Surgeon and his assistants, before the introduction of anaesthetics, prepared to perform an amputation at the shoulder. Surgeon stands, left, next the assistant surgeon (behind patient). An assistant on the ground supports the arm to be removed, and the two figures standing on the right support the patient. Bell's comment on this operation was It requires decision and rapidity: and the knife is to be handled more like a sabre, than a Surgeon's scapel. Engraving from Illustrations of the Great Operations of Surgery by Charles Bell (London, 1821).