Introduction of Surgery (外科学绪论) XIANG BO (向 波), MD. PhD Department of Pediatric Surgery West China Hospital, Sichuan University (四川大学华西医院小儿外科 )

Introduction (绪论) Definition Content (外科内容介绍) Learning method (外科学习方法介绍) Orientation for Whole Medical Career (特点：不是考试的内容，却是医学生涯中的指南)

DEFINITION of the Surgery (什么是外科) Deal with a group of diseases which need to be treated by intervention (外科学是研究需要手术治疗疾病的临床及相关基础理论的学科。) Surgery（英语）─ Chirurgia（拉丁语） Cheir ergon（希腊） 手 工

一、现代外科学的发展 Development of Modern Surgery 解剖学 Anatomy John Hunter (1728-1793), the father of experimental surgery and a superb anatomist and teacher.

麻醉 Anesthesia Willam t.G. Morton (1819-1868), a Boston dentist whose successful demonstration of ether anesthesia on October 16, 1846, at the Massachusetts Gneeral Hospital, was a landmark in the history of surgery

3. 抗菌术 Antisepsis Joseph Lister (1827-1912), the originator of antiseptic surgery carbolic acid solutions

输血 Blood transfusion Richard Lewisohn (1875-1961), a surgeon at the Mount Sinai Hospital, introduced the modern technique of blood transfusion, developed from his discovery of a method of preventing coagulation of the blood outside the body. Karl Landsteiner (1868-1943), one of the first scientists to study the physical processes of immunity. He is best known for his identification and characterization of the human blood groups, A, B, and O.

Innovators & Pioneers in Surgery Theodor Billroth (1829-1894), professor at the University of Vienna and pioneer abdominal surgeon, Billroth was one of the most influential teachers of his time. Theodor Kocher (1841-1917), professor of surgery at the University of Berne and pioneer in the development of surgery of the thyoid. He received the Nobel Prize in 1909.

John H. Gibbon (1903-1973), pioneer cardiothoracic surgeon who developed extracorporeal circulation. Alexis Carrel (1873-1944), an experimental surgeon interested in wound healing, tissue culture, organ transplantation, and blood vessel anastomosis. He was awarded the Nobel Prize in 1912.

Category of Surgery (外科学范畴) Classification of Surgical Diseases (外科疾病分类) 1) Trauma (损伤) --mechanical, thermal, chemical, electrical… 2) Infection (感染) 3) Neoplasia (肿瘤) --Benign, Malignant 4) Anatomical abnormalities (畸形) --Congenital, Acquired

5) Metabolic & Hormonal disorder (内分泌功能失调) 6) Infarction & Ischamia (梗塞与缺血) 7) Others (其它) Obstruction (梗阻) Parasite diseases (寄生虫病) Vein varicose (静脉曲张)

Trauma (损伤) 其他：肠梗阻、尿路梗阻、静脉曲张、胆石症、尿路结石等

INFECTIONS (感染)

Neoplasia (肿瘤)

Anatomical abnormalities (畸形)

Others (其他)

Development of Surgery (外科发展) 20th C. AD. (廿世纪) 期 展 5th C.AD. (Ⅴ 世纪) 发 期 Advance 期 没 始 复 落 起 恢 Greco-Roman civilization Early civilization 期 Renaissance 15th C. AD (ⅩⅤ世纪) Middle Ages Dark Ages

Starting Period (起始期) (夏商甲骨 疥疮) 140 AD (汉华陀) AC 1066(周 疡科) Galen,2nd C.AD. Celsus, 1st C.AD. (医学拉丁) Greek AC 400 Hippocrates(古希腊) 72 books & 59 treaties Separate Science from religion Hippocrates’ Oath Father of modern medicine AC 1066(周 疡科) Ancient Egypt AC 1600 Papyrus (古埃及) AC1400 (夏商甲骨 疥疮)

DECLINE period (没落期) Religious taboo Feudal society Contrary to Science （中世纪、宗教、封建） Middle Ages Dark Ages （4 -15世纪） Barber =Surgeon （外科医师＝理发匠）

Renaissance Period （恢复期） Blood transfusion Blood type Landstainer 血型1901 Hemostat Wells 止血钳1872 Hemorrhage（出血） Conception of asepsis Steam sterilization 1877 Bergmen 无菌观念 post-amputation inf. Puerperal fever Spray of Carbolic acid Principle of Antiseptic（抗菌技术） 1852 Lister 石炭酸, Infection（感染） Chloride of Lime （Semmelweis 石灰水1840） Pain（疼痛） Ether anesthesia （Morton乙醚 1846） Andreas Vesalius, Leonardo de Vinci （一个基础 解剖） 三大障碍 -The age of Scientific revolution（十九世纪科学革命）

Advancing Period （发展期） Liver Kidney Heart New era Transplantation / Mini invasive surg （器官移植/微创外科 时代） Intensive Care Nutritional support Anti-sepsis Anti-shock Stimulating effects （两次世界大战） Abdominal Surgery （Billroth 打开腹腔禁区） Thyroid Surgery （甲状腺外科 Kocher Nobel Prize） 20th C. AD

Develpments in ideas: Microsurgery—Minimally Invasive Surgery---robotic surgical system Damage control surgery—fast track surgery---day surgery Cloning, stem cell, molecular biology, nanotechnology, gene engineering, Bioengineering…

How to learn surgery (如何学习外科) ● Moral Character (外科医师的职业道德) ● Theory and Practice (理论联系实践) ● Basic theory Basic knowledge Basic technique (外科基础)

Some figure of speech about the basic demands (形象化的要求) Bravery as tiger (老虎的胆) Eyes of eagle (老鹰的眼) Hands of women(女人的手) Heart of mother(慈母的心)

LEARN and QUESTION (学问) - Learn to find questions - Learn to ask questions - Learn to solve questions Books are you best teachers Library is your best school

结束语 Now, you may have a good start -why to learn -how to learn. Well begun, half done. (良好的开端，成功的一半。目标已明，努力干吧！)