166-423: Castration is any action, surgical , chemical , or otherwise, by which a male loses use of the testicles : the male gonad . Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical castration uses pharmaceutical drugs to deactivate the testes. Castration causes sterilization (permanently preventing the castrated person or animal from reproducing ); it also greatly reduces
332-474: A radiosurgical procedure (e.g. irradiation of a tumor). Surgical procedures are commonly categorized by urgency, type of procedure, body system involved, the degree of invasiveness, and special instrumentation. Inpatient surgery is performed in a hospital, and the person undergoing surgery stays at least one night in the hospital after the surgery. Outpatient surgery occurs in a hospital outpatient department or freestanding ambulatory surgery center, and
498-525: A surgical procedure or surgical operation , or simply "surgery" or "operation". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments , surgical facility or surgical nurse . Most surgical procedures are performed by a pair of operators: a surgeon who is the main operator performing the surgery, and a surgical assistant who provides in-procedure manual assistance during surgery. Modern surgical operations typically require
664-412: A surgical team that typically consists of the surgeon, the surgical assistant, an anaesthetist (often also complemented by an anaesthetic nurse ), a scrub nurse (who handles sterile equipment), a circulating nurse and a surgical technologist , while procedures that mandate cardiopulmonary bypass will also have a perfusionist . All surgical procedures are considered invasive and often require
830-486: A $ 12.3 trillion loss in economic productivity by the year 2030. This was especially true in the poorest countries, which account for over one-third of the population but only 3.5% of all surgeries that occur worldwide. It emphasized the need to significantly improve the capacity for Bellwether procedures – laparotomy , caesarean section , open fracture care – which are considered a minimum level of care that first-level hospitals should be able to provide in order to capture
996-505: A 12th-century English adventurer and invader of the Scottish coast, was blinded and castrated after losing a power struggle. In medieval England, men found guilty of high treason were hanged, drawn and quartered , which often included emasculation (removal of the genitalia). Wim Deetman was criticized by the Dutch parliament for excluding evidence of castration in his report on sexual abuse by
1162-489: A Component of Universal Health Coverage . The Lancet Commission for Global Surgery outlined the need for access to "available, affordable, timely and safe" surgical and anesthesia care; dimensions paralleled in ICESCR General Comment No. 14, which similarly outlines need for available, accessible, affordable and timely healthcare. Surgical treatments date back to the prehistoric era. The oldest for which there
1328-505: A brother to a sister, Abelard commended to her. Sometime before 1140, Abelard published his masterpiece, Ethica or Scito te ipsum (Know Thyself), where he analyzes the idea of sin and that actions are not what a man will be judged for but intentions. During this period, he also wrote Dialogus inter Philosophum, Judaeum et Christianum (Dialogue between a Philosopher, a Jew, and a Christian), and also Expositio in Epistolam ad Romanos ,
1494-583: A cabin of stubble and reeds, created a simple oratory dedicated to the Trinity, and became a hermit . When his retreat became known, students flocked from Paris, and covered the wilderness around him with their tents and huts. He began to teach again there. The oratory was rebuilt in wood and stone and rededicated as the Oratory of the Paraclete . Abelard remained at the Paraclete for about five years. His combination of
1660-486: A commentary on St. Paul 's epistle to the Romans, where he expands on the meaning of Christ's life. It is not clear whether Abelard stopped teaching after 1136, or whether he continued with all except his lectures on logic until as late as 1141. Whatever the exact timing, a process was instigated by William of St-Thierry , who discovered what he considered to be heresies in some of Abelard's teaching. In spring 1140 he wrote to
1826-605: A component of universal health coverage." This not only mandated the WHO to prioritize strengthening the surgical and anesthesia care globally, but also led to governments of the member states recognizing the urgent need for increasing capacity in surgery and anesthesia. Additionally, the third edition of Disease Control Priorities (DCP3), published in 2015 by the World Bank , declared surgery as essential and featured an entire volume dedicated to building surgical capacity. Data from WHO and
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#17330846972381992-461: A disciple of Anselm of Laon (not to be confused with Saint Anselm ), a leading proponent of philosophical realism . Retrospectively, Abelard portrays William as having turned from approval to hostility when Abelard proved soon able to defeat his master in argument. This resulted in a long duel that eventually ended in the downfall of the theory of realism which was replaced by Abelard's theory of conceptualism / nominalism . While Abelard's thought
2158-510: A dog bite them off. During the Yuan dynasty , eunuchs became a desirable commodity for tributes , and dog bites were replaced by more sophisticated surgical techniques. The Vietnamese adopted the eunuch system and castration techniques from China. Records show that the Vietnamese performed castration in a painful procedure by removing the entire genitalia with both penis and testicles being cut off with
2324-558: A eunuch attendant at the Vietnamese imperial palace in Thang Long . After years of service, he was promoted at the death of the Vietnamese ruler in 1497 to a military position in northern Vietnam. A soldier told him of an escape route back to China and Wu Rui escaped to Longzhou . The local chief planned to sell him back to the Vietnamese, but Wu was rescued by the Pingxiang magistrate and then
2490-593: A hymnbook for the religious community that Héloïse joined. This hymnbook, written after 1130, differed from contemporary hymnals, such as that of Bernard of Clairvaux , in that Abelard used completely new and homogeneous material. The songs were grouped by metre, which meant that it was possible to use comparatively few melodies. Only one melody from this hymnal survives, O quanta qualia . Abelard also wrote six biblical planctus ( laments ): In surviving manuscripts, these pieces have been notated in diastematic neumes which resist reliable transcription. Only Planctus VI
2656-413: A less irritating emollient, made of egg yolk , rose oil and turpentine . He also described more efficient techniques for the effective ligation of the blood vessels during an amputation . Pierre Ab%C3%A9lard Peter Abelard ( / ˈ æ b ə l ɑːr d / ; French: Pierre Abélard [abelaʁ] ; Latin : Petrus Abaelardus or Abailardus ; c. 1079 – 21 April 1142)
2822-594: A mental illness, chemical castration has been used on gay men, as in the case of Alan Turing . In modern times, the Czech Republic practices surgical castration of convicted sex offenders. According to the reports compiled by Council of Europe, a human-rights forum, the central European country physically castrated at least 94 prisoners in the 10 years up to April 2008. The Czech Republic defends this procedure as voluntary and effective. According to Dr. Martin Hollý, director of
2988-520: A military physician". The researchers were impressed by the complexity of the brain surgical operation. In 1991 at the Polystylon fort in Greece, researchers discovered the head of a Byzantine warrior of the 14th century. Analysis of the lower jaw revealed that a surgery has been performed, when the warrior was alive, to the jaw which had been badly fractured and it tied back together until it healed. During
3154-419: A nun and shared the nuns' life, though she was not consecrated. Fulbert, infuriated that Heloise had been taken from his house and possibly believing that Abelard had disposed of her at Argenteuil in order to be rid of her, arranged for a band of men to break into Abelard's room one night and castrate him. In legal retribution for this vigilante attack, members of the band were punished, and Fulbert, scorned by
3320-513: A period of postoperative care (sometimes intensive care ) for the patient to recover from the iatrogenic trauma inflicted by the procedure. The duration of surgery can span from several minutes to tens of hours depending on the specialty , the nature of the condition, the target body parts involved and the circumstance of each procedure, but most surgeries are designed to be one-off interventions that are typically not intended as an ongoing or repeated type of treatment. In British colloquialism,
3486-498: A peripheral IV line is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given. When the patient enters the operating room and is appropriately anesthetized, the team will then position the patient in an appropriate surgical position . If hair is present at the surgical site, it is clipped (instead of shaving). The skin surface within the operating field is cleansed and prepared by applying an antiseptic (typically chlorhexidine gluconate in alcohol, as this
