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शल्यचिकित्सा

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शल्यचिकित्सा वा शल्यक्रिया छगु चिकित्सायागु ख्यः खः। थुकिलि ल्वे या घापाःयात अपरेसन याना लंकी।

इतिहास

सम्पादन

प्राचीन भारत

सम्पादन

भारतीय चिकित्सक सुश्रुत (६०० बि सि) नं आ वाराणासी दुगु थासे शल्यक्रिया यायेगु व स्येनेगु ज्या यागु खने दु। वेकलं च्वयादिगु सुश्रुत संहितानं वेकयागु शल्यक्रियायागु ज्ञानयु बारेय् येक्व खँ सीके छिं। थ्व सफू शल्यचिकित्सायागु दक्ले पुलाँगु सफू खः। थ्व सफूय् वेकलं येक्व ल्वेयागु बिस्तारय् जांच, डायग्नोसिस, उपचार, व प्रोग्नोसिसया वर्णन व प्लास्टिक सर्जरी, दसु- कस्मेटिक सर्जरी व राइनोप्लास्टीयागु वर्णन याना दिगु दु।[१]

धन्वन्तरी नं न्ह्येथनादिगु आयुर्वेदिक ज्ञान दिवोदास यात वसपोलं स्येना दिल धासा दिवोदासं सुश्रुत, औपधेनव, औरभ्र, पौशकलावत, गोपुरारक्षित, व भोजयात स्येना दिल।

सुश्रुतयागु शल्यचिकित्साय् दुगु येक्व प्रारम्भिक योगदाअनयागु लागि वेकयात "शल्यचिकित्सायागु अबु" धका नं हनातगु दु। वेकयागु संहिताय् छुं भाग १गु शताब्दी तक्क्यागु नं खनेदु। अतः, छुं विषेशज्ञतेसं थ्व सफूय् मेमेपिं मनुतेगु नं योगदान दुगु विचाः तगु दु। सुश्रुत प्लास्टिक सर्जरी व कस्मेटिक सर्जरीयागु नं जन्मदाता खः। वेकयागु फोरहेड फ्ल्याप राइनोप्लास्टी (स्यंगु न्ह्याययात कपायागु छ्येंगु तया देकिगु) पद्दति अब्लेयागु अपराधयागु दण्ड कथं न्ह्याय चानाबीगु ज्या नं याना दयावल। थ्व पद्दति आयागु आधुनिक शल्यक्रियाय् नं छ्येलातगु दु। थ्व ज्ञान भारतय् १८गु शताब्दीयागु उत्तरार्ध तक्क नं दुगु खंयात अब्लेयागु जेन्टलम्यान्‌स्‌ म्यागाजिनं(अक्टोबर १७९४) पुष्टि यागु दु।

सुश्रुत संहिताय् बावल स्वायेगु, प्रोस्ट्रेट ग्रन्थि लिकायेगु, क्याटार्‍याक्ट लेन्स लिकायेगु, एब्सेस पिकायेगु थें न्यागु खं च्वयातगु दु।

प्राचीन मिश्र

सम्पादन

अन्वेषकतेसं प्राचीन मिश्रय् २६५० बी सीयागु प्रथम मोलार वायागु जरायागु क्वे निगु हो दुगु म्यान्डिबल लुइकुगु दु। थुकिलिं एब्सेस दुगु वा लिकाइगु पद्दतियात ईंगीत याई। न्हुगु उत्खनन कथं पिरामिड देकुपिं ज्यामिय् न्ह्येपू शल्यक्रिया याना व ज्यामि नि दं लिपा तक्क म्वागु प्रमाण लुगु दु।[पुष्टि(साइटेसन) मागु]

