Surgery (from the Greek. chier — hand, ergon — action; literally "roctest-vye") is an ancient branch of medicine dealing with the treatment diseases through manual techniques, surgical instruments and appliances (surgery).

In all probability, the oldest surgical technique was aims to stop the bleeding and wound treatment. This is evidenced by these paleopathology examining fossil skeletons of ancient humans (Union of bones, amputations, trepanation skulls).

The first written evidence of surgical operations are contained in the hieroglyphic texts of ancient Egypt (II—I Millennium . to BC), Hammurabi (eighteenth century BC), Indian Samhita (first century of our era). The development of surgery devoted to the work "Hippokratia collection", the writings of prominent physicians of ancient Rome (Aulus Cornelius Celsus, Galen), The Byzantine Empire (Paul of Aegina), medieval East (Abu l-Qasim al-Zahrawi, Ibn Sina).

In Western Europe medieval scholasticism braked the development of surgery. Religion forbade the dissection of cadavers and "shed roof". Surgery was not considered scientific medicine. Most surgeons University education was not in the class of doctors is not allowed. They were artisans and shop according to the organization of the medieval city United in corporations for the professions (bathhouse attendants, barbers, surgeons), where master surgeon passed his knowledge to his students-apprentices.

Outstanding surgeons of medieval Europe, guy de Soliac (XIV), of para-Celsus (1493-1541), Ambroise pare (1517— 1590).

The rapid development of science in the Renaissance and later, the company created the preconditions for the development of surgery as a scientific discipline. This is due to the search for solutions to three critical problems that thousands of years hindered its development: bleeding, no pain relief and the infection of wounds.

Teaching on blood transfusion

The first experiments on blood transfusion for animals began in 1638 (K. Potter), 10 years after the publication of the work of William Harvey (1628), approved the laws of circulation.

In 1667 French scientist J. Denis (J'.-B. Denis) he performed the first successful transfusion of animal (lamb), man (Fig. 143). However, after the fourth experience ended with death the patient, experiments on the transfusion of human blood was stopped for almost century. The failure suggests that a person can pour only human blood. The first time it was implemented, the English obstetrician John. Blundell (J. Blundell) in 1819, In Russia, the first successful blood transfusion from human-to-human produced G. wolf (1832) —he saved a woman dying after  birth from uterine bleeding.

However, science-based blood transfusion became possible only after the establishment of the doctrine of immunity (II Mechnikov, P. Ehrlich, 1908) and the discovery of blood group system ABO Austrian scientist Karl land-Steiner (Landsteiner, Karl, 1900), for which in 1930 he was awarded the Nobel award. Mixing the red blood cells of some people with a blood serum other, K. Landsteiner found that under certain combinations of red blood cells and serum occurs GE-agglutinate, and when others have it. no. Showing thus the heterogeneity of various blood  patients, it is conventionally identified three blood groups: A, b and C.

Later decastello A., and A. Stuhr-Lee (A. Decastello and A. Sturli, 1902) found another blood group, which, in their opinion, not fit into the scheme of Landsteiner. In 1907 Czech doctor Jan Jansky (Jansky, Jan, 1873-1921), who studied in the neuropsychiatric clinic of the Charles University (Prague) influence of blood serum of the mentally ill on the blood of experimental animals described all possible variants of agglutination confirmed the presence . four blood groups in humans, and created their first full classification, denoting Roman numerals from I to IV. Along with digital there is also  letter nomenclature of blood groups, approved in 1928 by the League of Nations.

The technique of surgical interventions. Creating a topographic anatomy

Before the discovery of anesthesia, the attention of surgeons was directed on the improvement of techniques of surgical interventions. It was dictated by the need to make complicated operations in the shortest possible time. Many of them described in the three-volume manual "Surgery" Lawrence of Gaster (Heister, Lorenz, 1683-1758), a distinguished German surgeon of the XVIII century, one of the founders of scientific surgery in Germany. This work (Fig. 144) was translated into almost all European languages (including Russian) and served guide for many generations of surgeons. The first volume consists of five  books: "the wounds, fractures, dislocations, tumors, ulcers." Second dedicated to surgical operations, and the third the bandages. L. Gaster detail describe the operation of amputation of the lower leg, which at that time most often was carried out in field conditions in the theater of operations.

Her technique was designed so clearly that the whole operation lasted a few minutes. In the absence of anesthesia, it had of paramount importance for the patient and for the surgeon.

In 1846, American dentist William Morton (Morton, William, 1819-1868), who have experienced the soporific and analgesic the action of the vapour of ether, suggested George. Warren check the ether during surgery. Warren agreed and, on 16 October 1846, for the first time successfully carried out the removal of a tumor in the region^ of the neck under ether anesthesia, which gave Morton. It should be noted that information about the action of ether on the body of William Morton received from his teachers chemist and doctor Charles Jackson (Jackson, Charles, 1805-1880), which  must share the priority of this discovery. Russia was one of the the first countries where ether narcosis found the widest application. First in Russia operation under ether anesthesia was produced in Riga (B. F. Behrens, January 1847) and Moscow (F. I. Inozemtsev, 7 Feb 1847 g). Experimental verification of the action of ether on animals (in Moscow) was led by the physiologist A. M. Filoma-vitsky.