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#17330846972383652-414: A person shows signs of infection and not as a preventative. A systematic review published by Cochrane (organisation) in 2016, though, concluded that topical antibiotics applied over certain types of surgical wounds reduce the risk of surgical site infections, when compared to no treatment or use of antiseptics . The review also did not find conclusive evidence to suggest that topical antibiotics increased
3818-403: A physical exam which did not indicate a chest x-ray. Routine x-ray examination is more likely to result in problems like misdiagnosis, overtreatment, or other negative outcomes than it is to result in a benefit to the person. Likewise, other tests including complete blood count , prothrombin time , partial thromboplastin time , basic metabolic panel , and urinalysis should not be done unless
3984-534: A place in Fulbert's house, and by 1115 or 1116 began an affair. In Abelard's autobiography, he describes the relationship as a seduction, he used example phrases in his teaching such as "Peter loves his girl"; and he wrote popular poems and songs of his love that spread throughout the country. Heloise's letters depict a relationship of equals kindled by mutual attraction. Once Fulbert found out, he separated them, but they continued to meet in secret. Héloïse became pregnant and
4150-411: A point of view which Thomas F. Graham argues Abelard was unable to separate himself from objectively to argue more subtly "because of his own mental health." Abelard stressed that subjective intention determines the moral value of human action and therefore that the legal consequence of an action is related to the person that commits it and not merely to the action. With this doctrine, Abelard created in
4316-544: A prehistoric individual from the Indus River valley show evidence of teeth having been drilled. Sushruta Samhita is one of the oldest known surgical texts and its period is usually placed in the first millennium BCE. It describes in detail the examination, diagnosis, treatment, and prognosis of numerous ailments, as well as procedures for various forms of cosmetic surgery, plastic surgery and rhinoplasty . In 1982 archaeologists were able to find significant evidence when
4482-562: A prerequisite for their release from prison. The castration may be voluntary or mandated. The assumption is that it prevents future crimes. Reports are available from American and European countries for over 80 years (chemical for circa 30). The effectiveness and ethics of this treatment are heavily debated. A temporary "chemical castration" has been studied and developed as a preventive measure and punishment for several repeated sex crimes , such as rape or other sexually related violence . Where homosexuality has been criminalised or treated as
4648-944: A professor at Newcastle University 's Institute of Neuroscience who also runs a chemical castration program backed by the UK's Ministry of Justice , was initially opposed to physical castration. After visiting the Czech Republic, however, he agreed that some form of castration might be of benefit to some sex offenders. Surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery such as gastric bypass ), to reconstruct or improve aesthetics and appearance ( cosmetic surgery ), or to remove unwanted tissues ( body fat , glands , scars or skin tags ) or foreign bodies . The act of performing surgery may be called
4814-418: A punishment for disobedience. In the medieval kingdom of Georgia , the 12th-century pretender Demna was castrated by his uncle George III of Georgia to ensure the supremacy of George's branch of the family. Another victim of castration was the 12th-century medieval French philosopher, scholar, teacher, and (later) monk Pierre Abélard . He was castrated by relatives of his lover, Héloïse . Bishop Wimund ,
4980-440: A recent study done with lumbar decompressions, the patient's length of stay was decreased by 1–3 days. The use of topical antibiotics on surgical wounds to reduce infection rates has been questioned. Antibiotic ointments are likely to irritate the skin, slow healing, and could increase risk of developing contact dermatitis and antibiotic resistance . It has also been suggested that topical antibiotics should only be used when
5146-466: A risk factor for adverse post-surgical outcomes. It has been linked to many disorders such as obesity hypoventilation syndrome, atelectasis and pulmonary embolism, adverse cardiovascular effects, and wound healing complications. If removable skin closures are used, they are removed after 7 to 10 days post-operatively, or after healing of the incision is well under way. It is not uncommon for surgical drains to be required to remove blood or fluid from
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5312-477: A scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and they must scrub hands and arms with an approved disinfectant agent before each procedure. Prior to surgery, the person is given a medical examination , receives certain pre-operative tests, and their physical status is rated according to the ASA physical status classification system . If these results are satisfactory,
5478-485: A second document, he ordered Abelard to be confined in a monastery and his books to be burned. Abelard was saved from this sentence, however, by Peter the Venerable, abbot of Cluny . Abelard had stopped there, on his way to Rome, before the papal condemnation had reached France. Peter persuaded Abelard, already old, to give up his journey and stay at the monastery. Peter managed to arrange a reconciliation with Bernard, to have
5644-416: A sharp knife or metal blade. The procedure was agonizing since the entire penis was cut off. The young man's thighs and abdomen would be tied, and others would pin him down on a table. The genitals would be washed with pepper water and then cut off. A tube would be then inserted into the urethra to allow urination during healing. Many Vietnamese eunuchs were products of self-castration in order to gain access to
5810-636: A specialty of medicine, rather than an accessory field. Basic surgical principles for asepsis etc., are known as Halsteads principles . There were some important advances to the art of surgery during this period. The professor of anatomy at the University of Padua , Andreas Vesalius , was a pivotal figure in the Renaissance transition from classical medicine and anatomy based on the works of Galen , to an empirical approach of 'hands-on' dissection. In his anatomic treaties De humani corporis fabrica , he exposed
5976-472: A stand-in for criticizing the government. Commoners were banned from undergoing castration in Vietnam; only adult men of high social rank could be castrated. Most eunuchs were born as such with a congenital abnormality. The Vietnamese government mandated that boys born with defective genitalia were to be reported to officials, in exchange for the town being freed from mandatory labor requirements. The boy would have
6142-470: A weekend, and also, decrease number and level of experience over a weekend. Postoperative pain affects an estimated 80% of people who underwent surgery. While pain is expected after surgery, there is growing evidence that pain may be inadequately treated in many people in the acute period immediately after surgery. It has been reported that incidence of inadequately controlled pain after surgery ranged from 25.1% to 78.4% across all surgical disciplines. There
6308-417: Is administered to prevent pain from the trauma of cutting, tissue manipulation, application of thermal energy, and suturing. Depending on the type of operation, anesthesia may be provided locally, regionally , or as general anesthesia . Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia,
6474-587: Is almost certain that these references are to the same person. Astrolabe is recorded in the Paraclete necrology as dying on 29 or 30 October, year unknown, appearing as "Petrus Astralabius magistri nostri Petri filius" (son of our master Peter). In his early forties, Abelard sought to bury himself as a monk of the Abbey of Saint-Denis with his woes out of sight. Finding no respite in the cloister , and having gradually turned again to study, he gave in to urgent entreaties, and reopened his school at an unknown priory owned by
6640-647: Is among the controversial topics related to surgery in children. Doctors perform surgery with the consent of the person undergoing surgery. Some people are able to give better informed consent than others. Populations such as incarcerated persons , people living with dementia , the mentally incompetent, persons subject to coercion, and other people who are not able to make decisions with the same authority as others, have special needs when making decisions about their personal healthcare, including surgery. Global surgery has been defined as 'the multidisciplinary enterprise of providing improved and equitable surgical care to
6806-449: Is applied to the area of the person's body that will be operated on. Sterile drapes are placed around the operative site. Surgical masks are worn by the surgical team to avoid germs on droplets of liquid from their mouths and noses from contaminating the operative site. Work to correct the problem in body then proceeds. This work may involve: Blood or blood expanders may be administered to compensate for blood lost during surgery. Once
