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- Author: Emily Cock x
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This book explores seventeenth- and eighteenth-century Britain’s experiences with and responses to the surgical reconstruction of the nose, and the concerns and possibilities raised by the idea of ‘nose transplants’ in this period. Challenging histories of plastic surgery that posit a complete disappearance of Gaspare Tagliacozzi’s reconstructive operation after his death in 1599, the book traces the actual extent of this knowledge within the medical community in order to uncover why such a procedure was anathema to early modern British culture. Medical knowledge of Tagliacozzi’s autograft rhinoplasty was overtaken by a spurious story, widely related in contemporary literature, that the nose would be constructed from flesh purchased from a social inferior, and would die with the vendor. The volume therefore explores this narrative in detail for its role in the procedure’s stigmatisation, its engagement with the doctrine of medical sympathy, and its attempt to commoditise living human flesh. Utilising medical research and book histories alongside literary criticism, the project historicises key modern questions about the commodification and limits of the human body, the impact of popular culture on medical practice, and the ethical connotations of bodily modification as response to stigma.
Chapter one engages with the modification and legibility of the body, focussing on the face, and introduces the special role of the nose in early modern culture. It examines surgical and prosthetic responses to facial injuries as a test to the limits of body work in early modern Britain. The chapter draws on sociological critiques of passing and capital to examine these anxieties, and their effects on the nose. Popular texts show a distinct concern for individuals’ abilities to pass as members of socially superior groups by disguising their bodies in significant ways. Women bore the brunt of these accusations, as satirists derided them as commercialised bodies, indistinguishable from their beautifying commodities. Fashionable men were mocked by contemporaries for effeminately modifying their bodies in similar ways, but the reconstruction of the nose was instead tied to a mask of healthy masculinity. The chapter therefore examines representations of male body work in contemporary texts, alongside the real-world manipulation of body evidence by men such as Henry Bennet, First Earl of Arlington. This facilitates investigation into the relationship between corporal self-fashioning and masculinity in the early modern period, and its place within transhistorical considerations of masculinity and plastic surgery.
This chapter studies book provenance, auction and library catalogues, and reading networks to explore the circulation of Tagliacozzi’s rhinoplasty technique in medical society across early modern Britain. Copies of relevant medical texts can be traced to numerous individual surgeons, physicians, and other educated men, as well as several university and medical libraries that would have exposed the procedure to an interested readership. An English translation of De curtorum chirurgia was appended to the Chirurgorum comes of surgeon Alexander Read in 1686. The chapter explores Read’s attitudes towards plastic surgery techniques and the treatment of stigmatised (especially poxed) patients more broadly, and argues that he has been overlooked in the field. The publication history of this translation is explored in detail, and physician Francis Bernard proposed as the anonymous translator and editor. Further important owners of De curtorum chirurgia and Chirurgorum comes are discussed, including Francis’ brother, Sergeant Surgeon Charles Bernard. The chapter finally examines the writings of James Yonge, a Plymouth naval surgeon who publicised the use of a skin flap in amputations, for his strategic differentiation of his procedure from Taliacotian skin flaps.
Chapter two details the medical approach to nose surgery in published early modern texts. In De curtorum chirurgia per insitionem (1597), Gaspare Tagliacozzi provided a detailed account of how the reconstruction of a damaged or missing nose, lip, or ear could be performed using a skin flap lifted from the patient’s arm, but it was the reconstruction of the nose that really caught the attention of early modern Europe. Although he had not invented the procedure, Tagliacozzi was the first to describe it in detail to European surgeons and became synonymous with the operation. The chapter explores the grounds on which Tagliacozzi was criticised by contemporaries like Ambroise Paré, and his and his supporters’ defensive strategies, especially the careful selection of patient narratives that emphasised masculine military endeavour and feminine virtue. It subsequently maps how the procedure and its historiography were reported into the nineteenth century, when the ‘Indian method’ of forehead-flap rhinoplasty was employed by surgeons such as Joseph Constantine Carpue, and thence through Britain, Europe, America, and Australia. It shows how Tagliacozzi’s operation continued to inform facial surgery, prompting a renaissance in Tagliacozzi’s reputation within nineteenth-century science and shaping the early historiography of plastic surgery.
