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Journal of Indian Association of Pediatric Surgeons
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Year : 2012  |  Volume : 17  |  Issue : 3  |  Page : 144-145

Children's Surgery: A Worldwide History

Department of Pediatric Surgery, SRM Medical College, SRM University, Chennai 603203, India

Date of Web Publication6-Jul-2012

Correspondence Address:
V Raveenthiran
Department of Pediatric Surgery, SRM Medical College, SRM University, Chennai 603203
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Raveenthiran V. Children's Surgery: A Worldwide History. J Indian Assoc Pediatr Surg 2012;17:144-5

How to cite this URL:
Raveenthiran V. Children's Surgery: A Worldwide History. J Indian Assoc Pediatr Surg [serial online] 2012 [cited 2023 Mar 31];17:144-5. Available from: https://www.jiaps.com/text.asp?2012/17/3/144/98142

Author: John G Raffensperger

Year of publishing: 2012

Publisher: McFarland & Co, Jafferson, North Carolina

Size: 10 x 7 Inch; paperback; 340 pages

Price: US $ 50.87

ISBN: 0786468254, 9780786468256
"Those who cannot remember the past are condemned to repeat it", said George Santayana. Veracity of this statement is beautifully illustrated by John Raffensperger in his recently published book on history of children's surgery. A book of this kind is long awaited. A century before surgeons operated upon both adults and children. Thus, the history of pediatric surgery inevitably overlaps with that of surgery in general. For this reason, the book is divided into two parts: the first part, which contains 19 chapters, deals with the evolution of pediatric surgery in the chronological order incorporating important discoveries such as anesthesia with a wider scope; the second part of the book containing 18 chapters with more focused descriptions of individual pediatric surgical disorders such as tracheo-esophageal fistula.

Raffensperger sets the tone and pace rightly by beginning the book with a poetic speculation, "The first pediatric patient may well have been a child who stepped on a thorn." He then dramatically describes as to how his mother might have nursed him to cure. This scintillating narration motivates the reader to sail through the subsequent 340 pages.

Several historical anecdotes found in this book are unique. Every surgeon is familiar with the quote of Ambrose Pare "I dressed the wound; God healed it." But, how many of us know that Mondeville, another iconic French surgeon, admonished anyone who attributed cure to divine powers rather than the skill of surgeons? It is interesting to know that Robert Gross spent his entire professional life with defective vision in one eye without revealing it to anyone. After his retirement, Gross consulted Trygve Gundersen who removed congenital cataract and Dr Gross thereafter enjoyed binocular vision for the rest of his postretirement life! Surely pediatric surgery would have missed this genius had not the legendary Harvery Cushing humiliated him, when he approached the latter for learning neurosurgery. It is moving to read as to how Gross lost his opportunity to garner another jewel to his crown. He emphatically rejected the idea of Dr Taussig to create a shunt between subclavian and pulmonary arteries to save "blue-babies". She subsequently approached Blalock and now Blalock-Taussig shunt is a milestone in the history of cardiovascular surgery. Gross, in his later years, repented this as the greatest judgmental error of his professional career.

There is no dearth of amusing anecdotes in this volume. One such is that of Nicholas Senn. In an era when there were no radiographs or sonography, Senn designed an ingenious (perhaps dangerous) method of diagnosing bowel perforations in gun-shot wounds. He would instill hydrogen gas through the rectum of victim. Senn would then hold a lighted candle near the entry wound and press the abdomen. The gas percolating the gut would escape through the perforation and gets ignited. The gas would burn with continuous flame at the entry wound for Dr Senn to make a diagnosis. When he attempted to demonstrate the technique in a female dog at Berlin Medical Congress, the show was a flop because his assistant placed the hydrogen-instilling catheter in wrong orifice!

Raffensperger captures a variety of emotions in his book: horrifying is to know that Albucacis, the great Arabian surgeon, amputated penis for hypospadias, and Charles Balance ligated carotid artery to reduce CSF production in hydrocephalus; pathetic are the tragic deaths of Vesalius, the great anatomist of Padua and Edward Revere Osler, the only son of legendary William Osler; surprising is to learn that ventriculo-peritoneal shunt was conceived and designed by John Holter who was a mechanic with no medical background (He invented the shunt as doctors expressed helplessness when his son Casey Holter was born with hydrocephalus); mystifying was the association between Halifax disaster and William Ladd's career as pediatric surgeon; humbling is to know that Yperman practiced laparostomy as early as 1300 AD; awesome is the information that Madam Herzfeld, the pioneering woman pediatric surgeon could accomplish six herniotomies in 54 minutes and Denis Browne completed 25 tonsillectomies in a day!

Why a skilled and ethical doctor is praise as "the spring of apricot forest"? Who was Lord Byron's surgeon during his childhood? Who coined the terms orthopedics and anesthesia? What was the first pediatric operation done under chloroform anesthesia? Why Wilms' tumor is better called as Osler's tumor? What is "scours" and its relevance to pediatric surgeons? Who said the famous quote "ontogeny recapitulates phylogeny"? What is Cannon's law relevant to Hirschsprung's disease? To know the answers of these curious queries one must consult Raffensperger.

This book leaves us with many quotable quotes. While commenting on heroic attempts to save a neonate with multiple anomalies, John remarks, "Neonatal intensive-care unit was a medical milestone but a moral hazard". Junior residents will endorse him for saying, "Surgeons slavishly adhere to rules laid by their mentors and professors as if Moses had written them on stones". When asked to define the field of pediatric surgery, Robert Gross was said to have replied, "It is a field that is impossible to define exactly; it is easier to tell what it is not."

A book of this magnitude is ought to have some defects and Raffensperger is no exception to this. The dispute between William Hunter and Percival Pott on neonatalhernia has been described only sketchily. Further there is some mix-up of the names of John Hunter and William Hunter in this issue. "Roentgen used his own hand to demonstrate first x-ray" could be a misrepresentation of history. It was Mrs. Roentgen's hand with her wedding ring that is seen in the first x-ray. History of pediatric urological disorders is inadequately covered as is that of biliary atresia. One would love to have separate chapters on the history of endoscopic surgery, extracorporeal membrane oxygenator, fetal surgery and so forth. Biographies of great personalities are important component of any history book and that is conspicuously missing in this compendium. It would have been more informative had the history of pediatric surgery been described in the background of sociopolitical and scientific developments of various time periods. There could have been more illustrations to nurture the readers' imagination of historical ages and great personalities. Glossy paper would have added glory and tribute to the scientific discoveries and eminent surgeons described therein. Index needs to be more comprehensive. However, these demerits can easily be rectified in subsequent editions.

Barring a few demerits this book is highly laudable. All the 18 contributors of the book have done a commendable job by recording the history of pediatric surgery with authenticity. This book deserves to find a place in every library and is a "must read" for every surgeon especially those who are interested in children's surgery.


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