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6972-444: Is being done to find a solution.As such, surgical care globally has been described as the 'neglected stepchild of global health,' a term coined by Paul Farmer to highlight the urgent need for further work in this area. Furthermore, Jim Young Kim , the former President of the World Bank , proclaimed in 2014 that "surgery is an indivisible, indispensable part of health care and of progress towards universal health coverage." In 2015,
7138-587: Is considered one of the founders of the secular university and pre-Renaissance secular philosophical thought. Abelard argued for conceptualism in the theory of universals . (A universal is a quality or property which every individual member of a class of things must possess if the same word is to apply to all the things in that class. Blueness, for example, is a universal property possessed by all blue objects.) According to Abelard scholar David Luscombe , "Abelard logically elaborated an independent philosophy of language ...[in which] he stressed that language itself
7304-481: Is credited with the performance of the first thyroidectomy . Al-Zahrawi pioneered techniques of neurosurgery and neurological diagnosis, treating head injuries , skull fractures , spinal injuries , hydrocephalus , subdural effusions and headache . The first clinical description of an operative procedure for hydrocephalus was given by Al-Zahrawi, who clearly describes the evacuation of superficial intracranial fluid in hydrocephalic children. In Europe ,
7470-744: Is evidence is trepanation , in which a hole is drilled or scraped into the skull , thus exposing the dura mater in order to treat health problems related to intracranial pressure. Prehistoric surgical techniques are seen in Ancient Egypt , where a mandible dated to approximately 2650 BC shows two perforations just below the root of the first molar , indicating the draining of an abscessed tooth . Surgical texts from ancient Egypt date back about 3500 years ago. Surgical operations were performed by priests, specialized in medical treatments similar to today, and used sutures to close wounds. Infections were treated with honey. 9,000-year-old skeletal remains of
7636-551: Is increasingly recognized as an integral aspect of healthcare and therefore is evolving into a normative derivation of human right to health . The ICESCR Article 12.1 and 12.2 define the human right to health as "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health" In the August 2000, the UN Committee on Economic, Social and Cultural Rights (CESCR) interpreted this to mean "right to
7802-500: Is insufficient evidence to determine if giving opioid pain medication pre-emptively (before surgery) reduces postoperative pain the amount of medication needed after surgery. Postoperative recovery has been defined as an energy‐requiring process to decrease physical symptoms, reach a level of emotional well‐being, regain functions, and re‐establish activities. Moreover, it has been identified that patients who have undergone surgery are often not fully recovered on discharge. In 2011, of
7968-423: Is jokingly referenced as relating to lard, as in excessive ("fatty") learning, in a secondary anecdote referencing Adelard of Bath and Peter Abelard (and in which they are confused to be one person). In the great cathedral school of Notre-Dame de Paris (before the construction of the current cathedral there), he studied under Paris archdeacon and Notre-Dame master William of Champeaux , later bishop of Chalons,
8134-456: Is made to access the surgical site. Blood vessels may be clamped or cauterized to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then the peritoneum. In certain cases, bone may be cut to further access
8300-545: Is mentioned as Dionysius of Corinth by Eusebius . This irritated the monks so much that eventually Abelard was allowed to leave. Abelard initially lodged at St. Ayoul of Provins, where the prior was a friend. Then, after the death of Abbot Adam in March 1122, Abelard was able to gain permission from the new abbot, Suger , to live "in whatever solitary place he wished". In a deserted place near Nogent-sur-Seine in Champagne , he built
8466-484: Is not able to demonstrate the truth of things (res) that lie in the domain of physics." Writing with the influence of his wife Heloise, he stressed that subjective intention determines the moral value of human action. With Heloise, he is the first significant philosopher of the Middle Ages to push for intentionalist ethics. He helped establish the philosophical authority of Aristotle , which became firmly established in
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#17330846972388632-542: Is presumed that he returned to Paris and resumed teaching on the Montagne Sainte-Geneviève . His lectures were dominated by logic, at least until 1136, when he produced further drafts of his Theologia in which he analyzed the sources of belief in the Trinity and praised the pagan philosophers of classical antiquity for their virtues and for their discovery by the use of reason of many fundamental aspects of Christian revelation. In 1128, Abbot Suger claimed that
8798-518: Is sometimes credited as a chief forerunner of modern empiricism . In history and popular culture, he is best known for his passionate and tragic love affair, and intense philosophical exchange , with his brilliant student and eventual wife, Héloïse d'Argenteuil . He was a defender of women and of their education. After having sent Héloïse to a convent in Brittany to protect her from her abusive uncle who did not want her to pursue this forbidden love, he
8964-401: Is that the physician might discover some unknown medical condition which would complicate the surgery, and that upon discovering this with the chest x-ray, the physician would adapt the surgery practice accordingly. However, medical specialty professional organizations recommend against routine pre-operative chest x-rays for people who have an unremarkable medical history and presented with
9130-424: Is twice as effective as povidone-iodine at reducing the risk of infection). Sterile drapes are then used to cover the borders of the operating field . Depending on the type of procedure, the cephalad drapes are secured to a pair of poles near the head of the bed to form an "ether screen", which separate the anesthetist / anesthesiologist 's working area (unsterile) from the surgical site (sterile). Anesthesia
9296-510: Is used to slow down the cancer. Surgical removal of one or both testicles known as orchidectomy is the most common treatment for testicular cancer. Castration has also been used in the United States for sex offenders as a way of avoiding incarceration. It can greatly reduce sex drive or interest in those with sexual drives, obsessions, or behaviors, or any combination of those that may be considered deviant. Involuntary castration appears in
9462-535: The Theologia Summi Boni , than his adversaries picked up on his rationalistic interpretation of the Trinitarian dogma. Two pupils of Anselm of Laon , Alberich of Reims and Lotulf of Lombardy, instigated proceedings against Abelard, charging him with Sabellianism in a provincial synod held at Soissons in 1121 . Through irregular procedures, they obtained an official condemnation of his teaching, and Abelard
9628-521: The Bishop of Chartres and to Bernard of Clairvaux , denouncing them. Another, less distinguished, theologian, Thomas of Morigny , also produced at the same time a list of Abelard's supposed heresies, perhaps at Bernard's instigation. Bernard's complaint mainly was that Abelard had applied logic where it is not applicable, and that is illogical. Amid pressure from Bernard, Abelard challenged Bernard either to withdraw his accusations, or to make them publicly at
9794-582: The Fourth Chinese domination of Vietnam , the Ming Chinese under the Yongle Emperor castrated many young Vietnamese boys, choosing them for their handsomeness and ability, and brought them to Nanjing to serve as eunuchs. Among them were the architect-engineer Nguyễn An and Nguyen Lang (阮浪). Vietnamese were among the many eunuchs of different origins found at Yongle's court. Among the eunuchs in charge of
9960-695: The Han dynasty were also used as slave labor. In the Han dynasty (206 BC–220 AD), castration continued to be used as a punishment for various offences. Chinese historian Sima Qian was castrated by order of the Han Emperor of China for dissent. In another incident multiple people, including a chief scribe and his underlings, were subjected to castration. During the early part of the Ming dynasty (1368–1644 AD), China demanded eunuchs to be sent as tribute from Korea . Some of them oversaw
10126-512: The Islamic Golden Age , largely based upon Paul of Aegina 's Pragmateia , the writings of Albucasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi), an Andalusian-Arab physician and scientist who practiced in the Zahra suburb of Córdoba , were influential. Al-Zahrawi specialized in curing disease by cauterization . He invented several surgical instruments for purposes such as inspection of
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#173308469723810292-642: The Shang dynasty ( c. 1700 –1050 BC), when the Shang kings castrated prisoners of war. During the reign of Mu of the Zhou dynasty (10th c. BC) the Minister of Crime, Marquis Lu, reformed the law in 950 BC to make it easier for people to be sentenced to castration instead of death. As long as the practice existed in China, not only were the testicles removed but castration included
