Progress in pediatric surgery. Historical aspects.

Abstract

Although thoracic afflictions may be traced to the prehistoric age, successful thoracic surgery was a development of the late nineteenth and early twentieth centuries. From 1543 to 1661, Vesalius, Servetus, Harvey and Malpighi established the dynamic anatomy of the pulmonary system. Boyle, Hooke, Black and Lavoisier elaborated upon the respiratory gases between 1660 and 1794. Although the drainage of empyema had been known since Hippocratic times, the underwater seal drainage bottle to prevent pneumothorax was not invented until 1872. At the turn of the century, Sauerbruch delayed the development of thoracic surgery for 30 years by opposing the use of positive pressure ventilation, which had not only been known to the ancients but also in clinical practice since the mid-1800s. Once positive pressure ventilation was established, routine successful thoracic surgery still had to await the development of safe blood transfusion by Landsteiner (1900, 1940) and the availability of antibiotics discovered by Chain, Florey and Waksman in the 1940s. Techniques and instrumentation were then developed for the safe and routine surgery of specific thoracic organs.