In the late nineteenth century, for the first time in history, major surgery became relatively safe, with a mortality of 'only' 20-30%. The era of major internal surgery had begun and the great cavities of the body (abdomen, chest and skull) began to be opened routinely. There followed a big increase not only in operations for local problems (such as abscesses, haemorrhages and tumours) but also in operations for 'diseases' that existed only in the minds of the doctors and their patients. This was the 'fantasy surgery' of this book. It was strongly advocated by some surgeons and equally strongly criticized by others.

Dr Ann Dally analyses the theories behind some of these operations and the motives of those who performed them. She focuses on Sir William Arbuthnot Lane (1856-1943), perhaps the most talented surgeon of his age, whom many thought was a genius. He built up international reputations in three different branches of surgery, then, encouraged by the future Nobel prizewinner Elie Metchnikoff, he became convinced that removing the colon for constipation was a good form of medical treatment. For doing this on a large scale he has been vilified ever since.