प्राचीन युनान

सम्पादन

आयागु ईले शल्यचिकित्सकतेत विशेष चिकित्सक धका हना तसां थ्व पेशायागु न्ह्येथनेज्या मेगु हे ख्यलं जुगु खः। युनानी संस्कृति कथलं मनुतेसं मनुयागु म्ह चायेके मज्यु, व हिपोक्र्याटिक शपथ नं चिकित्सकतेत शल्यचिकित्सा ज्यायात चेतावनी ब्युगु खने दु। विषेश कथलं, cutting persons laboring under the stone (अर्थात लिथोटोमी, "जलासेंयागु शल्यक्रियायागु ज्या व हे ज्याय् पोख्त मनुतेत त्वता बी मा" धैगु धारणा खने दु। शल्यचिकित्सायागु ज्ञान म्हयात बानास्वया जक्क वई, थ्व विज्ञान अब्लेयागु येक्व उसांयकमितेत मयगु खने दु।[पुष्टि(साइटेसन) मागु]

प्राचीन चीन

सम्पादन

हुवा तुवो पूर्वी हान व स्वंगु राजशाही ई यागु छम्ह नांजाम्ह चिनियामि चिकित्सक खः। वेक एनेस्थेसिया छ्येला शल्यक्रिया यानादिम्ह दक्ले न्हापायाम्ह मनु खः। वेकलं आधुनिक चिकित्सा स्वया १६०० दं न्ह्य एनेस्थेसिया छ्येला दिगु खः।[पुष्टि(साइटेसन) मागु]

Medieval Europe

सम्पादन

Abulcasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi) was an Andalusian-Arab physician and scientist who practised in the Zahra suburb of Cordova. He is considered a great medieval surgeon, whose comprehensive medical texts, combining Middle Eastern and Greco-Roman classical teachings, shaped European surgical procedures up until the Renaissance. He is often regarded as the Father Of Surgery[पुष्टि(साइटेसन) मागु]. Patients and students from all parts of Europe came to him for treatment and advice. According to Will Durant, Cordova was in this period the favourite resort of Europeans for surgical operations.

 
Surgery in Holland (ca. 1690)

By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Montpellier, Padua and Bologna Universities were particularly interested in the academic side to Surgery, and by the fifteenth century at the latest, Surgery was a separate university subject to Physics. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius Salernitanus composed his Chirurgia, which laid the foundation for the species of the occidental surgical manuals, influencing them up to modern times.

Europe

सम्पादन
 
Hieronymus Fabricius, Operationes chirurgicae, 1685

Ambroise Paré pioneered the treatment of wounds by gunshots. Among the first modern surgeons were battlefield doctors in the Napoleonic Wars who were primarily concerned with amputation. Naval surgeons were often barber surgeons, who combined surgery with their main jobs as barbers.

In London, an operating theatre or operating room from the day before modern anaesthesia or antiseptic surgery still exists, and is open to the public. It is found in the roof space of St Thomas Church, Southwark, London and is called the Old Operating Theatre.

आधुनिक शल्यचिकित्सायागु विकास

सम्पादन

आधुनिक ईले वेत शल्यचिकित्सायात स्वंगु मू बाधा पार याये माल। थ्व स्वंगु बाधा खः-

  • हि बाहा वनिगु
  • संक्रमण
  • स्याइगु

Bleeding

सम्पादन

Before modern surgical developments, there was a very real threat that a patient would bleed out on the table during an operation or bleed to death while being attended after an accident or wound. The first real progress in combating bleeding had come when early cultures realized they could close wounds using extremes of heat, a procedure called cauterizing. The early cauterization was successful, but only useable in a limited fashion, highly destructive, and painful, with terrible long term outcomes.

The next real breakthrough to come was the invention of ligatures, something widely believed to have originated with Ambrose Pare during the 16th century. A ligature is a piece of material used to tie closed the end of a cut blood vessel preventing any further bleeding by serving to occlude it. Ligatures form the basis of modern control bleeding, but at the time, they were more of a hazard than a help because the surgeons using them had no concept of infection control.

A final barrier to be overcome was the problem of replacing blood lost. Limiting bleeding is important, but ultimately, a surgeon is fighting a losing battle if blood cannot be replaced, and this final barrier was only conquered when early 20th century research into blood groups allowed the first effective blood transfusions.

