As Rutkow writes, the emergence of surgery from its barbaric past rested on four pillars — the understanding of anatomy, the control of bleeding, anesthesia and antisepsis. The story, however, is not one of steady, rational progress ... The history of surgery, especially until the modern era, is as much about doctors’ innate conservatism as it is about innovation. It is, however, ultimately a history of triumphant progress — although not without dark episodes ... Rutkow discusses at great length the evolution of surgery as a separate specialty, and the rivalry between surgeons and other medical practitioners. But even here, in the rather tedious detail, there are human stories ... Rutkow is a surgeon, but freely admits he has always been more drawn to the history of surgery than surgery itself, and he confines his own surgical practice to relatively simple cases. Readers of the book looking for the blood and drama that is such a vital part of surgery will not find much of it. Instead, they will learn that the history of modern surgery is the history of the rise of the modern world, with all that has involved — not just science and technology but also politics, architecture, demographics and institutions.

Ira Rutkow’s Empire of the Scalpel: The History of Surgery romps through the field’s development from rude 'sawbones' trade to meticulous professional discipline. Rutkow has a raconteur’s touch, and he is especially good on the rugged, difficult, obstinate characters that propelled the field’s advance during a heroic age of medicine ... He’s also notably generous. Perhaps to a fault ... There’s much to marvel at in surgery’s history, but its practitioners today command status and prestige.

Rutkow’s history links surgical advances to concurrent social and scientific developments ... Rutkow’s book is interspersed with depictions of significant, largely Western figures in the history of surgery and experiences from his 40 years as a surgeon ... This is a well-documented and jargon-free work, aimed at helping laypeople better understand surgery and its practitioners.

Rutkow, who has written multiple books about surgery, offers both useful historical context and deserved recognition to the key figures ... The author avoids jargon, arguing against the idea of surgeons as a quasi-priestly elite and emphasizing that surgery is, ultimately, about saving lives rather than building reputations ... a knowledge of history provides a crucial element of humility for the profession and understanding for the public. A fascinating, well-rendered story of how the once-impossible became a daily reality.

Rutkow does a good job of discussing the cultural issues surrounding surgery: war, for example ... He’s at his best when delving into the stories behind specific breakthroughs—as with his colorful description of the first surgery that used anesthesia, in 1846 Massachusetts. The result is a unique take on the history of medicine.