The_Invention_of_Surgery

eliminate pain, it would be a triumph. Of course, the advancement of
medicine and surgery has been much more than the simple eradication of
pain—it is the reversal of degradation, the conquering of microbial
infection, the management of trauma, the pharmacological alteration of
systemic disease, the halting of cancer, the reconstruction of damaged
body parts, and the enhancement of biological tissues. But, in the
beginning, the instinctual desperation to lessen pain (even when there was
no understanding of the human machine) drove early civilized man to the
heavens—and to the earth.
Feeling better, experiencing euphoria, or sensing nothing at all became
possible with empirical experimentation with botanicals, starting in
ancient times. Comprehensive control of wakefulness, or even the ability
to induce profound sleep was the Gordian knot of surgery.
The cross-reactivity among plants and animals in our chemical world is
startling. Why does ethanol, produced via plant fermentation, have such
powerful effects in our minds? How has Mother Nature dictated that the
poisonous chemicals in spiders, snakes, and flying insects have their evil
potentialities in our bodies? What is the explanation for the efficacy of the
simple chemical element, lithium, in the treatment of bipolar disorder and
depression? And why do some plants fabricate chemical compounds that
have no internal use and seem to have been tapped by the gods to make
wondrous substances that only work on the minds and hearts of men?
The foxglove plant, an ornamental plant with vividly colored, elongated
bell-shaped flowers, produces digitalis, a molecule that is powerfully used
to treat cardiac arrhythmias (like atrial fibrillation) and congestive heart
failure. In the foxglove, the digitalis base molecule has no physiologic
role, and only functions as a pigment, and more importantly, as a toxic
deterrent to pesky herbivorous woodland animals. Why would nature
fashion a small molecule in a decorative plant that makes our heart
contract more dynamically and rhythmically? It’s an enigma, and nature is
replete with oddly symbiotic chemicals.
Ancient shamans had no understanding of chemistry and pharmacology,
or even the concept of disease treatment. Greek and Roman healers had
imagination and curiosity, but a dearth of effective medicines; antiquity’s
tool chest was mostly empty, and the few remedies that existed were
minimally effective and dangerously toxic. The most important
characteristic of any intervention, therefore, was that there was an effect.