Once upon a time they were not considered true doctors. They were educated in guilds, gained a trade as journeymen, and they treated “slicing” people as a craft. Surgeons – because we are talking about them – did not enter the academic thresholds until the XNUMXth century. Centuries of experience combined with systematized knowledge and scientific research meant that Polish surgery did not differ in any way from the achievements of foreign medicine.
- Until the mid-nineteenth century, surgery was the domain of the so-called barbers who performed basic procedures, such as amputation of limbs, making fractures or bloodletting
- A milestone in the development of surgery was the use of anesthesia – ether during the operation
- The beginnings of Polish surgery as a separate field of medicine date back to the end of the XNUMXth century, when the efforts of Hugo Kołłątaj appointed the first professor of anatomy, surgery and obstetrics – Rafał Czerwiakowski
- The achievements of Polish surgeons in the XNUMXth century were impressive; many of them have become pioneers in developing new surgical tools and solutions, and performing groundbreaking operations
- You can find more such stories on the TvoiLokony home page
Breakthrough anesthesia
Amputation of limbs, making fractures, incision of abscesses, hernia and cataract operations, removal of kidney stones, bloodletting – a surgeon, or rather a barber, because this was the name of the “medicine man cutting people” profession for many centuries, and for a long time he performed only basic surgical procedures . Although the needs were much greater, the room for maneuver was significantly limited by the pain to which the patient was exposed to the table. The operations were short, and the surgeon acted quickly, unable to use advanced suturing techniques, not to mention an in-depth analysis of the subject of the procedure or, to put it simply, the patient’s guts.
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Unfortunately, even efficient and skilled hands often had to collapse over the table where the body and the body of a sick person lay no longer on the table. Patients died due to infection or hemorrhages. The perioperative mortality was very high, and even if the patient survived the procedure, there was no guarantee that the operation would be successful and he would recover. This was the case in Poland and all over the world, until the mid-nineteenth century.
Only the use of anesthesia during surgery became a milestone in the development of surgery. On October 16, 1846, in Boston, the patient was first protected from operational pain by administering ether to him. The effect was immediate and spectacular. The surgeon operating Gilbert Abbot – a man suffering from a jaw tumor – John Collins Warren, chief surgeon of Massachusetts General Hospital, reportedly shouted to anesthesiologist William Morton and the rest of the team, “Gentlemen, this is not a fraud!” The scale of the event is also evidenced by the words of another surgeon, the French Antonin Gosset, who, after the substance was spread in medicine, said: “Everything that happened in surgery before the discovery of anesthesia was a night of ignorance, suffering and fruitless searching in the dark”.
- See also: What happens to people after anesthesia?
The anesthesia reached Polish soil quickly, as early as February 1847, i.e. less than four months after a successful dental operation in the United States. Ludwik Bierkowski was the father of this success – a Polish surgeon who would embarrass many doctors with the hunger for knowledge and medical novelties. While still studying in Berlin, he became known to his colleagues as an extremely active researcher, developing anatomical tables with comments and an anatomical-surgical atlas with a description of the operation.
In Krakow, he organized a modern surgical clinic to which he brought new tools and where he tested and perfected surgical techniques, but he was also active on an academic basis. Practice in particular was at his heart, which is why he attached great importance to the passive participation of students in operations and anatomy lessons. He taught long and a lot, because in addition to surgery, he also lectured in obstetrics, ophthalmology and venereology (pharmacists still issue medicinal products prepared on the basis of some dermatological prescriptions that he developed), and he also published the first surgical journal in Krakow. It was he who founded the first anatomopathological museum, as well as an orthopedic facility and a gymnastic school in Krakow,
The use of ether for the first time was an enormous, though not the only “surgical” achievement by Bierkowski. The doctor also introduced … cotton wool into the operating room. It was to be used to dress wounds and to replace the previously used linen tears, and its effectiveness was checked by the doctor in exceptional circumstances – serving the wounded during the November Uprising.
Surgery clinic in Polish
Speaking about the true beginnings of Polish surgery as a separate field of medicine, one should, however, go back over half a century. That’s when in 1779, thanks to the efforts of Hugo Kołłątaj, the first professor of anatomy, surgery and obstetrics was appointed. It was Rafał Czerwiakowski – a doctor from Pinsk in Polesie, who gained knowledge and experience in surgery in Rome, Naples, Padua, Bologna, Paris, Vienna and Berlin.
When he got to the Main Crown School in Krakow (formerly known as the Krakow Academy, later and to this day – the Jagiellonian University – ed.), He had to overcome many obstacles to develop his ideas for running the first department of surgery in the country. Admittedly, an excellent lecture entitled “An excerpt on Cyrilic tools”, with which he inaugurated his presence at the university, echoed widely in the environment of doctors and scientists, but Czerwiakowski still had to put a lot of effort into such basic issues as a place to conduct classes or teaching aids, such as delays to demo sections.
