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Moments in Surgical History |

Were the People Different?

Ira M. Rutkow, MD, MPH, DrPH
Arch Surg. 1999;134(12):1404. doi:10.1001/archsurg.134.12.1404.
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WHENEVER I examine medical texts from the 19th century's preanesthetic era (ie, prior to October 1846), I am always startled at the relaxed demeanor in which patient's are portrayed while undergoing obviously painful surgical operations. Regardless of the procedure, be it extraction of a cataract, resection of a tongue cancer, mastectomy, or trephination of a depressed skull fracture, individuals were drawn as if they were experiencing just another one of life's seemingly innocuous events. How were human beings able to tolerate such suffering and endure overwhelming levels of pain? There are no easy answers but, certainly, people of today would cringe at yesterday's thought of having to be so surgically tortured. With this in mind, the obvious question is how was 19th century society so accepting of such nonanesthetized surgical gore? More to the point, were the people different?

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There are few more terrifying plates from a 19th century preanesthesia medical text than this view of a resection of the upper jaw. Taken from Joseph Pancoast's (1805-1882) remarkable A Treatise on Operative Surgery (1844), the idealized patient is depicted as placid and wide awake while undergoing an operation that would seem to have been completely unbearable.

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