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(More customer reviews)The lurid title of Richard Hollingham's "Blood and Guts" is appropriate, considering its gruesome subject matter. The author traces the history of surgery from ancient times, with the disclaimer that he has not attempted to cover the subject in its entirety. Rather, Hollingham surveys significant events in trauma surgery, cardiac surgery, plastic surgery, transplant surgery, and neurosurgery. He points out that early surgeons, well-meaning though they may have been, probably killed more people than they saved. What chance did hapless patients have without x-rays to show the body's inner workings, anesthesia to reduce pain, and antibiotics and sterile operating rooms to prevent infection? The sick and injured were literally at the mercy of whoever was cutting them. Even if the "victim" miraculously survived, he or she was likely to come out of the operation badly mutilated.
Britain's finest surgeon in 1842 was Robert Liston. Although his operations were "messy, bloody, and traumatic," at least he knew enough to work quickly and under relatively clean conditions. Compared to his peers, he had a low mortality rate--one in six. However, he was arrogant and sometimes careless. During one of his operations, he had a three hundred percent mortality rate--two people died in addition to the patient!
We have come a long way from the days of Liston and especially from the time of the Roman physician, Galen. The latter thought that the heart is a furnace and that the body's humours needed to be rebalanced through vomiting, bloodletting, and purging. The annals of medicine are filled with ghastly mistakes, such as a hand transplant that went terribly wrong, hideously botched amputations, crude plastic surgery that disfigured rather than healed, and one of the most repugnant practices of all--prefrontal lobotomies. Some of the saddest and most poignant stories are those of severely wounded and maimed soldiers and the doctors who tried to save them.
"Blood and Guts" celebrates such heroes as Louis Pasteur and Joseph Lister, who laid the groundwork for today's emphasis on antisepsis; Walter Lillehei, who with Dick DeWall, worked on a "bubble oxygenator" that served as a heart-lung machine (this would make open heart surgery safer); and Sir Harold Gillies, who dedicated his life to refining the techniques of reconstructive surgery. Richard Hollingham horrifies and fascinates us with his lively and often astonishing accounts of various experimental procedures. Although the book's themes are anything but amusing, Hollingham's crisp and occasionally tongue-in-cheek writing makes this somewhat macabre work a bit more palatable. Still, many readers will be appalled at the ways in which surgeons used human beings as guinea pigs. However risky surgery is now, going under the knife was far more dangerous when surgeons "were prepared to have a go and see what happens." If they failed, they chalked it up to experience. Pity the poor person at whose expense this knowledge was gained.
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Today, astonishing surgical breakthroughs are making limb transplants, face transplants, and a host of other previously un dreamed of operations possible. But getting here has not been a simple story of medical progress. In Blood and Guts, veteran science writer Richard Hollingham weaves a compelling narrative from the key moments in surgical history. We have a ringside seat in the operating theater of University College Hospital in London as world-renowned Victorian surgeon Robert Liston performs a remarkable amputation in thirty seconds—from first cut to final stitch. Innovations such as Joseph Lister's antiseptic technique, the first open-heart surgery, and Walter Freeman's lobotomy operations, among other breakthroughs, are brought to life in these pages in vivid detail. This is popular science writing at it's best.
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