Pre-nineteenth-Century Surgery

Abstract

Some might consider early civilisation, as well as an interest in the subject of medicine, to date from around 1000 BC. However, there is evidence that well before this, the ancient Egyptians were recording details of human anatomy. There is no doubt that attempts were made to heal wounds from very early times. The practice of amputation of the nose as a punishment for sexual misdemeanours appears to date from around 3000 BC, and it has been stated that attempts were made in India to reconstruct amputated noses as early as 1500 BC. Many works on early attempts at plastic surgery mention the name of Susruta who is said to have been a Hindu surgeon born about 600 BC. Over the years I have been puzzled and then confused by varying dates, spellings and suggestions that there was no such a person but that Susruta Samhita was a compilation of works written by different authors over several centuries. Susruta (or whoever contributed to the above book) rebuilt noses with a flap of skin raised from the forehead. One thing is certain and that is the Indian surgeon was not a plastic surgeon and nor was the Italian Tagliacozzi (1530–1599), who devised a flap of arm skin to rebuild an absent nose, securing it with a complicated device depicted in the picture shown here. Nevertheless both names almost always appear in publications on early ‘plastic surgery’ as an example of early attempts at reconstructive surgery.