WORLD SURGERY Surgical History Arrow Wounds: Major Stimulus In
World J. Surg. 25, 1550–1555, 2001 DOI: 10.1007/s00268-001-0168-3 WOR L D Journal of SURGERY © 2001 by the Socie´te´ Internationale de Chirurgie Surgical History Arrow Wounds: Major Stimulus in the History of Surgery Bernd Karger, M.D., Hubert Sudhues, M.D., Bernd Brinkmann, M.D. Institute of Legal Medicine, University of Münster, Von-Esmarch-Strasse 62, 48129 Münster, Germany Published Online: October 25, 2001 Abstract. To illustrate how the high incidence of arrow wounds provided fatalities (e.g., in the battles of Liegnitz, Gran, Sajo, Pest) and a a major stimulus for the development of surgery until a century ago, we considerable number were killed by arrows from recurve-bows conducted a literature search. Our research shows that archaic peoples developed considerable surgical skill for extraction of arrows, including fired by horse-bound warriors [4, 7–9]. thoracotomy and trephination. A classical Hindu veda describes a variety The high incidence of arrow wounds obviously stimulated ef- of extraction methods, and Homer’s Iliad introduces the term iatros, which forts to improve medical care. The treatment of arrow wounds is means “he who extracts arrows.” Hippocrates of Kos and Galen, repre- an old core element of surgery, and the changing patterns of sentatives of the humoral doctrine, both shunned surgical intervention wound care reflect progress but also regression and errors in the and considered purulence a drainage of materia peccans (spoiled humors). Cornelius Celsus was the first to systematically differentiate removal of genesis of modern surgery. arrows per extractionem and per expulsionem. Celsus recommended the spoon of Diocles, an ancient surgical instrument specially designed for extraction of arrows.
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