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By Holly Tucker
For your viewing pleasure: a classic illustration from Gaspare Tagliacozzi's De curtorum chirurgia per insitionem (1597, book 2).
Tagliacozzi shows autografting--grafts using the patient's own skin. In addition to the ravages of syphilis, nose jobs were needed to repair injuries in battle, but also after duels.
The question that I always get is: Did they work? The problem is that we do not have a lot a data on survival rates after such surgeries. We have a good number of case histories, but often there is more information about the specifics of the surgery--rather than the post-op outcomes.
I can say that it's important to remember that antisepsis and anesthesia were 19th-century discoveries. This means that surgery had an even more complex set of potential complications than it does today. Like most of the early-modern folks, I would certainly not line up to get a nose job or breast enhancement surgery just for the heck of it. Come to think of it...I wouldn't do that now anyway!
For more on all of this, I recommend Sander Gilman's excellent Making the Body Beautiful: A Cultural History of Aesthetic Surgery. Gilman is on the faculty at Emory and a top cultural historian.
Image courtesy of: Lilly Library, Medical Collections.
It's hard to be sure, but his method was one of the two standard methods before modern surgery. The other was developed in India.
ReplyDeleteThe only alternative, whether the nose was lost to syphilis or the sword, was replacement with a gold nose, too expensive for most people. The astronomer Tycho Brahe had one, as I recall.
The best source for the history of reconstructive plastic surgery, including skin grafts for the nose, is the historical and bibliographical works of the plastic surgeon T.J. "Tom" Patterson. In his own practice at Oxford, he refused to perform cosmetic surgery, instead taking on only the less remunerative but more satifying reconstructive work.
As for anaethesia and antisepsis, laudanum and vinegar can go a long way, but speed was the most important element in successful surgery, so that stitches could be applied as soon as possible. It was this, combined with new methods of entry, that rapidly improved the success rate for lithotomy in the years around 1700.
[The stirrups posture for childbirth was known as the lithotomy position.]
David Harley