Introduction

Abstract

The impulse to perform surgery antedates literacy by some thousands of years, as demonstrated by the large number of prehistoric trephined skulls that have been discovered. These earliest operations were based at best on superficial empirical experience and not on knowledge, in any way in which that term could be understood today. Thus it is remarkable that they were performed at all. What is even more remarkable is that the “patients” allowed themselves to be subjected to such surgery. All this suggests that the need to operate or to suffer surgery is primitive and not entirely rational. In fairness to the stone age surgeons, many of these prehistoric trephine openings show signs of healing. Thus their operations were in fact often successful, measured by the yardstick of technical success.