Articles - Features

It was after reading, in a 1794 edition of London-based The Gentleman's Magazine: or, Trader's monthly intelligencer, an account of an Indian nose job penned by army Surgeon General Lucas, that Joseph Constantine Carpue first began to meditate on the possibilities of performing a similar procedure in his modern surgery at Duke of York's hospital. Carpue is credited with performing the first "modern" rhinoplasty 20 years later. 

Cowasjee, the patient in the Indian rhinoplasty, was a bullock driver for the British army and was captured by the troops of the enemy, Tipu Sahib, Sultan of Mysore, who cut off his hands and nose. So he remained for a year, until a local potter performed the operation, known to Westerners as the Hindu Method, and restored his features.

According to Lucas' report rhinoplasties were commonplace in India, where noses had for centuries been amputated as a form of punishment for criminals, war prisoners or people indulged in adultery.

According to "Sushruta: Rhinoplasty in 600 B.C" an article by specialist plastic surgeon, Sanjay Saraf published in The Internet  Journal of Plastic Surgery 2007 : Volume 3 Number 2 (www.ispub.com), the nose was regarded in Indian society as a symbol of dignity and respect. Rhinoplasty was developed, millennia ago, as a way of restoring these qualities to those who had lost their noses.

Saraf's article quotes a passage from Sushruta Samhita, an encyclopaedic treatise written around 600 B.C by Father of Indian surgery Sushruta, which vividly describes his method for restoring a patient''s nose to its former glory: "The portion of the nose to be covered should be first measured with a leaf. Then a piece of skin of the required size should be dissected from the living skin of the cheek, and turned back to cover the nose, keeping a small pedicle attached to the cheek. The part of the nose to which the skin is to be attached should be made raw by cutting the nasal stump with a knife. The physician then should place the skin on the nose and stitch the two parts swiftly, keeping the skin properly elevated by inserting two tubes of eranda (the castor-oil plant) in the position of the nostrils, so that the new nose gets proper shape. The skin thus properly adjusted, it should then be sprinkled with a powder of liquorice, red sandal-wood and barberry plant. Finally, it should be covered with cotton, and clean sesame oil should be constantly applied. When the skin has united and granulated, if the nose is too short or too long, the middle of the flap should be divided and an endeavor made to enlarge or shorten it.”



PICTURE:
The famous Indian Rhinoplasty (reproduced in the October 1794 issue of the Gentleman's Magazine of London) Science Museum, sciencemuseum.org.uk