Week6_Surgery

Celsus and Ancient Medicine

• Celsus: A Roman writer from the middle of the first century CE.

  • Uncertain if he was a physician or a wealthy elite writing for leisure.

  • Main work that survives is On Medicine (De Medicina).

Divisions of Medicine According to Celsus

• Three major divisions of medicine as per Celsus:

  1. Regimen: Lifestyle changes, including diet and exercise.

  2. Pharmacology: Use of drugs to restore health.

  3. Surgery: Considered a last resort due to its associated risks and pain.

Importance of Surgery

• Celsus emphasizes that while regimen and pharmacology are safer, surgery is crucial when needed.

• Text largely focuses on surgical procedures for:

  • Traumatic combat wounds.

  • Eye diseases, especially cataracts.

Celsus on Surgical Procedures

• Surgery is referred to as "that which treats by the hand."

• Celsus highlights that surgical advancement is primarily attributed to Hippocrates, noting its older origins but significant development.

• Emergence of surgery as a distinct field with prominent figures like Philoxenus and several other Alexandrian surgeons.

Handling Wounds and Weapon Removal

• Celsus discusses the challenges in removing projectiles (e.g., arrows) from the body:

  • Weapons can be barbed; thus extraction is complicated.

  • Two main extraction methods:

    • Pull weapon out from the entry point, if safe.

    • Push it through if deeply embedded.

• Importance of assessing:

  • Depth of penetration.

  • Location in relation to major blood vessels and tendons.

• Celsus mentions specialized tools like scalpels for incising flesh to access weapons.

Eye Surgery and Cataracts

• Celsus outlines criteria for evaluating cataracts:

  • Possible to treat if small, stationary, and exhibiting specific colors.

  • Poor prognosis if cataracts are large, irregularly shaped, or symptomatic of other issues.

• Celsus describes the procedure for cataract surgery:

  • Pre-operative fasting for the patient.

  • Surgical setting requiring optimal lighting and patient immobilization.

  • Use of specialized instruments (e.g., a specific needle) for the incision.

  • Post-operative care including diet management and inflammation control.

Inscriptions and Divine Influence

• Inscriptions serve as testaments to healing and divine intervention:

  • Example of Hermodicus of Lampsacus offers insight into ancient health beliefs.

  • Marcus Ulpius Honoratus's inscription reflects gratitude towards both physician and divine forces for healing.

Conclusion and Further Study

• Celsus' writings provide valuable insight into ancient surgical practices.

• Knowledge of surgical techniques was likely intended as a guide for practitioners.

• Suggested further study through recommended videos on historical surgical methods.