The First Treatise On Nose Surgery

 By: Jhon Cena
Rhinoplasty is often believed to be a modern medical development; however, various historical facts indicate that the first rhinoplasty procedures were performed thousands of years ago, in ancient India. The 'Sushruta Samhita' is a medical treatise written in around 600 BC, which explained a traditional procedure for performing reconstructive nose surgery. It was written by Sushruta, an ancient Indian physician, who is recognised as the 'father of plastic surgery'.

Sushruta developed rhinoplasty techniques for reconstructing noses that were amputated as part of religious, criminal, or military punishments, imposed on people during that period. His nose surgery techniques were also used to restore the noses of soldiers, which were damaged in battle.

Below is an outline of the procedure mentioned in the 'Sushruta Samhita', for reconstructing damaged noses:

1. Measure the portion of the nose to be covered with a leaf.
2. Dissect a piece of skin of the same size, from the living skin on the cheek.
3. Turn this skin over to cover the nose, keeping a small pedicle attached to the cheek.
4. Prepare the nose, by cutting the nasal stump with a knife.
5. Place the skin on the nose, and stitch up the two parts, while keeping the skin elevated by inserting two tubes of the castor oil plant, for nostrils.
6. Sprinkle a powder made of herbs, such as the barberry plant.
7. Cover the nose with cotton, and apply clean sesame oil continuously.
8. After the skin has united and granulated, the nose can be modified to change its size.

In the 11th century, an Arab physician named Ibn Abi Usaybia visited India, and had the Sushruta Samhita translated from Sanskrit to Arabic. In due course, Sushruta's nose surgery techniques travelled across the region, from Persia to Arabia to Egypt. In the 15th century, European physicians came across the treatise in the form of an illustrated medical book called 'Cerrahiyet-ul Haniye'.

During the eighteenth century, surgeons from the East India Company visited India, and witnessed traditional rhinoplasty procedures being performed at the British Residency in Poona. They later published a report about a variation of Sushruta's free graft nose surgery technique in the October 1794 issue of the Gentleman's Magazine of London.
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