

Article

Surgery: An Illustrated History
By Ira M. Rutkow. 550 pp., illustrated. St. Louis, Mosby-Year Book, 1993. $99. ISBN: 0-8016-6078-5

Here is the most recent project of the remarkably prolific Ira Rutkow. Among his recent books are the two volumes of his History of Surgery in the United States (1775-1900): Textbooks, Monographs and Treatises (San Francisco: Norman, 1988) and Periodicals and Pamphlets (San Francisco: Norman, 1992). Although this new book is not confined to a discussion of surgery in the United States, it has the same impressive properties as the previous two-volume work: a magnificent appearance; a wonderful assortment of illustrations, charts, diagrams, and drawings; a scholarly text; and an eclectic view of its subject.

Many histories of world surgery have been written. A recent classic comes to mind -- Owen H. and Sarah D. Wangensteen's The Rise of Surgery: From Empiric Craft to Scientific Discipline (Minneapolis: University of Minnesota Press, 1978). As compared with the Wangensteens, Rutkow has less of an axe to grind. He is not trying to defend the field against detractors who would state that surgery is too much action and not enough science. Rather, he sees surgery for just what it is and what it has done over all these centuries -- “doing with the hands,” removing disease, repairing injury, rectifying functional aberration by manipulation or sharp dissection -- and all that these activities have come to mean.

Many of the illustrations will be familiar to students of surgical history, including works by Leonardo Da Vinci (reproduced with a special beauty, as are all the other illustrations) and Vesalius (including a full-color rendition of the frontispiece to the first edition of De humani corporis fabrica).

Few reviewers would feel competent to comment on all of this detailed history. The book covers the span of years from the ancient civilizations of Mesopotamia and Egypt to the appearance of the surgical specialties in the first half of the 20th century. With respect to this most recent era, there is a reference to Murray's Nobel prize in 1990 and a picture painted by Sir Roy Calne of an early liver transplantation. But there is no real discussion either of the development of cardiac surgery as a new field or of tissue transplantation. I assume these will have to await a subsequent book.

This book tells the story of the development of surgery. It does not deal with the collateral fields that contributed so strongly to it. Although Pasteur is mentioned in a discussion of Lister's advances, there is no attempt to examine the growth of microbiology in relation to that of surgery. The same constraint applies to the development of such things as antibiotics, the newer anesthetic agents, new methods of imaging, and immunology. These are petty criticisms, because such collateral material is not the focus of the book. Rather, the author attempts to recapture pictorially the colorful events and people that marked the growth of the art and science of treating with the hands.

At a cost of $99, the book is richly rewarding and should be available to every surgical trainee through the department library, at the very minimum.

Francis D. Moore, M.D.
Harvard Medical School, Boston, MA 02115