Prior to the aseptic era, by far the most commonly performed major surgical procedure was an amputation, which was also one of the earliest operations depicted in medical literature.
Saints Cosmas and Damian performing the miraculous transplantation of a leg (late sixteenth century) by Ambrosius Francken
Cosmas and Damian were prominent Arab twins who converted to Christianity and traveled about Persia, freely giving their medical services to the needy. Unfortunately, however, the brothers were tortured and beheaded during the reign of Emperor Diocletian (303 A.D.), though they subsequently became the patron saints of barber-surgeons as the legends of their medical and surgical accomplishments grew in time. They became famous following their legendary transplantation of the leg of a Moor. It seems that a Christian Roman deacon, Justinian, had a malignant growth on his leg and fell asleep while praying for a cure in the Church of Cosmas and Damian in Rome. In his dreams, the saints amputated the diseased limb and transplanted the leg of a Moor who had been brought to the church for burial. The patient awoke and gratefully observed a now healthy leg, though black in color.
Feldbüch der Wundartzney (1497) by Hans von Gersdorff
In the illustration by the famous German surgeon Hans von Gersdorff (ca 1480-1540), note that the physician was using his left hand as a tourniquet to both reduce bleeding, and to compress the nerves for pain control. The man on the right of the illustration was wearing a “T,” likely indicating that he suffered from St. Anthony’s Fire, which was probably erysipelas, a Group A streptococcal infection common at the time.
A General System of Surgery (1743) by Laurence Heister
The removal of a limb was the last surgical resort, and the most dramatic surgical procedure prior to the discovery of anesthesia in the middle of the nineteenth century. The pain and fear must have been beyond description, and patients often had to be held down by several assistants.
Mid to late eighteenth-century amputation saws
(top left column) exhibition bow saw by Aubry,(Richard) Butcher’s bow saw by Evans & Co., Hey’s saw by Down, serrated Parker’s Capital saw by Tiemann; (top right column) Sattertlee’s saw by Tiemann, Rust’s bow saw by Tiemann, chain saw with carrier by Aubry, lifting-back metacarpal saw with universal handle by Tiemann; Tenon saw by Evans & Wormull
Traité complet d’anatomie de l’homme, 2nd ed. (1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
The earliest method for amputation was the circular technique, first described by Aulus Cornelius Celsus (25 B.C.-50 A.D.). Military surgeons preferred this technique because the wound healed quickly, and there was less soft tissue to be exposed to the possibility of infection. Additionally, circular amputation resulted in less operative pain, and patients could be transported with fewer complications.
Eighteenth century circular amputation knife by Price
This is an eighteenth century circular amputation knife by Price with the sharpened edge on the top of the knife. With one quick swipe of the blade, a limb could be removed in a matter of a few minutes, a blessing in the days before anesthesia was available.