1 00:00:01,120 --> 00:00:04,080 Speaker 1: Welcome to Stuff You Missed in History Class from how 2 00:00:04,120 --> 00:00:13,760 Speaker 1: Stuff Works dot com. Hello, and welcome to the podcast. 3 00:00:13,880 --> 00:00:17,439 Speaker 1: I'm Tracy V. Wilson and I'm Holly Fry. Over the 4 00:00:17,480 --> 00:00:21,119 Speaker 1: holidays this winter, I noticed a tweet from friend of 5 00:00:21,120 --> 00:00:25,079 Speaker 1: the podcast and past guest Mary robin at Call in 6 00:00:25,120 --> 00:00:28,159 Speaker 1: which she asked herself this question, I wonder if I 7 00:00:28,200 --> 00:00:31,520 Speaker 1: can reference plastic surgery in the nineteen sixties, how early 8 00:00:31,520 --> 00:00:34,640 Speaker 1: did it start World War One? Right? And then the 9 00:00:34,680 --> 00:00:37,720 Speaker 1: tweet goes on to express her total astonishment that it 10 00:00:37,840 --> 00:00:41,440 Speaker 1: was actually much much earlier than that. I was astonished 11 00:00:41,479 --> 00:00:43,839 Speaker 1: to learn that also, and I meant to make a 12 00:00:43,920 --> 00:00:46,400 Speaker 1: note of that as something to look into when I 13 00:00:46,440 --> 00:00:49,199 Speaker 1: got back into the office, but then, of course, with 14 00:00:49,280 --> 00:00:54,160 Speaker 1: it being the holidays, I forgot. Fortunately, though, Mary Robinett 15 00:00:54,240 --> 00:00:56,320 Speaker 1: dropped me a note with a name to look into, 16 00:00:56,480 --> 00:01:00,760 Speaker 1: and that was shrewd A. Sashuda wrote the s Schuda 17 00:01:00,840 --> 00:01:04,880 Speaker 1: Samita or Sashuta's Compendium, and that's one of the foundational 18 00:01:04,920 --> 00:01:08,679 Speaker 1: texts of ayur Veda, which is India's traditional system of medicine. 19 00:01:09,000 --> 00:01:12,360 Speaker 1: He is also known as the father of plastic surgery. 20 00:01:13,360 --> 00:01:17,560 Speaker 1: Sashuda lived at least twenty six hundred years ago, although 21 00:01:17,600 --> 00:01:20,120 Speaker 1: it might have been even longer, and that means that 22 00:01:20,160 --> 00:01:23,920 Speaker 1: he was writing about medicine and surgery at least two 23 00:01:23,959 --> 00:01:28,440 Speaker 1: hundred years before Hippocrates, who's the person who usually gets 24 00:01:28,520 --> 00:01:31,679 Speaker 1: the credit as being the father of medicine. So the 25 00:01:31,680 --> 00:01:35,240 Speaker 1: oldest medical texts we know about today are Egyptian papyrie 26 00:01:35,280 --> 00:01:37,840 Speaker 1: that date back to between two thousand and fifteen hundred 27 00:01:37,880 --> 00:01:42,039 Speaker 1: b C. But those texts are based on or copied from, 28 00:01:42,080 --> 00:01:44,680 Speaker 1: ones that are much older and have not survived until 29 00:01:44,720 --> 00:01:47,440 Speaker 1: modern times, at least not that we have ever discovered yet. 30 00:01:47,760 --> 00:01:50,920 Speaker 1: Perhaps it will be a future on Earth. But these 31 00:01:50,960 --> 00:01:54,600 Speaker 1: papyride document medical information that is at least five thousand 32 00:01:54,720 --> 00:01:58,440 Speaker 1: years old. One of these is the Edwin Smith Papyrus, 33 00:01:58,520 --> 00:02:01,720 Speaker 1: which is the oldest known surgical document in the world 34 00:02:01,800 --> 00:02:04,320 Speaker 1: and is named after the antiquities dealer who bought it 35 00:02:04,320 --> 00:02:08,440 Speaker 1: in eighteen sixty two. This papyrus was written sometime around 36 00:02:08,480 --> 00:02:11,920 Speaker 1: sixteen hundred BC, but it's like the others, believed to 37 00:02:11,919 --> 00:02:13,399 Speaker 1: be a copy of a work that was at least 38 00:02:13,440 --> 00:02:17,600 Speaker 1: a thousand years older. The Edwin Smith Papyrus includes forty 39 00:02:17,639 --> 00:02:20,880 Speaker 1: eight case studies of wounds and trauma and It details 40 00:02:20,919 --> 00:02:24,880 Speaker 1: the treatments for these that include things like suturing, setting 41 00:02:24,880 --> 00:02:28,960 Speaker 1: a broken nose, and preventing infections with honey. Given the 42 00:02:29,000 --> 00:02:32,080 Speaker 1: types of trauma that it discusses, it was probably written 43 00:02:32,080 --> 00:02:34,840 Speaker 1: for military use to deal with soldiers who had been 44 00:02:34,840 --> 00:02:38,600 Speaker 1: injured in battle. The oldest descriptions of medicine and surgery 45 00:02:38,639 --> 00:02:41,520 Speaker 1: in what's now India date to just after this, from 46 00:02:41,560 --> 00:02:44,880 Speaker 1: the Vedic period, which spanned from roughly fifteen hundred to 47 00:02:45,040 --> 00:02:49,040 Speaker 1: five hundred BC. This is when the Sanskrit scriptures and 48 00:02:49,160 --> 00:02:51,799 Speaker 1: hymns known as the vetas went from being passed down 49 00:02:51,919 --> 00:02:56,119 Speaker 1: orally to being written down. The word veta translates to knowledge, 50 00:02:56,360 --> 00:03:00,560 Speaker 1: and the vetas are the oldest sacred texts and Hinduism. 