Partial ear repair, using cheek flaps for lobes that had been mutilated as punishment for adultery or in the branding of slaves, was first mentioned in the Vedas (sacred writings) from ancient India, where Sushruta, a disciple of Dhanvantarti, wrote his encyclopedic ayurvedic medical treatise, which has been called the Samhita. The date is uncertain, but the style seems to indicate that it was written about 600 B.C., which means it was contemporary with Gautama Buddha. As oral transmission of knowledge had existed for many centuries, these writings are the product of experience long before. There was little knowledge of anatomy because it was considered defiling to dissect the dead. Surgeons of the time used 101 metal instruments, which were kept in a wooden box. Anesthesia was with alcohol. Postoperatively, patients were allowed a special diet of meat, normally forbidden for Hindus. Repair for an earlobe with cheek flaps is described in the sixteenth section of the book on surgery, the Uttara Sthana. Little progress was added to these classic writings for the next twenty-five centuries in India, where this surgery remained in the hands of the potter caste.
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