10458-403: The 2000 comment to include timely access to "basic preventative, curative services… for appropriate treatment of injury and disability .". Obstetric care shares close ties with reproductive rights , which includes access to reproductive health. Surgeons and public health advocates, such as Kelly McQueen , have described surgery as "Integral to the right to health ". This is reflected in
10624-418: The 38.6 million hospital stays in U.S. hospitals, 29% included at least one operating room procedure. These stays accounted for 48% of the total $ 387 billion in hospital costs. The overall number of procedures remained stable from 2001 to 2011. In 2011, over 15 million operating room procedures were performed in U.S. hospitals. Data from 2003 to 2011 showed that U.S. hospital costs were highest for
10790-603: The Capital Battalions of Beijing was Xing An, a Vietnamese. In the Lê dynasty the Vietnamese Emperor Lê Thánh Tông was aggressive in his relations with foreign countries including China. A large amount of trade between Guangdong and Vietnam happened during his reign. Early accounts recorded that the Vietnamese captured Chinese whose ships had blown off course and detained them. Young Chinese men were selected by
10956-832: The Chinese boys in a biography on Wang Ji'en. Some legends say that the Mongol Genghis Khan was castrated by a Tangut princess using a knife, who wanted revenge against his treatment of the Tanguts and to stop him from raping her. During the Qing dynasty (1644–1911 AD), the sons and grandsons of the rebel Yaqub Beg in China were all sentenced to castration. Surviving members of Yaqub Beg's family included his four sons, four grandchildren (two grandsons and two granddaughters), and four wives. They either died in prison in Lanzhou , Gansu, or were killed by
11122-447: The Chinese. His sons Yima Kuli, K'ati Kuli, Maiti Kuli, and grandson Aisan Ahung were the only survivors in 1879. They were all underage children, and put on trial, sentenced to an agonizing death if they were complicit in their father's rebellious "sedition", or if they were innocent of their fathers crimes, were to be sentenced to castration and serving as eunuch slaves to Chinese troops, when they reached 11 years old, and handed over to
11288-791: The Council of Sens, where he was accused of heresy and was unable to speak in reply. In the words of Geoffrey of Auxerre: his "memory became very confused, his reason blacked out and his interior sense forsook him." Medieval understanding of mental health precedes development of modern psychiatric diagnosis. No diagnosis besides "ill health" was applied to Abelard at the time. His tendencies towards self-acclaim, grandiosity , paranoia and shame are suggestive of possible latent narcissism (despite his great talents and fame), or – recently conjectured – in keeping with his breakdowns, overwork, loquaciousness and belligerence – mood-related mental health issues such as mania related to bipolar disorder . At
11454-537: The Imperial Household to be executed or castrated. Although some sources assert that the sentence of castration was carried out, official sources from the US State Department and activists involved in the incident state that Yaqub Beg's son and grandsons had their sentence commuted to life imprisonment with a fund provided for their support. The eunuchs of Korea, called Naesi (내시, 內侍), were officials to
11620-716: The Khitan founded the Liao dynasty they developed a harem system with concubines and wives and adopted eunuchs as part of it. All of the eunuchs captured were ethnic Chinese from the Central Plains that came from two sources. The Khitan captured Chinese people who were already eunuchs at the Jin court when they invaded the Later Jin . Another source was during their war with the Chinese Song dynasty :
11786-523: The Khitan would raid China, capture Han Chinese boys as prisoners of war and emasculate them to become eunuchs. The emasculation of captured Chinese boys guaranteed a continuous supply of eunuchs to serve in the Liao dynasty harem. The Empress Dowager Xiao Chuo (Chengtian) played a large role in the raids to capture and emasculate the boys. Chengtian took power at age 30 in 982 as a regent for her son. Some reports suggest that she personally led her own army against
11952-782: The Korean concubines in the harem of the Chinese Emperor. When the Chinese overthrew Mongol rule, many Mongol captives were castrated and turned into eunuchs. When the Ming army finally captured Yunnan from Mongols in 1382, thousands of prisoners were killed and, according to the custom in times of war, their young sons—including Zheng He —were castrated. During the Miao Rebellions (Ming dynasty) , Chinese commanders castrated thousands of Miao boys when their tribes revolted, and then distributed them as eunuch slaves as gifts to various officials. At
12118-716: The Lancet Commission on Global Surgery (LCoGS) published the landmark report titled "Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development", describing the large, pre-existing burden of surgical diseases in low- and middle-income countries (LMICs) and future directions for increasing universal access to safe surgery by the year 2030. The Commission highlighted that about 5 billion people lack access to safe and affordable surgical and anesthesia care and 143 million additional procedures were needed every year to prevent further morbidity and mortality from treatable surgical conditions as well as
12284-624: The Lê dynasty of Annam (Vietnam) as they were returning to Malacca from China. The Vietnamese enslaved and castrated the young from among the captured. A 1472 entry in the Ming Shilu reported that when some Chinese from Nanhai county escaped back to China after their ship had been blown off course into Vietnam, where they had been forced to serve as soldiers in Vietnam's military. The escapees also reported that they found out up to 100 Chinese men remained captives in Vietnam after they were caught and castrated by
12450-575: The Middle Ages the idea of the individual subject central to modern law. This gave to School of Notre-Dame de Paris (later the University of Paris) a recognition for its expertise in the area of Law, even before the faculty of law existed and the school even recognized as an universitas and even though Abelard was a logician and a theologian. Abelard was also long known as an important poet and composer. He composed some celebrated love songs for Héloïse that are now lost, and which have not been identified in
12616-537: The Paliokastro on Thasos ten skeletal remains, four women and six men, who were buried between the fourth and seventh centuries A.D. Their bones illuminated their physical activities, traumas, and even a complex form of brain surgery. According to the researchers: "The very serious trauma cases sustained by both males and females had been treated surgically or orthopedically by a very experienced physician/surgeon with great training in trauma care. We believe it to have been
12782-523: The Psychiatric Hospital Bohnice in Prague, none of the nearly 100 sex offenders who had been physically castrated had committed further offences. One serial offender stated that being castrated was the "best decision" he ever made: "On the one hand you have to protect the potential victims and on the other hand I wanted to be protected from myself, I wanted to live like a normal person." Don Grubin,
12948-552: The Roman Catholic Church, where ten children were allegedly "punished" by castration in the 1950s for reporting sexual abuse by Roman Catholic priests. The Deetman Commission had rejected it as the person who reported the incident admitted it was speculative. In Spain, a law against castration was used to deny sex-reassignment surgery to transgender people until the Penal Code was reformed in 1983. According to legend, during
13114-618: The Roman Empire reports castration of defeated Byzantine Greeks at the hands of the Frankish marquis Theobald of Camerino and Spoleto in the course of 10th-century wars in Italy. Gibbon also alludes to a 12th-century incident set out in William Fitzstephen 's Vita Sancti Thomae ( Life of St. Thomas ) in which Geoffrey of Anjou castrated the members of the cathedral chapter of Sens as
13280-521: The Song Chinese in 986. Her army defeated them in battle, fighting the retreating Chinese army. She then ordered the castration of around 100 ethnic Chinese boys she had captured in China, supplementing the Khitan's supply of eunuchs to serve at her court, among them was Wang Ji'en . The boys were all under ten years old and were selected for their good looks. The History of Liao 遼史 described and praised Empress Chengtian's capture and mass castration of
13446-506: The Venerable of Cluny , who wrote to Héloise: "I will gladly do my best to obtain a prebend in one of the great churches for your Astrolabe, who is also ours for your sake". 'Petrus Astralabius' is recorded at the Cathedral of Nantes in 1150, and the same name appears again later at the Cistercian abbey at Hauterive in what is now Switzerland. Given the extreme eccentricity of the name, it
13612-462: The Vietnamese after their ship was blown off course while traveling from Hainan to Guangdong 's Qin subprefecture ( Qinzhou ), after which they ended up near the coast of Vietnam, during the Chenghua Emperor 's rule (1447–1487). Twelve of them were enslaved to work as agricultural laborers, while the youngest, Wu Rui (吳瑞) was selected for castration since he was the only young man and he became