Thanks to his vast knowledge, experience and self-denial, the doctor quickly achieved his goals. Among them was not only the organization of work in the surgery clinic or the publication of the first textbook in this field of medicine, but also the opening of a school for midwives who gave birth at home, and a maternity ward (this was Czerwiakowski’s second specialty). Committed socially and politically, he gained recognition at the summit and became the court physician of King Stanisław August Poniatowski.
While Ludwik Bierkowski was importing to Poland a breakthrough invention, which was ether anesthesia, another Polish doctor was experimenting with anesthesia in Warsaw. Alexander Le BrunLike other surgeons of this period, he studied abroad (the longest in Paris) and equally efficiently transplanted Western standards into native conditions. It’s him for the first time in the country, on December 11, 1847, he used chloroform for general anesthesia (it took place during an operation for incising a multiple boil). Significantly, he did so only a month after the first use of this substance for anesthesia in the world.
Bierkowski was not afraid of changes. He significantly improved the functioning of hospital wards and the work of medical staff by setting up a hospital outpatient clinic, introducing obligatory medical rounds, night duty of nurses and scrupulously noting descriptions of patients’ treatment in observation cards, which he later stored in the archives. This he is also credited with performing operations in a specially designed room – an operating room. Previously, the procedures were performed in patient rooms.
The successes of their colleagues encouraged other doctors to broaden their knowledge, draw inspiration from the achievements of world medicine and boldly test new solutions in their workplaces. A good example here are antiseptic dressings developed by the British surgeon Joseph Lister, the introduction of which significantly reduced the number of postoperative complications in the form of wound infections.
One of the first Polish doctors to use this method was Julian Kosinski – head of the Department of Surgery at the Warsaw School of Economics (later at the Imperial University of Warsaw). A graduate of the Military and Medical Academy in St. Petersburg, he had numerous groundbreaking operations, among others he was the first in Poland to successfully remove the spleen, kidney and gallbladder surgically, surgically created a fistula in the esophagus and excised the larynx in endotracheal dormancy.
Breakthrough after breakthrough
Introducing the basic rules of asepsis and antisepsis to the operating room allowed for the reduction of the number of infections after procedures, which most often resulted in the patient’s death, by almost a half. This breakthrough was visible both in Warsaw and Kraków, where these issues were regulated by Jan Mikulicz-Radecki, educated in Vienna. The world-famous surgeon, who eventually settled in Wrocław, was known for his versatile scientific interests, which included orthopedics and gynecology, as well as ENT and gastroenterology.
Thanks to him, surgery, not only Polish, but also world-wide (the doctor was willingly invited to give lectures and perform demonstration operations in Europe and the United States) gained many new tools and solutions. Among them were: the use of iodoform in decontamination, the introduction of cotton gloves and surgical masks, the development of a scoliosometer, hemostatic forceps and compressions, as well as ointments for difficult-to-heal wounds (it contained silver nitrate).
Mikulicz-Radecki was also a pioneer in performing many surgical procedures and developing new surgical methods. He was the first in the world to suture a ruptured gastric ulcer, developed the technique of esophageal and gastric colonoscopy and osteoplastic foot resection, described a new disease – juvenile bone cysts, and another disease was named after him, characterized by bilateral enlargement of the lacrimal glands and salivary glands. And this is just an introduction to the extremely rich achievements of the surgeon, which had a huge impact on the development of this field of medicine in Poland and in the world.
The dynamic development of Polish surgery led to the establishment of the Society of Polish Surgeons at the end of the 80s. The event was initiated by Ludwik Rydygier – a doctor gaining professional experience in Gryfia (today Greifswald – ed.), And then in Gdańsk, Jena and Chełmno, a doctor who studied medical studies in Gryfia, Berlin and Strasbourg. Abdominal and thoracic surgery remained the main area of Rydygier’s interests. It was he who paved the way for the first successful pyloric resections (final section of the stomach – ed.). Work on this issue was continued by, among others, Maksymilian Rutkowski, focusing on the impact of resection on gastric secretion.
- See also: Ludwik Rydygier – one of the founders of modern surgery
As Krzysztof Bielecki rightly notices, the history of Polish surgery is the history of the last 170 years. The above-mentioned surgeons took the first important, but not the only steps in this field, and research in this field of science was carried out over the next decades with consistency and remarkable meticulousness. Their authors are – to use modern colloquialism – a galaxy of surgical stars who did not hesitate to risk their own positions in order to make revolutionary changes in the existing medical reality. As a result, today a patient who comes to the operating room can be sure that the doctors who treat him use the most modern methods and tools to ensure his treatment has the desired effect.
Image source: National Digital Archives
The material was created thanks to the cooperation of Onet with its partner – the National Digital Archives, whose mission is to build a modern society aware of its past. NAC collects, stores and makes available photos, audio recordings and films. Digitized photos can be viewed at nac.gov.pl
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