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February 3, 2019

Graphic Illustrations Reveal the Horror of Surgical Removal of Unwanted Parts of the Human Body During the 19th Century

With the beginning of meaningful American contributions to surgical literature in the early 19th century, the manifold epic events that enlivenour country’s surgical past began to receive wide dissemination. Of the various surgical texts published in this still preanesthetic period (ie, prior to fall 1846), the most physically impressive and artistically dazzling is Joseph Pancoast’s (1805-1882) massive A Treatise on Operative Surgery. With 80 quarto plates comprising 486 separate illustrations and 380pages of description, the tome’s most distinguishing features are the wonderfully executed lithographs, many of which are from drawings of surgical operations by Pancoast.

Professor of anatomy and surgery at Jefferson Medical College, Pancoast developed a number of new operations, including the first successful plastic operation for exstrophy of the bladder, the “plow and groove” suture for rhinoplasty, and the neurosurgical procedure of sectioning the second and third branches of the fifth pair of nerves as they emerge from the base of the brain. His Treatise also includes one of the earliest accounts of a free skin graft, used in this case in the reconstruction of an earlobe.

Below are some of images from the book. Yes, they are, most definitely, if not outright terrifying!

Hand painted wood engraving showing the necessary position for the patient for removal of bladder stones.


Plate 55, J. Pancoast, A treatise on operative surgery, 1846.

Plate XLIX. Surgery to correct strabismus, involving the division of the internal rectus of the right eye. Strabismus is the misalignment of the eyes.

Removing cataracts

Removal of tumours of uterus

Plate LVI. Surgery for the removal of the mammary gland. 19th Century.

Tomo II, Tavola 57 bis. Procedure for the removal of stones from the prostate and urethra.

Tomo II, Tavola 19. Surgical instruments used on the tonsils and nasal cavity for the removal of polyps.

Plate 16. Various operative stages of the removal of a tumour from the uterus.

Plate 46, Illustration of the removal of nasal polyps and tonsillectomy.

Plate 65, Surgical removal of tumours from the scrotum.

Surgery on the eye for the removal of a cataract.

Plate XIX. Surgical removal of a stone from the bladder.

Fig. 1. Removal with the forceps by torsion and traction. Fig. 2, 3. Removal by ligature. Fig. 4,5. Simple hare-lip. Fig. 6, 7, 8. ‘Double hare-lip’ and ‘complicated hare-lip’.

Plate 43, Illustration and anatomy of ear surgery.

Plate XXXIV. Surgical instruments used for external urethrotomy in prostatectomy (removal of part of the prostate gland).

Plate LXVI. Surgical technique for lithotomy.

Plate LXVII. Surgical technique for lithotomy (the removal of a bladder stone). Bilateral and vesico-rectal operation.

Plate 70, Surgical techniques for lithotripsy (the removal of bladder and kidney stones).

Plate 42, Techniques for the removal of cataracts.

Plate XLVIII. Illustration of surgery on the eye for the removal of a cataract. Operation by extraction – inferior section of the cornea.

Removing the placenta and umbilical cord after birth.

(via Flashbak)



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