13778-487: The Vietnamese after their ships were blown off course into Vietnam. The Chinese Ministry of Revenue responded by ordering Chinese civilians and soldiers to stop going abroad to foreign countries. China's relations with Vietnam during this period were marked by the punishment of prisoners by castration. A 1499 entry in the Ming Shilu recorded that 13 Chinese men from Wenchang including a young man named Wu Rui were captured by
13944-501: The Vietnamese for castration to become eunuch slaves to the Vietnamese. It has been speculated by modern historians that the Chinese who were captured and castrated by the Vietnamese were involved in trade between China and Vietnam instead of actually being blown off course by the wind and they were punished as part of a crackdown on foreign trade by Vietnam. Several Malay envoys from the Malacca sultanate were attacked and captured in 1469 by
14110-644: The World Bank indicate that scaling up infrastructure to enable access to surgical care in regions where it is currently limited or is non-existent is a low-cost measure relative to the significant morbidity and mortality caused by lack of surgical treatment. In fact, a systematic review found that the cost-effectiveness ratio – dollars spent per DALYs averted – for surgical interventions is on par or exceeds those of major public health interventions such as oral rehydration therapy , breastfeeding promotion , and even HIV/AIDS antiretroviral therapy . This finding challenged
14276-715: The age of eight to twelve had their penises and scrota completely amputated. Reportedly, about two out of three boys died, but those who survived drew high prices. The employment or enslavement of eunuchs (castrated men) was practiced in classical and Roman antiquity and continued into the Middle Ages. In the 10th century, slave traders in Verdun in France and in Becâne ( Pechina ), Spain, castrated captives who were then enslaved as harem attendants in Al-Andalus . Edward Gibbon 's Decline and Fall of
14442-550: The ancient land, called 'Alahana Pirivena' situated in Polonnaruwa, with ruins, was excavated. In that place ruins of an ancient hospital emerged. The hospital building was 147.5 feet in width and 109.2 feet in length. The instruments which were used for complex surgeries were there among the things discovered from the place, including forceps, scissors, probes, lancets, and scalpels. The instruments discovered may be dated to 11th century AD. In ancient Greece , temples dedicated to
14608-434: The anesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home. During the post-operative period, the person's general function is assessed, the outcome of the procedure is assessed, and the surgical site is checked for signs of infection. There are several risk factors associated with postoperative complications, such as immune deficiency and obesity. Obesity has long been considered
14774-483: The anonymous repertoire. (One known romantic poem / possible lyric remains, "Dull is the Star".) Héloïse praised these songs in a letter: "The great charm and sweetness in language and music, and a soft attractiveness of the melody obliged even the unlettered". His education in music was based in his childhood learning of the traditional quadrivium studied at the time by almost all aspiring medieval scholars. Abelard composed
14940-533: The area of Law (and later led to the creation of a Faculty of Law of Paris ). Abelard, originally called "Pierre le Pallet", was born c. 1079 in Le Pallet , about 10 miles (16 km) east of Nantes , in the Duchy of Brittany , the eldest son of a minor noble French family. As a boy, he learned quickly. His father, a knight called Berenger, encouraged Abelard to study the liberal arts , wherein he excelled at
15106-519: The art of dialectic . Instead of entering a military career, as his father had done, Abelard became an academic. During his early academic pursuits, Abelard wandered throughout France, debating and learning, so as (in his own words) "he became such a one as the Peripatetics ." He first studied in the Loire area, where the nominalist Roscellinus of Compiègne , who had been accused of heresy by Anselm ,
15272-620: The birth of their child, Astrolabe, Héloïse and Abelard were both cloistered. Their son was thus brought up by Abelard's sister, Dionysia, at Abelard's childhood home in Le Pallet. His name derives from the astrolabe , a Persian astronomical instrument said to elegantly model the universe and which was popularized in France by Adelard of Bath . He is mentioned in Abelard's poem to his son, the Carmen Astralabium, and by Abelard's protector, Peter
15438-1072: The common misconception that surgical care is financially prohibitive endeavor not worth pursuing in LMICs. A key policy framework that arose from this renewed global commitment towards surgical care worldwide is the National Surgical Obstetric and Anesthesia Plan (NSOAP). NSOAP focuses on policy-to-action capacity building for surgical care with tangible steps as follows: (1) analysis of baseline indicators, (2) partnership with local champions, (3) broad stakeholder engagement, (4) consensus building and synthesis of ideas, (5) language refinement, (6) costing, (7) dissemination, and (8) implementation. This approach has been widely adopted and has served as guiding principles between international collaborators and local institutions and governments. Successful implementations have allowed for sustainability in terms of longterm monitoring, quality improvement, and continued political and financial support. Access to surgical care
15604-452: The concept of limbo , and his introduction of the moral influence theory of atonement . He is considered (alongside Augustine of Hippo ) to be the most significant forerunner of the modern self-reflective autobiographer. He paved the way and set the tone for later epistolary novels and celebrity tell-alls with his publicly distributed letter, The History of My Calamities , and public correspondence. In law, Abelard stressed that, because
15770-455: The concept that human beings "speak to God with their thoughts". He was one of the developers of the insanity defense , writing in Scito te ipsum , "Of this [sin], small children and of course insane people are untouched...lack[ing] reason....nothing is counted as sin for them". He spearheaded the idea that mental illness was a natural condition and "debunked the idea that the devil caused insanity",
15936-472: The convent at Argenteuil, where Héloïse was prioress, belonged to his abbey of St Denis. In 1129 he gained possession and he made no provision for the nuns. When Abelard heard, he transferred Paraclete and its lands to Héloïse and her remaining nuns, making her abbess. He provided the new community with a rule and with a justification of the nun's way of life; in this he emphasized the virtue of literary study. He also provided books of hymns he had composed, and in
16102-478: The council the next day, he was presented with a list of condemned propositions imputed to him. Unable to answer to these propositions, Abelard left the assembly, appealed to the Pope, and set off for Rome, hoping that the Pope would be more supportive. However, this hope was unfounded. On 16 July 1141, Pope Innocent II issued a bull excommunicating Abelard and his followers and imposing perpetual silence on him, and in
16268-414: The demand grew for surgeons to formally study for many years before practicing; universities such as Montpellier , Padua and Bologna were particularly renowned. In the 12th century, Rogerius Salernitanus composed his Chirurgia , laying the foundation for modern Western surgical manuals. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as
16434-420: The domain a prey to outlaws, the house itself savage and disorderly. There, too, his relations with the community deteriorated. Lack of success at St. Gildas made Abelard decide to take up public teaching again (although he remained for a few more years, officially, Abbot of St. Gildas). It is not entirely certain what he then did, but given that John of Salisbury heard Abelard lecture on dialectic in 1136, it
16600-435: The early 1130s he and Héloïse composed a collection of their own love letters and religious correspondence containing, amongst other notable pieces, Abelard's most famous letter containing his autobiography, Historia Calamitatum ( The History of My Calamities ). This moved Héloïse to write her first Letter; the first being followed by the two other Letters, in which she finally accepted the part of resignation, which, now as
16766-451: The emotions. He should not be read as a heretic, as his charges of heresy were dropped and rescinded by the Church after his death, but rather as a cutting-edge philosopher who pushed theology and philosophy to their limits. He is described as "the keenest thinker and boldest theologian of the 12th century" and as the greatest logician of the Middle Ages. "His genius was evident in all he did"; as
16932-538: The end of the Ming dynasty, there were about 70,000 eunuchs (宦官 huànguān , or 太監 tàijiàn ) employed by the emperor, with some serving inside the Forbidden City . The last imperial eunuch in China was Sun Yaoting who died in 1996. The Khitan people adopted the practice of using eunuchs from the Chinese and the eunuchs used were non-Khitan prisoners of war. The Khitan were a nomadic Mongolic people and originally did not have eunuchs as part of their culture. When
