History

From the biomedical point of view, early definitions of health relied on the theme of the body’s ability to function. Diseases can disrupt health from time to time otherwise health was seen as a state of normal function. An example of such a definition of health is: “a state characterized by anatomic, physiologic, and psychological integrity; ability to perform personally valued family, work, and community roles; ability to deal with physical, biological, psychological, and social stress”. Then in 1948, in a radical departure from previous definitions, the World Health Organization (WHO) proposed a definition that aimed higher: linking health to well-being, in terms of “physical, mental, and social well-being, and not merely the absence of disease and infirmity”. Although this definition was welcomed by some as being innovative most of them claimed that it was vague, excessively broad and was not defined as measurable.

Most discussions of health returned to the practicality of the biomedical model. A shift happened in definitions of health. Again, the WHO played a leading role when it harbored the development of the health promotion movement in the 1980s. This brought in a new conception of health as “a resource for living”. In 1984 WHO revised the definition of health defined it as “the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities”.

Surgery is a technology consisting of a physical meditation on tissues. A procedure is considered surgical when it requires the cutting of a patient’s tissues or closure of a persisting wound. Angioplasty or endoscopy usually does not fall under the category of surgery. However, they may be considered surgery if they involve the use of a sterile environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing or stapling. All forms of surgery are considered invasive procedures. The noninvasive surgery refers to an abscission that does not penetrate the structure being excised (e.g. laser ablation of the cornea or irradiation of a tumor). Surgical treatments are being done since the prehistoric era. The oldest evidence for that is trepanation. In this procedure, a hole is drilled or scraped into the skull resulting in the Dura mater to get exposed. It is then observed and studied to treat health problems related to intracranial pressure and other diseases. Remains found in the early Harappan periods of the Indus Valley Civilization (c. 3300 BC) show evidence of teeth having been drilled dating back to 9,000 years.

Sushruta Samhita was written by an archaic Indian surgeon Susruta. He is known as the “founding father of surgery” that according to history is usually placed between the periods of 1200–600 BC. Instruments akin to surgical tools have also been found in the archaeological sites of Bronze Age China along with seeds likely used for herbalism. The ancient Greeks were also practitioners of surgical procedures, temples dedicated to the healer-god Asclepius, known as Asclepieia served as centers of medical advice, prognosis, and healing. Some of the surgical cures listed as the opening of an abdominal abscess or the removal of traumatic foreign material. The Greek Galen was one of the greatest surgeons of the ancient world He was known for performing many risky operations including brain and eye surgery. Two millennia will pass away until those operations will be tried again.