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2015 ; 59
(3
): 379-403
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The Days of Brilliancy are Past : Skill, Styles and the Changing Rules of
Surgical Performance, ca 1820-1920
#MMPMID26090735
Schlich T
Med Hist
2015[Jul]; 59
(3
): 379-403
PMID26090735
show ga
This paper examines how, over the course of the nineteenth and early twentieth
centuries, the appreciation of skill in surgery shifted in characteristic ways.
Skill is a problematic category in surgery. Its evaluation is embedded into wider
cultural expectations and evaluations, which changed over time. The paper
examines the discussions about surgical skill in a variety of contexts: the
highly competitive environment of celebrity practitioners in the amphitheatres of
early nineteenth-century Britain; the science-oriented, technocratic
German-language university hospitals later in the century; and the elitist
surgeons of late nineteenth and early twentieth-century United States with their
concerns about distancing themselves from commercialism and cheap showmanship.
For analysing the interaction of surgical practices with their various contexts
the paper makes use of the concept of 'performance' and examines how the rules of
surgical performance varied according to the prevailing technical, social, and
moral conditions. Over the course of the century, surgical performance looked
more and more recognisably modern, increasingly following the ideals of
replicability, universality and standardisation. The changing ideals of surgical
skill are a crucial element of the complex history of the emergence of modern
surgery, but also an illuminating example of the history of skill in modern
medicine.