History of Plastic Surgery ~ Part II (07-2004)
Hellenistic, Roman, and Byzantine Reconstructive Contributions
Documentation is not available to prove whether or not Hindu facial reconstruction techniques immediately became known throughout the ancient world. It may be that they did not proliferate until later centuries, during which connections between Western and Indian civilization are documented. We do have data that indicates that Greek and Indian civilizations shared medical knowledge even before Alexander the Great ventured to India in the fourth century BC, but we have nothing that confirms such sharing of techniques before the seventh century BC.
In the fourth century, the royal Byzantine physician Oribasius outlined his contributions to plastic surgery in a comprehensive medical encyclopedia called Synagogue Medicae. He devotes two chapters to the reconstruction of facial defects. It is clear from this work that he had an understanding of basic reconstructive principles and included the principles of wound management and facial reconstruction that were both important and lasting contributions to reconstructive plastic surgery.
Decline of the Middle Ages
Established methods of facial reconstruction continued into the early Middle Ages. Historical documentation describes in detail how Emperor Justinian II underwent nasal reconstruction in the eighth century. When he was overthrown, his nose, a symbol of nobility and power, was mutilated and he was so disfigured that his appearance would have kept him from regaining the status of emperor. When he did return to power, he did so having undergone nasal reconstruction. Facial features on ancient marble statues of the emperor reveal a forehead scar that suggests a reconstructed nose.
The fall of Rome in the fifth century, couples with the spread of barbarian tribes and Christianity throughout the Middle Ages, put a stop to any advancement in the field of reconstructive surgery. The 13th century Pope Innocent III specifically prohibited surgical procedures. Medicine devolved into an ethereal experience and surgery was avoided at all cost and medicine gave way to mysticism. The barber surgeon appeared and the art of surgery disappeared.
The Renaissance
With the Renaissance in the 14th century, science and medicine experienced a rebirth. Fortunately, reconstructive principles and techniques of the early Indian, Hellenistic, and Romans had been passed from generation to generation, and civilization to civilization. The rebirth of reconstructive surgery in the 15th century had both Eastern and Western origins. In Turkish-Islamic literature, Serafeddin Sabuncuoglu included a description of the several basic surgical principles which remain in use today. His method can be considered a precursor of modern reduction mammoplasty.
In 15th century Sicily, the Branca family also contributed to the rebirth of reconstructive surgery and may be credited with reintroducing the Indian method of nose reconstruction around the year 1442, using techniques of facial reconstruction which were well-kept secrets. Techniques continued to be passed down only from family to family.
Barber-surgeons continued to dominate the field of reconstructive surgery, while a physician trained at the University of Bologna, at that time (Leonardo Fioravanti) was a key player in disseminating knowledge and creating interests amongst fellow academics.
Reconstructive surgery in Europe near the end of the 16th century, once again saw surgery fall into the realm of superstition and ignorance. Why these periods of decline existed is difficult to understand, but the misconceptions surrounding reconstructive surgery contributed to the dearth of interest in the subject for the next two centuries.
Documentation is not available to prove whether or not Hindu facial reconstruction techniques immediately became known throughout the ancient world. It may be that they did not proliferate until later centuries, during which connections between Western and Indian civilization are documented. We do have data that indicates that Greek and Indian civilizations shared medical knowledge even before Alexander the Great ventured to India in the fourth century BC, but we have nothing that confirms such sharing of techniques before the seventh century BC.
In the fourth century, the royal Byzantine physician Oribasius outlined his contributions to plastic surgery in a comprehensive medical encyclopedia called Synagogue Medicae. He devotes two chapters to the reconstruction of facial defects. It is clear from this work that he had an understanding of basic reconstructive principles and included the principles of wound management and facial reconstruction that were both important and lasting contributions to reconstructive plastic surgery.
Decline of the Middle Ages
Established methods of facial reconstruction continued into the early Middle Ages. Historical documentation describes in detail how Emperor Justinian II underwent nasal reconstruction in the eighth century. When he was overthrown, his nose, a symbol of nobility and power, was mutilated and he was so disfigured that his appearance would have kept him from regaining the status of emperor. When he did return to power, he did so having undergone nasal reconstruction. Facial features on ancient marble statues of the emperor reveal a forehead scar that suggests a reconstructed nose.
The fall of Rome in the fifth century, couples with the spread of barbarian tribes and Christianity throughout the Middle Ages, put a stop to any advancement in the field of reconstructive surgery. The 13th century Pope Innocent III specifically prohibited surgical procedures. Medicine devolved into an ethereal experience and surgery was avoided at all cost and medicine gave way to mysticism. The barber surgeon appeared and the art of surgery disappeared.
The Renaissance
With the Renaissance in the 14th century, science and medicine experienced a rebirth. Fortunately, reconstructive principles and techniques of the early Indian, Hellenistic, and Romans had been passed from generation to generation, and civilization to civilization. The rebirth of reconstructive surgery in the 15th century had both Eastern and Western origins. In Turkish-Islamic literature, Serafeddin Sabuncuoglu included a description of the several basic surgical principles which remain in use today. His method can be considered a precursor of modern reduction mammoplasty.
In 15th century Sicily, the Branca family also contributed to the rebirth of reconstructive surgery and may be credited with reintroducing the Indian method of nose reconstruction around the year 1442, using techniques of facial reconstruction which were well-kept secrets. Techniques continued to be passed down only from family to family.
Barber-surgeons continued to dominate the field of reconstructive surgery, while a physician trained at the University of Bologna, at that time (Leonardo Fioravanti) was a key player in disseminating knowledge and creating interests amongst fellow academics.
Reconstructive surgery in Europe near the end of the 16th century, once again saw surgery fall into the realm of superstition and ignorance. Why these periods of decline existed is difficult to understand, but the misconceptions surrounding reconstructive surgery contributed to the dearth of interest in the subject for the next two centuries.
