[Surgical dogmas throughout history]

This article is a historical analysis of the role of dogmas and dogmatic thinking in surgery from the great pioneers and teachers of surgery of a hundred years ago to the present time. Medical knowledge applied schematically creates security and may benefit many patients, but when simplification and standardization degenerates into rigid dogma, creative thinking will be obstructed and the development of innovative concepts becomes difficult. In the old times of the 19th and early years of the 20th century, dogmas usually originated from the teaching of great and prestigious pioneers of surgery. Nowadays, dogmatic thinking may come as practice guidelines, protocols of consensus conferences and even from the interpretation of the results of prospective randomized studies. The author illustrates these thoughts by a number of examples taken from the history of surgery over the last one hundred years: The controversy between Sauerbruch's (under)pressurized chamber and the concept of intratracheal positive pressure ventilation and its influence on the development of thoracic surgery during the first half of the 20th century, the role of serendipity and undogmatic thinking in the development of damage control surgery towards the end of the 20th century, the fascinating history of two operations which kept their position as gold standard for almost a century, i.e. Halsted's radical mastectomy for breast cancer and the Miles operation for cancer of the rectum.