17098-485: The enjoyment of a variety of facilities, goods, services, and conditions necessary for the realization of the highest attainable health". Surgical care can be thereby viewed as a positive right – an entitlement to protective healthcare. Woven through the International Human and Health Rights literature is the right to be free from surgical disease. The 1966 ICESCR Article 12.2a described the need for "provision for
17264-539: The establishment of the WHO Global Initiative for Emergency and Essential Surgical Care in 2005, the 2013 formation of the Lancet Commission for Global Surgery, the 2015 World Bank Publication of Volume 1 of its Disease Control Priorities Project "Essential Surgery", and the 2015 World Health Assembly 68.15 passing of the Resolution for Strengthening Emergency and Essential Surgical Care and Anesthesia as
17430-574: The first to use 'theology' in its modern sense, he championed "reason in matters of faith", and "seemed larger than life to his contemporaries: his quick wit, sharp tongue, perfect memory, and boundless arrogance made him unbeatable in debate" — "the force of his personality impressed itself vividly on all with whom he came into contact." Regarding the un baptized who die in infancy , Abelard — in Commentaria in Epistolam Pauli ad Romanos — emphasized
17596-491: The goodness of God and interpreted Augustine 's "mildest punishment" as the pain of loss at being denied the beatific vision ( carentia visionis Dei ), without hope of obtaining it, but with no additional punishments. His thought contributed to the forming of Limbo of Infants theory in the 12th–13th centuries. Abelard was concerned with the concept of intent and inner life, developing an elementary theory of cognition in his Tractabus De Intellectibus , and later developing
17762-477: The greatest surgeons of the ancient world and performed many audacious operations – including brain and eye surgery – that were not tried again for almost two millennia. Hippocrates stated in the oath ( c. 400 BCE ) that general physicians must never practice surgery and that surgical procedures are to be conducted by specialists Researchers from the Adelphi University discovered in
17928-411: The half-century after his death. It was at this time that Aristotle's Organon first became available, and gradually all of Aristotle's other surviving works. Before this, the works of Plato were used in support of philosophical realism . Abelard is considered one of the greatest twelfth-century Catholic philosophers, arguing that God and the universe can and should be known via logic as well as via
18094-461: The healer-god Asclepius , known as Asclepieia ( Greek : Ασκληπιεία , sing. Asclepieion Ασκληπιείον ), functioned as centers of medical advice, prognosis, and healing. In the Asclepieion of Epidaurus , some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place. The Greek Galen was one of
18260-642: The history of warfare, sometimes used by one side to torture or demoralize their enemies. Over the 13 centuries of the Arab slave trade in Africa, unknown numbers of Africans were enslaved and shipped to the Middle East. "The Caliphate in Baghdad at the beginning of the 10th Century had 7,000 black eunuchs and 4,000 white eunuchs in his palace." The Arab slave trade typically dealt in the sale of castrated male slaves. Black boys at
18426-594: The hospital, and are three times as likely to be discharged to a skilled nursing facility instead of to their own homes. People who are frail and elderly (score of 4 or 5) have even worse outcomes, with the risk of being discharged to a nursing home rising to twenty times the rate for non-frail elderly people. Surgery on children requires considerations that are not common in adult surgery. Children and adolescents are still developing physically and mentally making it difficult for them to make informed decisions and give consent for surgical treatments. Bariatric surgery in youth
18592-449: The important church council at Sens planned for 2 June 1141. In so doing, Abelard put himself into the position of the wronged party and forced Bernard to defend himself from the accusation of slander. Bernard avoided this trap, however: on the eve of the council, he called a private meeting of the assembled bishops and persuaded them to condemn, one by one, each of the heretical propositions he attributed to Abelard. When Abelard appeared at
18758-409: The indicated problem, minimize the risk of complications, optimize the time needed for recovery, and limit the surgical stress response. The intraoperative phase begins when the surgery subject is received in the surgical area (such as the operating theater or surgical department ), and lasts until the subject is transferred to a recovery area (such as a post-anesthesia care unit ). An incision
18924-427: The interior of the urethra and for removing foreign bodies from the throat, the ear, and other body organs. He was also the first to illustrate the various cannulae and to treat warts with an iron tube and caustic metal as a boring instrument. He describes what is thought to be the first attempt at reduction mammaplasty for the management of gynaecomastia and the first mastectomy to treat breast cancer . He
19090-490: The interior of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic (chest) surgery to open up the rib cage . Whilst in surgery aseptic technique is used to prevent infection or further spreading of the disease. The surgeons' and assistants' hands, wrists and forearms are washed thoroughly for at least 4 minutes to prevent germs getting into the operative field, then sterile gloves are placed onto their hands. An antiseptic solution
19256-649: The king and other royalty in traditional Korean society. The first recorded appearance of a Korean eunuch was in Goryeosa ("History of Goryeo"), a compilation about the Goryeo period. In 1392, with the founding of the Joseon dynasty , the Naesi system was revised, and the department was renamed the "Department of Naesi " (내시부, 內侍府). The Naesi system included two ranks, those of Sangseon (상선, 尙膳, "Chief of Naesi "), who held
19422-415: The lectures of Anselm on Biblical exegesis and Christian doctrine. Unimpressed by Anselm's teaching, Abelard began to offer his own lectures on the book of Ezekiel. Anselm forbade him to continue this teaching. Abelard returned to Paris where, in around 1115, he became master of the cathedral school of Notre-Dame and a canon of Sens (the cathedral of the archdiocese to which Paris belonged). Abelard
19588-497: The many anatomical errors in Galen and advocated that all surgeons should train by engaging in practical dissections themselves. The second figure of importance in this era was Ambroise Paré (sometimes spelled "Ambrose" ), a French army surgeon from the 1530s until his death in 1590. The practice for cauterizing gunshot wounds on the battlefield had been to use boiling oil; an extremely dangerous and painful procedure. Paré began to employ
19754-489: The monastery. His lectures, now framed in a devotional spirit, and with lectures on theology as well as his previous lectures on logic, were once again heard by crowds of students, and his old influence seemed to have returned. Using his studies of the Bible and, in his view, inconsistent writings of the leaders of the church as his basis, he wrote Sic et Non ( Yes and No ). No sooner had he published his theological lectures,
19920-623: The most basic emergency surgical care. In terms of the financial impact on the patients, the lack of adequate surgical and anesthesia care has resulted in 33 million individuals every year facing catastrophic health expenditure – the out-of-pocket healthcare cost exceeding 40% of a given household's income. In alignment with the LCoGS call for action, the World Health Assembly adopted the resolution WHA68.15 in 2015 that stated, "Strengthening emergency and essential surgical care and anesthesia as
20086-508: The need for extended care. Assessment of older people before elective surgery can accurately predict the person's recovery trajectories. One frailty scale uses five items: unintentional weight loss, muscle weakness , exhaustion, low physical activity, and slowed walking speed. A healthy person scores 0; a very frail person scores 5. Compared to non-frail elderly people, people with intermediate frailty scores (2 or 3) are twice as likely to have post-surgical complications, spend 50% more time in
20252-422: The offerings of his pupils, and entertained with universal admiration, he came to think of himself as the only undefeated philosopher in the world. But a change in his fortunes was at hand. In his devotion to science, he claimed to have lived a very straight and narrow life, enlivened only by philosophical debate: now, at the height of his fame, he encountered romance. Upon deciding to pursue Héloïse, Abelard sought
20418-479: The official title of senior second rank, and Naegwan (내관, 內官, "Common official naesi "), both of which held rank as officers. 140 naesi in total served the palace in Joseon dynasty period. They also took the exam on Confucianism every month. The naesi system was repealed in 1894 following Gabo reform . According to legend, castration consisted of daubing a boy's genitals with human feces and having
