Long considered to be craftsmen comparable to butchers and barbers, surgeons began studying anatomy seriously and improved their art in the eighteenth century. With endless opportunities to practice, army surgeons on gory battlefields led the way. They learned that a soldier with an extensive wound, such as a shattered leg or arm, could perhaps be saved if the surgeon could obtain a flat surface above the wound that could be cauterized with fire. Thus, if a soldier had a broken limb and the bone stuck out, the surgeon amputated so that the remaining stump could be cauterized and the likelihood of death reduced.

The eighteenth-century surgeon (and patient) labored in the face of incredible difficulties. Almost all operations were performed without painkillers, for the anesthesia of the day was hard to control and too dangerous for general use. Many patients died from the agony and shock of such operations. Surgery was also performed in utterly unsanitary conditions, for there was no knowledge of bacteriology and the nature of infection. The simplest wound treated by a surgeon could fester and lead to death.