The History and Evolution of Surgical Instruments

Surgical instruments are not only illustrative of the changes in operative therapy, but may well serve as a framework around which can be built a representation of the development of medical culture. This, in an abbreviated form, Dr. Thompson has done, using the collection of which he is curator in the Royal College of Surgeons of England as a nucleus. This material, which was particularly rich in items associated with the great surgeons of Britain for the past 200 years, was in large part destroyed in the bombing of London a year ago. As a background he has sketched in the evolution of surgical instruments from the earliest times. The story is told in 12 chapters according to type of instruments; the scalpel, the amputation knife, the saw, the trepan, the vaginal dilator and speculum, head-saws, artery and dressing forceps, bullet-forceps and extrac-tors, instruments for phlebotomy and venesection, tourniquets, trocars, and operating tables. The illustrations are profuse and selected to show the progressive development of the tools of operative surgery. For the most part and necessarily so, these are reproductions from manuscripts and books and not representations of the material in the collection of the College. Therefore to only a small degree does this volume serve to preserve a record of those instruments lost by enemy action, but this is not the purpose of the author. Some crude line drawings suffice only to annotate the text, and by contrast emphasize the high quality of the other illustrations. There are a few errors of slight consequence. It is said (page 35) that the operation of trepanning "is still practised among the primitive tribes of New England." Presumably the island of New Britain is intended, inas-much as the neolithic peoples of New England under the tutelage of Harvey Cushing have gone somewhat beyond the methods described here. Peau is presumably a misprint for Pean and Kolbert for Koeberle (page 70). Jerome Brunschwig's name is spelled Braunschwig (page 71) in one citation, although given correctly in a later reference. Bibliographic references are scattered throughout the text, but in the case of several illustrations these are missing. It would have added to the usefulness of the volume had a comprehensive bibliography been appended, giving the sources of the information presented and of the field in general. There is an excellent index. This book in format and in literary presentation is a pleasing volume and …