The Sumerian civilization (Sixth to Fifth Millenia BCE) had two types of practitioner: the ashipu (sorcerer) and asu (physician). The Gods were honoured in both types. Gula was the goddess of healing. Ningishzida's emblem contained the origins of the caduceus with a double-edged snake. Preserved clay tablets contain descriptions of medicines and surgical instruments of the time. The Babylonian Code of Hammurabi (1790-1752 BCE) is the earliest surviving documentation of legislation concerning medical and surgical practice. During Egyptian times, the Ebers Papyrus dating back to 1550 BCE, provides some of the oldest surgical case descriptions available. The Edwin Smith papyrus has 48 descriptions of injuries and their treatment (c1600 BCE). In ancient India, Sushruta's Samhita, written in Sanskrit, described 60 types of upkarma for treating wounds, 120 surgical instruments, and 300 surgical procedures. Indian surgical skills from 600 BCE were clearly advanced including use of the forehead flap for nasal reconstruction. Hippocrates (c460-370 BCE) and his generation laid many of the foundations for modern medicine, basing their understanding on evidence and detailed case descriptions rather than mythology and superstition. Alexander the Great conquered Egypt (330 BCE) and established Alexandria which became a centre for medical knowledge and education over the next millenium. It was also a place where anatomical dissection on humans was permitted, enabling the advancement of anatomy by Herophilus and Erasistratus in the third century BCE. When Rome conquered Alexandria (30 BCE), the centre of medical knowledge shifted to Rome where the Empire's physicians and surgeons, such as Galen (129-200 CE), were still Greek, as the Romans regarded such trades as beneath them, though the medical practitioners were entitled to Roman citizenship. This chapter also covers surgery in ancient China from Bian Que (407-310 BCE), Hua Tuo (140-208 CE), Sun Simiao (d 682 CE) to the rise of Genghis Kahn and the Pax Mongolica (1250–1350) highlighting the advanced practices in the Orient and the exchange of medical knowledge along the Silk Road from China to India, Persia.and Europe. The Chapter concludes in the European 14th Century with a biography of Guy de Chauliac (1300-1368) and his text Chirugia Magna which was to heavily influence European surgery for the next two centuries.