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.Keywords: History of Surgery, Skill, Performance, Body History 'The brain of an Apollo, the heart of a lion, the eye of an eagle, and the hand of a woman' 1 -often used and attributed to a variety of original sources, this dictum brings together some of the heterogeneous qualities attributed to the ideal surgeon at various times in history.
Thomas SchlichAt the same time it represents a typical way of using cultural references to characterise surgical capabilities. It seems to be self-evident that among the capabilities of a surgeon technical skill is essential. But surgical skill is a problematic category that took on different meanings in the course of the history of modern surgery and it was associated with different values, specific to historical contexts. In this paper I look at how over the course of the nineteenth and early twentieth centuries the appreciation of skill in surgery shifted in characteristic ways. For that purpose I first define and characterise surgical skill as a historical phenomenon and introduce the concepts of style, repertoires and performance in order to describe and analyse its history. The idea of performance, in particular, makes it possible to connect the discussions of surgical skill and with the technical conditions, the professional contexts and the moral regimes at particular times and in particular places, as well as describing the overall trend towards a recognisably modern way of performing surgery.