The Historical Development of an Essential Tool

Early History

Throughout the history of medicine and surgery, the need to control bleeding has always been a concern. The earliest known surgical records describing the therapeutic use of cautery are in papyrus documents from Egypt dated as early as 3000 B.C. The Edwin Smith papyrus is a hieroglyphics description of procedures by one of the earliest physicians—Imhotep. Edwin Smith was an Egyptologist who acquired the papyrus in 1862 (Breasted, 1930). Cautery is described in the treatment of a tumor. It was called a fire drill—a device which when turned rapidly produced heat along the shaft that was then used as a cautery (Wicker, 1990).

Edwin Smith Papyrus

It is reasonable to assume that throughout the centuries cautery continued to be used to treat disease processes and control bleeding. Hippocrates (460-377 B.C.), the Father of Medicine, in ancient Greece described the use of cautery to treat hemorrhoids (Lifshutz, 2004). A fellow Greek, Thales (the Father of Science) first described the frictional properties of amber. Thales noted that when amber is rubbed an attraction to other materials is created. The Greek word for amber is “Elecktron,” the root of electricity (Greenwood, 1931).

Cautery was used throughout the Middle Ages. Its use was promoted by one of the greatest surgeons of that age—Albucasis, the Father of Modern Surgery. He lived and worked in Spain from about 1013-1106 (Goodrich, 2004). Albucasis wrote a 32-volume medical encyclopedia in which he described in-depth procedures that he performed, as well as instruments and devices he designed. He advocated using cautery, and because his writings were translated into many languages, many European surgeons were trained using his methods (Zahoor, 2006).

Woodcut 1532 During the 16th Century the use of cautery began to decline. Ambroise Paré (1510-1590) was a French surgeon who gained his experience and reputation from treating battlefield wounds. Paré had used cautery, but in 1552 is said to have used ligature rather than hot irons to amputate a leg. He stated that the wound healed better and with much less pain than when it was burned using cautery. Paré later recommended the use of ligature exclusively. The prevailing wisdom of the time seems to have been the use of suture required greater skill than simply applying cautery, and that wounds healed better than after the tissue damage that resulted when cautery was used (Harvey, 1929).
William Gilbert (1540-1603), was one of the researchers whose work laid the foundation for the development of modern day generators. He lived in England, and was a court physician to Queen Elizabeth. He was interested in magnetism, and was the first to use the term “electricity” (Kelly, 1932). Gilbert published his work in a book entitled, “De Magnete” in 1600. In Book II he describes his experimentation with electricity in which he studied amber’s frictional, or static electrical, properties. His work earned him the title of the Father of Electrotherapy (Greenwood, 1931).

During the 17th Century experiments with electricity heightened interest in the benefits of electrotherapy worldwide. Advances in the natural sciences occurred in Europe and America, sometimes at the same time. Each discovery served as a building-block for the next. Goldwyn (1979) and Vender (2005) suggest that the progression of knowledge in electrotherapeutics occurred during three eras. The first era involves experiments before 1786 with static electricity; the second era encompasses discoveries between 1786-1831 with muscle spasm and galvanization; and the third era spans from 1831 to modern times.

The discoveries related to static electricity were the first that looked at natural explanations for the phenomenon. It is called static electricity because the charge accumulates on an object—there is no current flow. Even though the current does not flow, the charge can jump from one object to another (Kurtus, 2006). The most common example is walking across a carpet and then getting shocked when the charge jumps to another object, such as a light switch or another person. Many researchers experimented with static electricity. Undoubtedly the most famous of these was Benjamin Franklin (1706-1790). As early as 1749 Franklin noted similarities between static electric sparks and lightning. Those deductions led to his renowned kite experiment where he induced lightning to flow from the kite. He was able to collect lightning in a Leyden jar, and proved both lightning and static electricity had the same properties. Benjamin Franklin’s work led to the installation of lightning rods on buildings to direct the charge to ground and prevent damage and fires (Walter, 2003).

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