Yes hitpoints in all editions have been, to a degree, abstract. They have also been, to a degree, concrete.
Healing surges are, almost in their entirety, abstract.
I don't know why people don't see that.
Some examples of hit points meaning "you got hit and got hurt" include "rider damage" or "rider effects". This can be things such as poison or fire damage. If the person has not been hit by the sword, how are they poisoned? If the troll has not been hit by the sword, why does the fire damage prevent its regeneration? A "wounding" weapon that causes you to "bleed" certainly has hit you, and you are losing blood. To say otherwise negates the narrative.
Yes, clerical curing is odd in many editions (why does a lvl 10 fighter not heal his tiny wounds from a spell that would bring a lvl 1 fighter back from near death). However, just about every single description of healing spells is "closing wounds". I have never, ever, in any edition, seen a healing spell written up as "restores adrenaline" or "improves endurance" or whatever.
In fact, most editions have other mechanics for the things that those defending healing surges are describing hps or HSs as. Endurance? That's tested by con checks and there is an endurance feat. Fatigue? There are fatigue rules.
All along, hit points have been suggested to be abstract, and in essence, they must be (to a degree). However, the rest of the game was written as if they were quite concrete, but with some small degree of abstraction. 4e has turned this on its head, actually following the intent they have claimed to be doing all along, but have actually not done. EDIT: Also, I'll dispute the degree/level of "hit points are abstractions" in prior editions being claimed as well. I attribute it as a nod to "this ain't always going to make sense, roll with us" rather than them saying "hit points represent far, far more than getting hit/hurt."
EDIT: from the 3e and 3.5 phbs and
http://www.dandwiki.com/wiki/SRD:Loss_of_Hit_Points
Instead of "the best mechanic we have to simulate combat and injury" hps (because of HSs) are now, in 4e "a complete abstraction of a pc's adventuring across a given day".
The change has been both subtle (subtle as in hard to see) and radical. Hence exactly this sort of thread every so often.
Make no mistake. Hps in 4e represent something different than they have in earlier editions. Healing surges enforce this.
However, and another possible reason for the dislike of healing surges is that the 4e phb considers them "healing" they are defined as such and it specifically states that when a character uses one, he has
healed. I can envision healing wounds, but are we to say "I healed, so I got luckier again"?
It seems to me that in every edition hit points have been a "have your cake and eat it too" situation. They represent getting hurt, but they also represent more than that. Healing surges go too far with that, mainly representing "you're healing, but you're not really healing".
There is a backwardness to healing surges. It's the same backwardness that is the cure light wounds does less on a light wound than a serious one (on a lvl 10 vs lvl 1 char). But this backwardness is even more in your face. At least with the curative spells, it is still healing that is being represented. The fact that the rules are ass backwards dosen't change this. With a healing surge, few seem willing to describe them as what wotc describes them as: healing.
Yes, hps represent some manner of luck. This is very telling in the 3.5 description of them when discussing how a lvl 10 ftr getting hit by an orc has suffered a "small wound" or "glancing blow". Healing these small wounds with spells closes the wounds.
So what does a healing surge actually do? Have I ever been hit? If so, do my wounds close? If so, how do I accomplish this as a normal human fighter?
In prior editions, yes, hps represented some luck/skill and some physical punishment. But the luck/skill was never restored by curative magics. That is a fundamental difference to what is being restored in 4e with healing surges...and thus causes a fundamental difference to the meaning of hps.