History’s Most Painful Surgeries

In an age without anesthesia, surgeons have done some of their most delicate work on patients screaming in pain from open wounds and broken bones. In many cases, this was before anesthetics had been developed.

In other cases, unskilled surgeons would administer a little alcohol or opium to numb the pain – often not much – just before going to work with saws and knives. 

doctor and nurses inside operating room

So what are some of history’s most painful surgeries? Let’s see:

  1. The Trepanation

A surgeon drills a hole in the patient’s skull to relieve pain and pressure. This procedure dates back to the Stone Age, where it was used on head wounds that had penetrated the cranium.

Some skulls from this era show evidence of multiple trepanations, which means that the poor patients would have been drilled at least twice into their heads before they died! Since there were no anesthetics or antibiotics back then, these surgeries could last for hours and leave the patients wide open to infection.

2) Appendectomy with Unusual Object

Surgeons use many tools today to remove organs, but one tool has remained unchanged throughout history: your hand. In some cases when removing the appendix, surgeons have had to use their bare hands to reach up into the patient’s abdomen and remove the organ. This is because, in some surgeries, there are simply no other tools available.

3) Anal Exenteration

Cancerous tumours of the anus are not easy to treat, especially before the invention of modern chemotherapy drugs. Back in the 1800s, one treatment involved removing all of a patient’s rectum, colon, uterus/prostate/testicles (depending on gender), among other organs.

This surgery would sometimes be followed by an artificial anus created out of skin from the inner thigh area (ouch). The patient was expected to live for about two months following this procedure; its purpose was more for relieving pain than for prolonging life.

4) Coronary Artery Bypass Surgery [CABG]

During a CABG, doctors usually remove blood vessels from the patient’s chest or legs and attach them to the coronary arteries leading to the heart. This is important because it re-routes clogged arteries around a patient’s diseased or damaged artery, which reduces the risk of death by about 30%.

Today this surgery is performed more often than any other in America, with more than 1 million procedures per year. In most cases, patients are given general anesthesia and then put on a heart-lung machine that takes over blood circulation while they are under.

During this time, their body temperature is lowered to 60 degrees Fahrenheit, which allows doctors to work on the heart without it beating.

5) Removing an Organ with Your Bare Hands

It sounds like something out of a horror movie when you say that surgeons used their bare hands in some surgeries but believe it or not they did (in some cases).

It’s difficult to fathom in this day and age, but before the invention of anesthesia in the mid-19th century, this was one method that permitted doctors to remove internal organs through small incisions.

One famous surgeon who would perform these kinds of surgeries was Baron Larrey, a chief surgeon under Napoleon Bonaparte “The operation is performed with naked fingers … We had no at disposal; so we had to make shift with what we could get,” Larrey said in 1815.

“After having buried our instruments in the body and brought them out again, soaked and reeking with blood, we had for sole assistants two men who held the poor creature down; but their strength was as nothing compared with that of the writhing patient — they might have been taken for a couple of little children holding a young tiger.

In such cases death is welcome … It gives rest to the sufferer.”

In other cases involving “bare hands” surgeries: So yes, there were barber-surgeons back in history who would perform these kinds of surgeries before anesthesia was invented that did not require an incision into a person’s body because unskilled surgeons would usually kill the patient.

6) Skull Removal with a Saw

Removing part of the skull to relieve pressure on the brain is one of surgery’s most important procedures today. However, before anesthesia was invented in 1846, this was done without anesthetics or antiseptics leading to death 90% of the time (not including surgery patients).

It wasn’t until 1865 when British surgeon Joseph Lister began using carbolic acid (phenol) as an antiseptic that mortality rates fell even slightly.

But it remained extremely difficult for surgeons to accurately make the first incision in the patient’s skin due to lack of sight; surgery remained largely guesswork since doctors couldn’t see what they were cutting into inside the body. Needless to say, it was extremely excruciating for the patient.

7) Lobotomy

UPDATED:  This surgery is now called a ‘ prefrontal leucotomy .’ The prefrontal lobotomy, or leukotomy, was pioneered by Dr Walter Freeman and Dr James W. Watts in 1935.

They believed that mental illness was caused by deeply seated emotions of fear, anger, hostility, etc., which are located in the frontal lobe of the brain (hence “prefrontal” lobotomy), and removing part of this lobe would help “cure” mentally ill patients.

This idea came about because they believed that these deep-seated emotions were located here rather than being caused by chemical imbalances or other neurological conditions that are now understood to cause mental illness.

The lobotomies were performed with an instrument called a leucotome, which is inserted through the eye socket so that the doctor could hit the brain without making any external cuts. Sometimes they would insert it up to four inches deep into the patient’s brain.

The surgery was extremely painful and also used as a punishment by guards at some mental institutions rather than providing treatment for patients who misbehaved.

Freeman himself thought that this surgery provided great benefits for patients, but he later said in 1977 that “I was fooled … I didn’t realize … these terrible after-effects .” He also went on to say that he believed he had probably done more harm than good, due to believing the myth of this procedure’s curability.

Want to know more about some of the worst surgeries?  Click on for additional readings. 

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