If one does not comprehend the anatomy and physiology...

If one does not comprehend the anatomy and physiology, he may commit a mistake that can kill the patient. I have seen someone, who pretended to be a surgeon, incised an aneurysm in the neck of a woman , mistaking it for an abscess.The woman bled to death." Heller stated that Al-Zahrawi described the ligature of arteries long before Ambrose Pare (Khairallah 1942). Al-Zahrawi also used cautery to control bleeding. He used wax and alcohol to stop bleeding from the skull during cranial surgery.

Sprengel said that Al-Zahrawi was the first to teach the lithotomy position for vaginal operations (Khairallah 1942). Al-Zahrawi also described the tracheotomy operation and performed it as an emergency on one of his servants. He was the first to write on orthodontia. He showed evidence of great experience from details of clinical picture and surgical procedures e.g. his description of varicose veins stripping, even after ten centuries, is almost like modern surgery (Al-Okbi 1971): "...

Have the leg shaved if it is much hairy. The patient gets a bath and his leg is kept in hot water until it becomes red and the veins dilate; or he exercises vigorously. Incise the skin opposite the varicose vein longitudinally either at the ankle or at the knee. Keep the skin opened by hooks. Expose, dissect, and separate the vein. Introducc a spatula underneath it. When the vein is elevated above the skin level, hang it with a blunt rounded hook.

Repeat the procedure about three fingers from the previous site and hang the vein with another hook as previously done. Repeat the procedure at as many sites along the varicose vein as necessary. At the ankle, ligate and strip it by pulling it from the incision just above. When it reaches there, repeat at the higher incision until all of it is stripped. Ligate the vein and then excise it.

If difficulty is encountered in pulling it, ligate its terminal part with a string and pass it under the spatula and dissect it further. Pull gently and avoid its tearing because if it does, it becomes difficult to strip all of it and can cause harm to the patient. When you have stripped it all, put alcohol spanges at the sites of the skin incisions and take care of the incisions until they heal.

If the varicose vein is tortuous, you have to incise the skin more frequently, at each change of direction. Dissect it and hang it with the hooks and strip it as previously described. Do not tear the vein or injure it. If this happens, it becomes difficult to strip it.