Scientific rationale for the use of ether anesthesia gave N. I. Pirogov. In animal experiments he has conducted extensive experimental study of the properties of ether at different ways of administration (inhalation, intra-vascular, rektalnom etc.) with further clinical validation of specific methods (including for yourself). 14 February 1847, he carried out his first operation under ether General anesthesia, removing the breast tumor 2.5 minutes.

In the summer of 1847 N. I. Pirogov was the first in the world to use ether narcosis in droves in the theater of military actions in Dagestan (in the siege of the village of Salt). The results of this Grand experiment struck Piroga-VA: the first operation took place without the groans and cries of the wounded. "The possibility of iferouane on the battlefield indisputably proven, he wrote in the "Report of the journey to Caucasus". — ...The most comforting result of iferouane was that operations manufactured by us in the presence of other wounded, was not at all frightened, but rather that, soothed them in their own fate."

So there was anesthesiology (lat. anaesthesia from Greek. anaisthesia — insensitivity) , the rapid development of which was associated with the introduction of new anesthetics and methods of their introduction. Thus, in 1847 Scottish obstetrician and surgeon James Simpson (Simpson, sir James Young,. 1811-1870) first used chloroform in "quality analgesic in obstetrics and surgery. In 1904 S. P. Fedorov and N. P. Krav-cov put the beginning of the development of methods for non-inhalation (intravenous) anesthesia.

With the discovery of anesthesia and the development of his methods started a new the era in surgery.

Russia is not the homeland of the military-field surgery-enough remember .Dominique larrey's ambulance volante (see p. 289), the founder of French military surgery, and his work, "Memoirs on the military field surgery and military campaigns" (1812-1817). However, no one did so much for the development of this science.. I. Pirogov — the founder of military field surgery in Russia.

In scientific and practical activities of N. I. Pirogov much was committed for the first time from the creation of entire Sciences (topographic anatomy and military field surgery), the first operation under rectal anesthesia (1847) to the first plaster bandage in the field (1854) and the first ideas about the bone plastic (1854).

The first successful resection of the stomach (1881) performed the German surgeon Theodor Billroth (Billroth, Theodor, 1829-1894) —the founder of surgery of the gastrointestinal tract. He has developed different methods of resection of the stomach, named after him (Billroth-I and Billroth-P), carried out the first resection of the esophagus (1892), larynx (1893), extensive excision of the tongue for cancer, etc. T.. Billroth wrote about the great influence of N. I. Piroga-VA on its activities. ( the sympathy was reciprocal .it is to T Billroth headed to Vienna N. I. Pirogov during his last illness.)

In the clinic Billroth worked as a foreign (including Russian) scientists who have had a significant impact on the development of surgery.'Among they Theodor Kocher (Kocher, Theodor* 1841 -1917) —student Billroth T. and B. Langenbeck. In 1909 he was awarded the Nobel prize for work on physiology, pathology and surgery of the thyroid gland. T. Kocher made great contributions in the development of abdominal surgery, traumatology and military surgery, in the development problems of asepsis and antisepsis.

In Russia an epoch in the history of surgery is associated with the activities of the Nikolai Sklifosovsky (1836-1904). In 1863 he' he defended his doctoral dissertation "blood okolomatocnah tumor." Developing abdominal surgery (gastrointestinal tract and urogenital system). V. Copernicus has developed a number of operations, many of which bear his name. In trauma he suggested an original method of osteoplastic surgery

bone connection ("Russian castle" or the castle Sklifosovsky). Participating as a physician in the Austro-Prussian (1866), the Franco-Prussian (1870-1871) and Russo-Turkish (1877-1878) wars, he made, a significant contribution to the development of military field surgery. Name N. V. Named Sklifosovsky Institute of emergency care in Moscow.

The era of antisepsis and asepsis opened broad prospects and for emergency surgery. Made possible the operation of suturing of perforated ulcers of the stomach and duodenum, intestinal surgical treatment obstruction and gunshot wounds of the abdomen. In 1884 he was done first surgery appendectomy in Germany and England. Before this could only reveal appendicular abscesses, a conservative treatment.

In surgical practice have been widely applied instrumental methods of examination and treatment. Surgery went fundamentally new scientific horizons.

 Widespread increase in surgical knowledge in the second half of the nineteenth century led to the selection of the surgeon ergy independent scientific disciplines: ophthalmology, gynecology, ENT, urology, orthopedics and, later, Oncology, neurosurgery etc.