Infection

सम्पादन

Big holes into sealed internal environments lead to infections, especially if the surgeon is using dirty tools, covered in blood and wearing his normal clothes. The first progress in combating infection was made by the Hungarian doctor Semmelweiss who noticed that medical students fresh from the dissecting room were causing excess maternal death compared to midwives. Semmelweiss, despite ridicule and opposition, introduced compulsory handwashing for everyone entering the maternal wards and was rewarded with a plunge in maternal and fetal deaths, however the royal society in the UK still dismissed his advice. The next true progress came when, after reading a paper by Louis Pasteur, the British surgeon Joseph Lister began experimenting with using phenol during surgery to prevent infections. Lister was able to quickly improve infection rates no end, a process that was further helped by his subsequent introduction of techniques to sterilise equipment, have rigorous hand washing and a later implementation of rubber gloves. Lister published his work as a series of articles in The Lancet (March 1867) under the title "Antiseptic Principle of the Practice of Surgery". The work was groundbreaking and laid the foundations for a rapid advance in infection control that saw modern aseptic operating theatres widely used within 50 years (Lister himself went on to make further strides in antisepsis and asepsis throughout his lifetime). The gradual development of germ theory has allowed the final step to be taken to create the highest quality of aseptic conditions in modern hospitals and this has allowed us to (theoretically) perform infection free surgery.

Pain

सम्पादन

Anesthesia was discovered by two American dentists, Horace Wells (1815-1848) and William Morton. Before the advent of anesthesia, surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient suffering. This also meant that operations were largely restricted to amputations and external growth removals.

Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as ether and chloroform. In Britain, John Snow pioneered the use of these two anaesthetics. In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body. In addition, the discovery of muscle relaxants such as curare allowed for safer applications.

Doctor or Mister?

सम्पादन

In the United Kingdom, Australia, South Africa and New Zealand surgeons are distinguished from physicians by being referred to as "Mister." This tradition has its origins in the 18th century, when surgeons were barber-surgeons and did not have a degree (or indeed any formal qualification), unlike physicians, who were doctors with a university medical degree.

By the beginning of the 19th century, surgeons had obtained high status, and in 1800, the Royal College of Surgeons (RCS) in London began to offer surgeons a formal status via RCS membership. The title Mister became a badge of honour, and today only surgeons who are Fellows of the Royal College of Surgeons generally call themselves Mister, Miss, Mrs or Ms in the course of their professional practice. [पुष्टि(साइटेसन) मागु]

By contrast, North American physicians and surgeons are always addressed as "Doctor." The title of doctor is represented in a physician and surgeon's name by the title M.D., D.O., D.P.M , D.D.S., or D.M.D. following his/her surname.

शल्यचिकित्सा नं लनिगु ल्वेत

सम्पादन

सामान्य शल्य प्रक्रियात

सम्पादन

१९९६यागु अमेरिकी उसायं तथ्यांकयागु राष्ट्रिय केन्द्रकथलं, अमेरिकाय् ४०.३ मिलियन इन्पेसेन्ट सर्जिकल प्रक्रिया जुल धासा ३१.५ मिलियन आउटपेसेन्ट अपरेसन जुल।

नांजापिं शल्यचिकित्सकत

सम्पादन

शल्यक्रियायागु पद्धति व प्रविधि

सम्पादन

स्वया दिसँ

सम्पादन

पिनेयागु स्वापूत

सम्पादन



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कार्डियोथोर्‍यासिक सर्जरी | छ्यंगु शल्यचिकित्सा | साधारण शल्यचिकित्सा | मिसा शल्यचिकित्सा | स्नायुशल्यचिकित्सा | मिखाशल्यचिकित्सा | ख्वा व म्हुतु शल्यचिकित्सा | अंग प्रत्यारोपण | क्वेंजोर्नी शल्यचिकित्सा | अटोराइनोल्यारिङ्गोलोजी (ENT) | मचाशल्यचिकित्सा | प्लास्टिक शल्यचिकित्सा | क्यान्सर शल्यचिकित्सा | घा:पा: शल्यचिकित्सा | युरोलोजी | धमनी शल्यचिकित्सा
  1. ↑ http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2002;volume=48;issue=1;spage=76;epage=8;aulast=Rana
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