Few are the sources, whether archaeological, ethnological or technological, regarding the manufacturing of instruments in the first periods of the existence of mankind. It is however possible to presume, from current behaviors, how the primitive man would have reacted to several situations. For example, when an object inserted in an accessible part of the body leads us to a spontaneous gesture of using fingers, nails, the tongue or our teeth while trying to extract it and, if not successfully, to ask for someone else's help to, using the same human appendixes, solve the situation.
In nowadays surgery, the mouth, teeth and nails lost their surgical purpose. There are, nevertheless, many situations where fingers replace a probe, dilators, hooks, parting forceps and tweezers. The hand, in a global sense, brings all its dynamics to the proximal extremity of the instrument. At the same time, it is also the hand that, inside a latex glove, directs every surgical gesture. Through a slow, though continuous period of adaptative evolution, the first man who introduced instruments - Homo Habilis - appeared in the history of mankind, two million tears ago. From the first carved stones, the pre-historical lithic instrumentation was characterized by growing quantity and complexity, witnessing the biological and cultural maturation. In the last times of this period, new natural materials - bone, horn, ivory - were the base for the use of new instruments. The first compound instruments belonged to the epipaleolithic: geometrical microliths and stone blades inserted in wood. A better technique was associated to the lightness of the new instrument. The introduction of copper would start the Metal Age and determine a deep instrumental revolution. At that time, an instrument with exclusively curing purposes was something impossible. Also unlikely was the hypothesis of the existence of manufacturers of surgical instruments, since a complex group structure and task distribution would have to exist together with a justified quality demand. The first instrument manufacturer probably began his activity by own motivation. The observation of nature had clarified his ideas regarding the benefits and cons of some gestures, as well as the most adequate physical method, seeking a general well being.

In the beginning of the process of human evolution, Man may have used rocks and other minerals randomly carved by nature for certain purposes, namely surgical.
Some paleonthological findings are particularly useful to testify the abundance in mineral materials, carved by man or not, that may well have been used with treating purposes. In Stone Age, (600.000 - 10.000 b.C), pointy silex fragments were used in hunting and in fights. In that period, a basic manufacturing technique led to the production of raw instruments, easy to imagine for the scarification, circumcising and bleeding, probably with curing purposes. In the most recent period of Stone Age (c. 8.000 - 3.000) we assist to a fast production of knifes, perforators and tearing instruments of growing quality. The cranial trepanation, a surgical with proven therapeutic intention, from the Neolithic period, is the most ancient evidence of human intervention. The incomplete trepanation holes offered a wide source of information about the technique and the instruments used.