51 00:03:00,600 --> 00:03:03,400 Speaker 1: They're not really medical texts on their own, but they 52 00:03:03,440 --> 00:03:07,160 Speaker 1: do contain a lot of references to medicine and surgery 53 00:03:07,200 --> 00:03:11,720 Speaker 1: and pharmacology and physicians. This includes lists of thousands of 54 00:03:11,800 --> 00:03:16,119 Speaker 1: drugs and descriptions of midwiffery. The rig Veta also includes 55 00:03:16,200 --> 00:03:19,880 Speaker 1: descriptions of limb amputations during wartime and the use of 56 00:03:19,919 --> 00:03:24,520 Speaker 1: iron proscesses in place of the amputated limbs. The Shahruda 57 00:03:24,600 --> 00:03:28,040 Speaker 1: Samhita was written in the mental Late Vedic period or 58 00:03:28,080 --> 00:03:31,600 Speaker 1: possibly just after, so some time between one thousand and 59 00:03:31,639 --> 00:03:34,920 Speaker 1: six BC, but we don't have a whole lot of 60 00:03:34,960 --> 00:03:39,440 Speaker 1: detail about Shahreuda himself. Under the cultural and religious traditions 61 00:03:39,440 --> 00:03:43,080 Speaker 1: of the time, life was essentially an illusion, so documenting 62 00:03:43,120 --> 00:03:46,960 Speaker 1: the lives of common people was generally regarded as vanity, 63 00:03:47,040 --> 00:03:50,320 Speaker 1: and we don't even know his given name. Sashrewda is 64 00:03:50,360 --> 00:03:55,440 Speaker 1: an honorific roughly translating to famous or renowned or well heard. 65 00:03:56,000 --> 00:03:59,680 Speaker 1: There is a Sashruda mentioned in the Mahabharata, which is 66 00:03:59,720 --> 00:04:02,920 Speaker 1: one of ancient India's two major epics and also dates 67 00:04:02,920 --> 00:04:06,200 Speaker 1: back to the Vedic period and the Mahaparata. He's the 68 00:04:06,240 --> 00:04:09,440 Speaker 1: son of a sage named vis Vimitra. Among people who 69 00:04:09,520 --> 00:04:13,480 Speaker 1: believe in transmigration, vis Pamitra was an incarnation of Don Ventari, 70 00:04:13,520 --> 00:04:16,279 Speaker 1: who's an avatar of Vishnu and surgeon to the gods, 71 00:04:16,320 --> 00:04:19,120 Speaker 1: and that would make Sashruda a descendant of the god 72 00:04:19,160 --> 00:04:23,440 Speaker 1: of medicine. S Shruda may have been born in southeastern India, 73 00:04:23,520 --> 00:04:26,000 Speaker 1: but he worked and taught in northern India near the 74 00:04:26,000 --> 00:04:29,839 Speaker 1: Ganges River in what was then known as Kashi or Benares. 75 00:04:30,480 --> 00:04:33,240 Speaker 1: Today it's the city of Varanasi, and Varanasi is one 76 00:04:33,240 --> 00:04:37,719 Speaker 1: of Hinduism's seven Sacred cities. Although Saddharta Gautama or the 77 00:04:37,720 --> 00:04:40,760 Speaker 1: Buddha was born in Nepal, he began teaching in this 78 00:04:40,880 --> 00:04:44,080 Speaker 1: same region of what is now India, and this part 79 00:04:44,120 --> 00:04:47,719 Speaker 1: of India very important is also known as the birthplace 80 00:04:47,720 --> 00:04:51,120 Speaker 1: of ira Veda or the Vedic system of medicine. Going 81 00:04:51,160 --> 00:04:54,000 Speaker 1: back to our earlier discussion of the Vedas, ira Veda 82 00:04:54,240 --> 00:04:57,680 Speaker 1: translates to knowledge of life. Listeners may have heard of 83 00:04:57,680 --> 00:05:00,279 Speaker 1: ira Veda even if they've never been to India, because 84 00:05:00,279 --> 00:05:04,160 Speaker 1: it's experienced a resurgence as part of complimentary and alternative medicine. 85 00:05:04,560 --> 00:05:06,640 Speaker 1: It is really not possible for us to give a 86 00:05:06,720 --> 00:05:10,560 Speaker 1: thorough overview of ayur Veda in the context of this podcast. 