Emotions and Surgery

by

Michael Brown

• LAST MODIFIED: 17 April 2025
• DOI: 10.1093/obo/9780197768723-0023

Introduction

Emotions, defined as mental or instinctive feelings deriving from one’s circumstances, mood, or relationship with others, have an abiding and important, if somewhat underappreciated, place in the history of surgery. For as long as humans have used implements to excise or remove diseased and injured parts of the body, evidence for which exists as far back as the Paleolithic period, those facing this unnatural violation of their corporeal integrity have experienced a range of powerful mental sensations. Although there is considerable debate about the cultural universality and temporal stability of emotions and their expression, there seems little doubt that those anticipating or enduring surgery have always felt something like anxiety, fear, or sorrow, perhaps even joy, or relief. This is particularly true for the period before the introduction of routine inhalation anesthesia in 1846 when surgical operations were undertaken with little or no pain relief and when levels of mortality from shock, blood loss, or postoperative infection were comparatively high. Because of these associated risks, surgeons of the premodern period did not generally intrude too far into the body’s interior, a major exception being lithotomy (the removal of stones from the bladder or urinary tract), which had been practiced since at least the time of Hippocrates (b. 460–d. 370 BCE). Indeed, coupled with its dangers, the limited curative efficacy of premodern surgery, especially in cases of disease rather than injury, meant that, prior to the later nineteenth century, surgeons generally only operated as a matter of last resort. Thus, while it was less common than it is today, people in the premodern past experienced operative surgery as highly fraught, something that almost certainly enhanced the dread with which it was contemplated. Even in more modern times, however, the prospect of undergoing surgery, particularly major surgery under general anesthetic, can still cause considerable apprehension and mental disquiet. It is only in recent years that historians have begun to explore the relationship between surgery and emotion in depth, and the historiography is therefore in its infancy. Although it has not necessarily been the primary focus of their research, scholars have generally been sensitive to the emotions experienced by patients in approaching and undergoing operative surgery. The emotions of surgeons themselves have, by contrast, been somewhat neglected. This is now beginning to change, as research is demonstrating the varied and important ways in which cultures of feeling have shaped professional practice and identity over time.

Emotions

As Boddice 2018 shows, the history of emotions can be traced back to the idea of a culturally legible “emotionology” first proposed in Stearns and Stearns 1985. However, it was only at the turn of the twenty-first century that it reached intellectual maturity. Reddy 2001 introduces the concept of the “emotive” to bridge anthropological and physiological perspectives and comprehend emotions as simultaneously physiological and cultural. Meanwhile its concept of “emotional regimes” considers certain feelings as both culturally normative yet also temporally and culturally specific. Rosenwein 2006 is a similarly influential work, especially with its theory of “emotional communities,” which proposes that certain communities participate in, and are shaped by, shared and distinct systems of feeling. Around this time, historians of medicine were also thinking about health and disease in affective terms. Bound Alberti 2009 uses the death of the surgeon-anatomist John Hunter (b. 1728–d. 1793) from heart failure induced by “affections of the mind” (p. 799), to highlight the intimate relationship between mind and body in premodern medicine and to assert the powerful role that emotions played in shaping ideas about health, disease, and embodied experience. This research marked the beginnings of a burgeoning scholarship at the intersection of the histories of emotion and medicine. Works such as Boddice 2020 demonstrate how hierarchies of feeling were central to the construction of medical modernity. In particular, it argues that late-19th-century advocates of vivisection defended their acts as being not only vital to the development of experimental physiology but also motivated by a sympathetic emotional impulse to alleviate the sufferings of humankind, one that they positioned as morally superior to the “sentimentalism” of their feminized opponents. Brown 2023 likewise demonstrates the importance of emotions to the development of modern medicine. In the author’s account of British surgery in the long nineteenth century, he considers the role played by emotions in structuring relations between practitioners and their patients as well as in shaping the professional identities and conceptual frameworks of surgeons. This work shows that a study of the emotions can help challenge unproblematically progressivist understandings of medicine’s past. As of the mid-2020s, emotion has come to occupy a far more prominent place within medical history, medical humanities, and the history of the body. For example, the edited collections Martín-Moruno and Pichel 2019; Arnold-Forster, et al. 2022; and Boddice and Hitzer 2022 have expanded the scope of research conceptually, thematically, and in terms of disciplinary intersections.

• Arnold-Forster, Agnes, Michael Brown, and Alison Moulds, eds. Special Issue: Health, Policy and Emotion. Medical Humanities 48.4 (December 2022).

  This special issue offers a multidisciplinary perspective on the relationship between emotions, health-care practice, and policy as well as providing a critical account of those relationships.

• Boddice, Rob. The History of Emotions. Manchester, UK: Manchester University Press, 2018.

  A very useful overview of the history of emotions as a field of study and serves as an accessible critical introduction to many of its most important concepts.

• Boddice, Rob. The Humane Professions: The Defence of Experimental Medicine, 1876–1914. Cambridge, UK: Cambridge University Press, 2020.

  A study of the emotional politics of modern medical science and of the hierarchization of feelings in relation to ideas of the “public good.” A good example of the author’s broader contributions of the history of vivisection and ideas of “sympathy” in the nineteenth century.

• Boddice, Rob, and Bettina Hitzer, eds. Feeling Disease in Modern History: Experiencing Medicine and Illness. London: Bloomsbury Academic, 2022.

  Provides a chronologically and conceptually broad-ranging study of the relationship between emotion, affect, and feelings of illness and wellness across the modern period and in a variety of contexts.

• Bound Alberti, Fay. “Bodies, Hearts, and Minds: Why Emotions Matter to Historians of Science and Medicine.” Isis 100.4 (December 2009): 798–810.

  DOI: 10.1086/652020

  Bound Alberti’s important manifesto article makes an empirically evidenced case for why historians of science and medicine should pay attention to the operations of emotion in their research.

• Brown, Michael. Emotions and Surgery in Britain, 1793–1912. Cambridge, UK: Cambridge University Press, 2023.

  Constitutes a sustained application of emotions history to understanding the transformations in medical practice and identity that took place across the modern period.

• Martín-Moruno, Dolores, and Beatriz Pichel, eds. Emotional Bodies: The Historical Performativity of Emotions. Urbana: University of Illinois Press, 2019.

  Provides a useful theoretical framework for thinking about the embodied and material aspects of emotional performance together with a series of empirical case studies, many of them touching directly on the histories of medicine and health.

• Reddy, William. The Navigation of Feeling: A Framework for the History of the Emotions. Cambridge, UK: Cambridge University Press, 2001.

  DOI: 10.1017/CBO9780511512001

  A foundational text for the history of the emotions, combining a theoretical framework with an empirical study of the longue durée emotional history of pre- and postrevolutionary France.

• Rosenwein, Barbara H. Emotional Communities in the Early Middle Ages. Ithaca, NY: Cornell University Press, 2006.

  An essential contribution to emotions history providing a social constructivist understanding of the relativity of historical emotions as well as a series of micro-historical case studies of emotional communities in action in the early medieval period.

• Stearns, Peter N., and Carol Z. Stearns. “Emotionology: Clarifying the History of Emotions and Emotional Standards.” American Historical Review 90.4 (October 1985): 813–836.

  DOI: 10.1086/ahr/90.4.813

  This pioneering article provides one of the first attempts to subject emotions to serious historical study by distinguishing the phenomenology of feeling from those expressive aspects that are culturally conditioned and historically legible.