20584-671: The option of serving as a eunuch official or serving the palace women when he became ten years old. This law was put in place in 1838 during the Nguyễn dynasty. The only males allowed inside the Forbidden City at Huế were the Emperor and his eunuchs. The presence of eunuchs in Vietnam was used by the French colonizers to degrade the Vietnamese. In 1778, Thomas Jefferson wrote a bill in Virginia reducing
20750-554: The palaces and power. In other cases, they might be paid to become eunuchs. They served in many capacities, from supervising public works, to investigating crimes, to reading public proclamations. Lý Thường Kiệt was a prominent eunuch general during the Lý dynasty (1009–1225). The Trần dynasty sent Vietnamese boy eunuchs as tribute to Ming dynasty China several times, in 1383, 1384 and 1385 Nguyen Dao, Nguyen Toan, Tru Ca, and Ngo Tin were among several Vietnamese eunuchs sent to China. During
20916-410: The person requiring surgery signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system , the person requiring surgery may be instructed to perform a bowel prep by drinking a solution of polyethylene glycol the night before
21082-585: The person who had surgery is discharged the same working day. Office-based surgery occurs in a physician's office, and the person is discharged the same day. At a hospital , modern surgery is often performed in an operating theater using surgical instruments , an operating table , and other equipment. Among United States hospitalizations for non-maternal and non-neonatal conditions in 2012, more than one-fourth of stays and half of hospital costs involved stays that included operating room (OR) procedures. The environment and procedures used in surgery are governed by
21248-483: The precincts of Notre-Dame, under the care of her uncle, the secular canon Fulbert. She was famous as the most well-educated and intelligent woman in Paris, renowned for her knowledge of classical letters , including not only Latin but also Greek and Hebrew . At the time Heloise met Abelard, he was surrounded by crowds – supposedly thousands of students – drawn from all countries by the fame of his teaching. Enriched by
21414-413: The principles of aseptic technique : the strict separation of "sterile" (free of microorganisms) things from "unsterile" or "contaminated" things. All surgical instruments must be sterilized , and an instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterile manner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire ( scrubs ,
21580-422: The procedure is complete, sutures or staples are used to close the incision. Once the incision is closed, the anesthetic agents are stopped or reversed, and the person is taken off ventilation and extubated (if general anesthesia was administered). After completion of surgery, the person is transferred to the post anesthesia care unit and closely monitored. When the person is judged to have recovered from
21746-444: The procedure. People preparing for surgery are also instructed to abstain from food or drink (an NPO order after midnight on the night before the procedure), to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the person vomits during or after the procedure. Some medical systems have a practice of routinely performing chest x-rays before surgery. The premise behind this practice
21912-516: The production of hormones , such as testosterone and estrogen . Surgical castration in animals is often called neutering . Castration of animals is intended to favor a desired development of the animal or of its habits, as an anaphrodisiac or to prevent overpopulation . The parallel of castration for female animals is spaying . Castration may also refer medically to oophorectomy in female humans and animals. The term castration may also be sometimes used to refer to emasculation where both
22078-400: The public, took temporary leave of his canon duties (he does not appear again in the Paris cartularies for several years). In shame of his injuries, Abelard retired permanently as a Notre Dame canon, with any career as a priest or ambitions for higher office in the church shattered by his loss of manhood. He effectively hid himself as a monk at the monastery of St. Denis, near Paris, avoiding
22244-436: The punishment for rape, polygamy, or sodomy from death to castration. Over the years, several U.S. states have passed laws regarding chemical castration for sex offenders but not one state has mandatory castration. In 2016, Alabama lawmaker Steve Hurst proposed a bill requiring certain sex offenses to require the perpetrator be castrated prior to their release from state custody. A 1969 study found that men institutionalized at
22410-455: The questions of his horrified public. Roscellinus and Fulk of Deuil ridiculed and belittled Abelard for being castrated. Upon joining the monastery at St. Denis, Abelard insisted that Héloïse take vows as a nun (she had few other options at the time). Héloïse protested her separation from Abelard, sending numerous letters re-initiating their friendship and demanding answers to theological questions concerning her new vocation. Shortly after
22576-430: The recovery period. A recent post-operative care philosophy has been early ambulation. Ambulation is getting the patient moving around. This can be as simple as sitting up or even walking around. The goal is to get the patient moving as early as possible. It has been found to shorten the patient's length of stay. Length of stay is the amount of time a patient spends in the hospital after surgery before they are discharged. In
22742-457: The reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child" which was subsequently interpreted to mean "requiring measures to improve… emergency obstetric services". Article 12.2d of the ICESCR stipulates the need for "the creation of conditions which would assure to all medical service and medical attention in the event of sickness", and is interpreted in
22908-502: The reign of the legendary Emperor Shun and Yu in China, in 2281 BC, castration was passed into law as a punishment, remaining so until the reign of Gaozu of Tang (618–626 AD). However, it was still practiced after his reign. According to historians, it was incorporated into Chinese law during the Zhou dynasty. It was one of the five physical punishments that could be legally inflicted on criminals in China. Records of castrations in China date to
23074-447: The results of these tests can help evaluate surgical risk. A surgical team may include a surgeon, anesthetist, a circulating nurse, and a "scrub tech", or surgical technician, as well as other assistants who provide equipment and supplies as required. While informed consent discussions may be performed in a clinic or acute care setting, the pre-operative holding area is where documentation is reviewed and where family members can also meet
23240-523: The risk of local skin reactions or antibiotic resistance. Through a retrospective analysis of national administrative data, the association between mortality and day of elective surgical procedure suggests a higher risk in procedures carried out later in the working week and on weekends. The odds of death were 44% and 82% higher respectively when comparing procedures on a Friday to a weekend procedure. This "weekday effect" has been postulated to be from several factors including poorer availability of services on
23406-491: The same facility in Kansas lived an extra 14 years, on average, if they were castrated. In 1983, Judge C. Victor Pyle sentenced three men convicted of rape to choose between 30 years in prison or castration. The South Carolina Supreme Court ruled that the castration option would be cruel, however, and the men were sentenced to prison. Chemical or surgical castration is practiced in many countries for people convicted of sex crimes as
23572-506: The sentence of excommunication lifted, and to persuade Innocent that it was enough if Abelard remained under the aegis of Cluny. Abelard suffered at least two nervous collapses, the first around 1104–5, cited as due to the stresses of too much study. In his words: "Not long afterward, though, my health broke down under the strain of too much study and I had to return home to Brittany. I was away from France for several years, bitterly missed..." His second documented collapse took place in 1141 at
23738-509: The severing of one's entire genitalia. Both organs were cut off with a knife at the same time. Men were castrated and made into state slaves during the Qin dynasty (221–206 BC) to perform forced labor for projects such as the Terracotta Army . The Qin government confiscated the property and enslaved the families of rapists who received castration as a punishment. Men punished with castration during
23904-443: The so-called "noninvasive surgery" ought to be more appropriately called minimally invasive procedures , which usually refers to a procedure that utilizes natural orifices (e.g. most urological procedures) or does not penetrate the structure being excised (e.g. endoscopic polyp excision , rubber band ligation , laser eye surgery ), are percutaneous (e.g. arthroscopy , catheter ablation , angioplasty and valvuloplasty ), or to
24070-464: The subjective intention determines the moral value of human action, the legal consequence of an action is related to the person who commits it and not merely to the action. With this doctrine, Abelard created in the Middle Ages the idea of the individual subject central to modern law. This eventually gave to School of Notre-Dame de Paris (later the University of Paris ) a recognition for its expertise in
