Surgery and pharmacology

Until two centuries ago, surgery had been an empirical mechanical art. The surgeon, unlike the physician, achieved his objectives by use of his hands, hence the origin of the word from chirurgien , one who works with his hands. Even after Hunter had begun to dispel empiricism and to place surgery on a scientific basis, manual dexterity and speed of action were essential characteristics of the successful surgeon. The introduction of anesthesia, and later the development of asepsis as opposed to antisepsis made speed and dexterity less important. However, even today the successful surgeon, while not dramatically rapid in his actions, does not waste time as he performs a surgical procedure. And this is as it should be, for the pharmacology of anesthesia and the intricate mechanisms of the iatrogenic coma of anesthesia are not sufficiently well understood to render the duration of an operation truly insignificant. Therefore, technical skill and inborn manual dexterity are still important qualities which distinguish the surgeon from his colleagues.