Chapter four considers the overwhelmingly dominant popular understanding of Tagliacozzi’s method. The story of the ‘sympathetic snout’ had its roots in Tagliacozzi’s own lifetime, but developed significantly over the seventeenth century in poems, plays, and pseudo-scientific texts before its inclusion in the first book of Samuel Butler’s hit poem, Hudibras, cemented its domination of Tagliacozzi’s legend. This remained the popular image of Tagliacozzi into the early twentieth century: a man who took the ‘flesh’ for his ‘supplemental noses’ from a lower-status man’s ‘bum’. When the allograft donor died, the nose would also putrefy and drop off, through the medical doctrine of sympathy. The chapter therefore positions this narrative in the history of transplantation. Sympathy had always been a controversial doctrine, but in the early eighteenth century it was increasingly relegated to quackery. The sympathetic snout proved a surprisingly persistent and flexible metaphor up to the early twentieth century, satirising notions of personal and political autonomy, and producing troubling echoes for sympathy as an important interpersonal emotion.
Chapter five engages with the commodification of living human flesh proposed within stories of sympathetic allograft rhinoplasty. In early accounts the flesh was sourced from a slave who gained manumission; as the story was domesticated for British economic conditions and concerns, this became a cash-in-hand servant. The chapter employs economic critiques of the alienability of gifts and commodities to read the attempted commoditisation of the transplanted flesh and other bodily products and argue that the accounts emphasised the failure of the graft in order to secure the inalienability of the living human body. The only British exception to the purchased graft story is a poem by Lady Hester Pulter in which she offers her own flesh to Sir William Davenant. As a first-person account of a noble, female, gifting individual, Pulter’s poem represents a striking deviation from other extant narratives, and the chapter offers a close analysis of her use of the conceit. Building on the evidence for book ownership in earlier chapters, Pulter’s (mis)understanding of Tagliacozzi’s procedure attests to the forms of restricted medical knowledge afforded to women who were otherwise able to engage with wider healthcare regimes, medications, and operations.
The conclusion uses two of the most famously disfigured noses in British literature to cohere strands of analysis pursued throughout the book. In both Henry Fielding’s Amelia and Laurence Sterne’s The Life and Opinions of Tristram Shandy, Gentleman, the eponymous character’s nose is crushed in an accident. In Amelia, Fielding was attempting to create an unimpeachable heroine whose forbearance is testimony to her good character. The ridicule with which critics greeted Amelia’s injury, including tying it to Taliacotian rhinoplasty, attests to the continued significance of the damaged nose. Sterne, meanwhile, openly ridiculed the stigmatisation of nasal injuries by casting this as naive and ostensibly outdated. Though he mentions Tagliacozzi, it is only briefly, and this and further evidence from his library suggests that he was not particularly familiar with De curtorum chirurgia. Physician John Ferriar’s essay on the nose in Sterne’s book is the most fully informed about Tagliacozzi’s procedure and its historiography. Ferriar’s essay, alongside Fielding’s and Sterne’s novels, serves to elucidate how the reception of Tagliacozzi, and wider themes attached to autograft and allograft rhinoplasty, persisted, but also shifted to allow for the successful revival of rhinoplasty at the end of the eighteenth century.
This chapter introduces the current historiographical understanding of ‘Taliacotian’ nose surgery, and the false narrative of disappearance that has hampered histories of plastic surgery while serving specific discursive ends for this controversial medical field from the nineteenth century to now. It introduces early modern rhinoplasty to the history of transplantation, and discusses its relationship to syphilis. The introduction ends with a clear, concise outline of chapters that highlights their thematic and interpretative connections.