24236-456: The surgical service line; the surgical service line costs were $ 17,600 in 2003 and projected to be $ 22,500 in 2013. For hospital stays in 2012 in the United States, private insurance had the highest percentage of surgical expenditure. in 2012, mean hospital costs in the United States were highest for surgical stays. Older adults have widely varying physical health. Frail elderly people are at significant risk of post-surgical complications and
24402-439: The surgical site is anesthetized, but the person can remain conscious or minimally sedated. In contrast, general anesthesia may render the person unconscious and paralyzed during surgery. The person is typically intubated to protect their airway and placed on a mechanical ventilator , and anesthesia is produced by a combination of injected and inhaled agents. The choice of surgical method and anesthetic technique aims to solve
24568-423: The surgical team. Nurses in the preoperative holding area confirm orders and answer additional questions of the family members of the patient prior to surgery. In the pre-operative holding area, the person preparing for surgery changes out of their street clothes and are asked to confirm the details of his or her surgery as previously discussed during the process of informed consent. A set of vital signs are recorded,
24734-601: The surgical wound during recovery. Mostly these drains stay in until the volume tapers off, then they are removed. These drains can become clogged, leading to abscess . Postoperative therapy may include adjuvant treatment such as chemotherapy , radiation therapy , or administration of medication such as anti-rejection medication for transplants. For postoperative nausea and vomiting (PONV), solutions like saline, water, controlled breathing placebo and aromatherapy can be used in addition to medication. Other follow-up studies or rehabilitation may be prescribed during and after
24900-460: The teaching of secular arts with his profession as a monk was heavily criticized by other men of religion, and Abelard contemplated flight outside Christendom altogether. Abelard therefore decided to leave and find another refuge, accepting sometime between 1126 and 1128 an invitation to preside over the Abbey of Saint-Gildas-de-Rhuys on the far-off shore of Lower Brittany. The region was inhospitable,
25066-713: The term "surgery" can also refer to the facility where surgery is performed, or simply the office / clinic of a physician , dentist or veterinarian . As a general rule, a procedure is considered surgical when it involves cutting of a person's tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy , may be considered surgery if they involve "common" surgical procedure or settings, such as use of antiseptic measures and sterile fields, sedation / anesthesia , proactive hemostasis , typical surgical instruments , suturing or stapling . All forms of surgery are considered invasive procedures;
25232-547: The testicles and the penis are removed together. In some cultures, and in some translations, no distinction is made between the two. Castration may have arisen in the Neolithic period in response to animal husbandry, rising populations and population specialisation. Either surgical removal of both testicles or chemical castration may be carried out in the case of prostate cancer . Testosterone -depletion treatment (either surgical removal of both testicles or chemical castration)
25398-479: The time, some of these characteristics were attributed disparagingly to his Breton heritage, his difficult "indomitable" personality and overwork. Abelard spent his final months at the priory of St. Marcel, near Chalon-sur-Saône , before he died on 21 April 1142. He is said to have uttered the last words "I don't know", before expiring. He died from a fever while suffering from a skin disorder, possibly mange or scurvy . Heloise and Peter of Cluny arranged with
25564-647: The world's population, with its core belief as the issues of need, access and quality". Halfdan T. Mahler , the 3rd Director-General of the World Health Organization (WHO) , first brought attention to the disparities in surgery and surgical care in 1980 when he stated in his address to the World Congress of the International College of Surgeons, "'the vast majority of the world's population has no access whatsoever to skilled surgical care and little
25730-416: Was a medieval French scholastic philosopher, leading logician , theologian, poet, composer and musician. In philosophy, he is celebrated for his logical solution to the problem of universals via nominalism and conceptualism and his pioneering of intent in ethics. Often referred to as the " Descartes of the twelfth century", he is considered a forerunner of Rousseau , Kant , and Spinoza . He
25896-461: Was almost able to attain the position of master at Notre Dame. For a short time, however, William was able to prevent Abelard from lecturing in Paris. Abelard accordingly was forced to resume his school at Melun, which he was then able to move, from c. 1110–12 , to Paris itself, on the heights of Montagne Sainte-Geneviève , overlooking Notre-Dame. From his success in dialectic, he next turned to theology and in 1113 moved to Laon to attend
26062-417: Was becoming the standard at higher levels in the church orders.) To avoid suspicion of involvement with Abelard, Heloise continued to stay at her uncle's house. When Fulbert publicly disclosed the marriage, Héloïse vehemently denied it, arousing Fulbert's wrath and abuse. Abelard sent her to the convent at Argenteuil , where she had been brought up, in an attempt to protect her from her uncle. Héloïse dressed as
26228-418: Was castrated by men sent by the uncle. Still considering herself as his spouse even though both retired to monasteries after this event, Héloïse publicly defended him when his doctrine was condemned by Pope Innocent II and Abelard considered a heretic. Among these opinions, Abelard professed the innocence of a woman who commits a sin out of love. In Catholic theology , he is best known for his development of
26394-437: Was closer to William's thought than this account might suggest, William thought Abelard was too arrogant . It was during this time that Abelard would provoke quarrels with both William and Roscellinus. Against opposition from the metropolitan teacher, Abelard set up his own school, first at Melun , a favoured royal residence, then, around 1102–04, for more direct competition, he moved to Corbeil , nearer Paris. His teaching
26560-437: Was fixed in square notation. Planctus as genre influenced the subsequent development of the lai , a song form that flourished in northern Europe in the 13th and 14th centuries. Melodies that have survived have been praised as "flexible, expressive melodies [that] show an elegance and technical adroitness that are very similar to the qualities that have been long admired in Abelard's poetry." Héloïse d'Argenteuil lived within
26726-657: Was his teacher during this period. Around 1100, Abelard's travels brought him to Paris. Around this time he changed his surname to Abelard, sometimes written Abailard or Abaelardus. The etymological root of Abelard could be the Middle French abilite ('ability'), the Hebrew name Abel/Habal (breath/vanity/figure in Genesis), the English apple or the Latin ballare ('to dance'). The name
26892-475: Was made to burn a copy of the Theologia himself. He was then sentenced to perpetual confinement in a monastery other than his own, but it seems to have been agreed in advance that this sentence would be revoked almost immediately because, after a few days in the convent of St. Medard at Soissons, Abelard returned to St. Denis. Life in his own monastery proved no more congenial than before. For this Abelard himself
27058-430: Was notably successful, but the stress taxed his constitution, leading to a nervous breakdown and a trip home to Brittany for several years of recovery. On his return, after 1108, he found William lecturing at the hermitage of Saint-Victor, just outside the Île de la Cité , and there they once again became rivals, with Abelard challenging William over his theory of universals. Abelard was once more victorious, and Abelard
27224-482: Was partly responsible. Since at least the ninth century, the legends of Dionysius the Areopagite and Denis of Paris had often been conflated, largely due to Hilduin , Abbot of Saint-Denis, eager to promote the dignity of the abbey. The monastic community at Saint-Denis took pride in this supposed connection. Abelard teasingly pointed out a possibility that the founder of the Abbey could have been another Dionysius, who
27390-400: Was sent by Abelard to be looked after by his family in Brittany, where she gave birth to a son, whom she named Astrolabe, after the scientific instrument . To appease Fulbert, Abelard proposed a marriage. Héloïse initially opposed marriage, but to appease her worries about Abelard's career prospects as a married philosopher, the couple were married in secret. (At this time, clerical celibacy
27556-546: Was sent to Beijing to work as a eunuch in the palace. The Đại Việt sử ký toàn thư records that in 1467 in An Bang province of Dai Viet (now Quảng Ninh Province ) a Chinese ship blew off course onto the shore. The Chinese were detained and not allowed to return to China as ordered by Le Thanh Tong. This incident may be the same one where Wu Rui was captured. In the Nguyễn dynasty the poet Hồ Xuân Hương mocked eunuchs in her poem as
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