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On-line version ISSN 1678-4774
J. Bras. Patol. Med. Lab. vol.43 no.4 Rio de Janeiro Aug. 2007
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During the 18th century surgery finally got rid of the chains that enslaved barbers to orthopedists. In the middle of the century, main universities of England, France and Germany offered chairs in surgery; in the following decades, surgeons got similar positions to physicians.
The first country to forbid barbers to practice surgery was France, where the Royal Academy of Surgery was founded in 1731. Its first president, Jean-Louis Petit (1674-1760), invented the spiral tourniquet and developed a process to mastoidectomy. His disciple Antoine Louis (1723-1792) wrote an important thesis about different signs of murder and suicide; he collaborated with Dr. Joseph-Ignace Guillotin in the improvement of the efficient execution machine of revolution.
An eminent English surgeon was William Cheselden (1688-1752), also a skilful architect that designed the plans to the Surgeons' Hall in London. He was one of the fastest surgeons of the time: he once performed a perineal cystotomy in 54 seconds. His best follower was John Hunter (1728-1793), one of the century's giants, who elevated surgery from technique to science, strongly based on physiology and pathology. Hunter was the youngest child of a poor Scottish family. Arriving in London, he intensely frequented taverns and theaters. He was brought back to track by his brother William and studied dissection, soon becoming a skillful surgeon and ardent researcher. He was a tireless essay writer in anatomy, pathology, comparative physiology and morphology. He described shock, phlebitis, pyemia; conducted valuable studies about inflammation, bullet wounds, and lesions in blood vessels. He inoculated himself with syphilis and demonstrated the difference between hard chancre and bacillary ulceration; yet made confusion between gonorrhea and syphilis, a common mistake at the time. His greater innovation in surgery was the principle that aneurysms could be treated with a simple proximal ligature instead of amputation, a technique that seems to have saved thousands of members.