13,14 Surgical instruments became even more varied and specialized with the Renaissance in the 14th and 15th centuries. Albucasis (Abū al-Qāsim Khalaf ibn al-‘Abbās al-Zahrāwī, 936–1013) in the Caliphate of Córdoba (modern Spain) used a scalpel that held a retractable blade. 12 With the collapse of the Roman Empire, surgical innovation flourished in the Islamic Golden Age. The Romans named their version of this tool the scallpellus, the diminutive form of the word scalper (“incisor” or “cutter”). Flint dagger of Ötzi the ice manĬourtesy of Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia, Charlottesville Some archeological specimens are still sharp enough to incise skin. 7 Evidence of obsidian blades used for more complex procedures such as craniotomies appeared around 4000 BC in prehistoric Anatolia, modern-day Turkey.
In fact, these instruments were still used for many of the same purposes by Alaska Native tribes well into the 19th century.
These types of tools were used for scarification, venesection, lancing, and circumcision. 6Ī particularly well-preserved prehistoric blade mounted onto a handle was found in 1991, preserved in ice near the Austrian-Italian border (see Figure 1). Fracture and flake techniques were then employed to refine these early blades into cutting instruments with desired characteristics, making these objects among the first human-refined tools. 5īlades were initially composed of flint, jade, and obsidian, with specific pieces chosen for their sharp edges. 4 Excavations of archaeological sites dating to the Paleolithic and Neolithic periods revealed knives for surgical use as early as 10,000–8,000 BC. Kirkup, circumcision with sharpened stones, one of the earliest recorded elective procedures, evolved into knives used for basic procedures. John Kirkup, MB, BS-a retired surgeon and honorary curator of the Historical Instruments Collection at the Royal College of Surgeons of England-researched the history of surgical tools for more than 20 years. Thumbnails for newborn circumcisions, scarification via plant stems, and venesection with sharks’ teeth served as the first examples of sharp tools for procedures on the human body. Shells, razor-like leaves, bamboo shoots, and even fingernails may all be viewed as early surgical instruments. Pinpointing a specific period of time when a cutting implement became the first surgical knife depends largely on perspective. Tracing the history of this tool reflects the evolution of surgery as a culture and as a profession. The quintessential instrument of surgeons, the scalpel is the longstanding symbol of the discipline. Today’s advances in scalpel technology include additional safety measures and gemstone and polymer coatings. Later, surgeons prized speed and sharpness. Barber-surgeons embellished their scalpels as part of the art of their craft. As surgery developed into a profession, knives dedicated to specific uses also evolved. While the word “scalpel” derives from the Latin word scallpellus, the physical instruments surgeons use today started out as flint and obsidian cutting implements during the Stone Age. The surgical knife, one of the earliest surgical instruments, has evolved over 10 millennia. For more information, please visit the ACS website. The session is sponsored each year by the Surgical History Group. Editor’s note: The following article is based on a poster presented at the History of Surgery Poster Session at the American College of Surgeons (ACS) Clinical Congress 2017 in San Diego, CA.
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