[Women under the knife--another history of surgery]

During the 19th century, surgery developed from management of lesions mainly on the surface of the body to operative treatment within the body as well as, at the same time, from a handicraft to a scientific discipline based on pathological anatomy. In the 1860s, ovariectomy became the 'key operation' in supervening traditional boundaries. The increasing safety of surgical intervention soon led to unspecifically indicated operations on normal organs within the female abdomen, aiming at curing 'typically female mental abnormalities', i.e. a kind of psychosurgery. This is still occasionally found today. The operative management of normal situations has even increased in gynaecology (hysterectomy) and obstetrics (caesarean section) in the 1970s and 1980s. Traditional medical ethos has therefore not been able to prevent it. Another new field, plastic and aesthetic surgery, had its specific ethical problems, which were well recognised as early as 1900. Because of the relative frequency of goitres and their operative treatment, after 1883 women came to the fore of the concepts of internal secretion, organ transplantation, and physiological surgery.

In view of cultural and gender history, socio-cultural factors have been at least as decisive as medico-scientific 'facts' for the frequency of some of the operations performed on women. These operations have, in turn, accelerated the progress in surgery and medicine in general.