87 00:05:11,120 --> 00:05:13,400 Speaker 1: Especially in the West, it is often distilled down to 88 00:05:13,440 --> 00:05:16,560 Speaker 1: the idea of using things like herbs and diet and 89 00:05:16,640 --> 00:05:20,279 Speaker 1: lifestyle to promote equilibrium among the three docias of vada 90 00:05:20,560 --> 00:05:25,039 Speaker 1: or air, pizza or fire, and kafa or water. These 91 00:05:25,040 --> 00:05:28,080 Speaker 1: three docias connect back to the Hindu idea of prana 92 00:05:28,120 --> 00:05:31,240 Speaker 1: meeting life force or breath, and sometimes this is all 93 00:05:31,279 --> 00:05:34,640 Speaker 1: compared to hippocrates idea of preserving the balance among the 94 00:05:34,680 --> 00:05:38,719 Speaker 1: four humors, and this is not entirely a new comparison. 95 00:05:39,040 --> 00:05:42,360 Speaker 1: When the Sashu Samsa was first translated into English in 96 00:05:42,400 --> 00:05:46,680 Speaker 1: the early twentieth century, the introduction contained this note quote 97 00:05:47,040 --> 00:05:51,480 Speaker 1: by a laments able oversight, the terms value, pitam, kafa, 98 00:05:51,560 --> 00:05:54,960 Speaker 1: and docia have been translated as wind, bile, flim and 99 00:05:55,160 --> 00:05:59,120 Speaker 1: humor in the first few chapters. I don't know why 100 00:05:59,200 --> 00:06:01,719 Speaker 1: that makes me laugh so hard. I guess part of 101 00:06:01,720 --> 00:06:04,200 Speaker 1: me is like, did you realize part way through the 102 00:06:04,279 --> 00:06:06,520 Speaker 1: chapters that you were doing it wrong and you couldn't 103 00:06:06,520 --> 00:06:11,160 Speaker 1: walk it back? Or questions for the ages. Although prana 104 00:06:11,240 --> 00:06:13,400 Speaker 1: and the three docias are part of the foundation of 105 00:06:13,440 --> 00:06:16,039 Speaker 1: ayur Veda, they really don't sum up the whole thing, 106 00:06:16,600 --> 00:06:19,400 Speaker 1: and even just that explanation of prana and the docias 107 00:06:19,480 --> 00:06:23,360 Speaker 1: is a very simplified one. Ayur Veda is a complex, 108 00:06:23,440 --> 00:06:28,080 Speaker 1: comprehensive and holistic medical system that incorporates a mind body connection, 109 00:06:28,560 --> 00:06:31,080 Speaker 1: a focus on proper diet and the protection of a 110 00:06:31,080 --> 00:06:35,279 Speaker 1: person's health, and it has three foundational texts. One is 111 00:06:35,320 --> 00:06:41,120 Speaker 1: Sa Shrewda's Compendium. Another is the Sharaka Samita or Sharaca's compendium, 112 00:06:41,160 --> 00:06:44,880 Speaker 1: and so Shrewda's compendium includes both medicine and surgery, while 113 00:06:44,920 --> 00:06:48,680 Speaker 1: Sharacas builds on earlier work by a stage named Atrea 114 00:06:48,800 --> 00:06:52,960 Speaker 1: and focuses only on medicine. Thanks to these compendia, Sashuda 115 00:06:53,080 --> 00:06:55,680 Speaker 1: is known as the father of ayer Vedic surgery and 116 00:06:55,760 --> 00:06:59,040 Speaker 1: Sharaca is known as the father of Iyervedic medicine. Sa 117 00:06:59,080 --> 00:07:01,840 Speaker 1: Shruda and Shara Taca are both believed to have been 118 00:07:02,000 --> 00:07:06,400 Speaker 1: individual people, but the their two compendia are more like 119 00:07:06,680 --> 00:07:11,720 Speaker 1: compilations of entire schools of medicine, really documenting and codifying 120 00:07:11,760 --> 00:07:14,720 Speaker 1: the whole theory and practice of these two schools, rather 121 00:07:14,760 --> 00:07:19,320 Speaker 1: than just one individual person's medical knowledge written down. The 122 00:07:19,440 --> 00:07:23,560 Speaker 1: third classic iur Vedic text is the Ashtanga Sagraha, which 123 00:07:23,600 --> 00:07:26,160 Speaker 1: was an attempt to combine and unify the teachings of 124 00:07:26,160 --> 00:07:31,000 Speaker 1: Sharaka and Sashruda. The Ashtanga tries to reconcile the places 125 00:07:31,000 --> 00:07:34,960 Speaker 1: where Sharaka and Sashreda disagree and resolve conflicts that had 126 00:07:35,000 --> 00:07:38,320 Speaker 1: grown out of those disparities over the centuries, and this 127 00:07:38,360 --> 00:07:41,240 Speaker 1: work dates back to the second century b C. Was 128 00:07:41,320 --> 00:07:44,840 Speaker 1: created by Vagbada the Elder. Of course, there are other 129 00:07:44,920 --> 00:07:48,840 Speaker 1: important texts as well, but together Sashuda, Sharaka and the 130 00:07:49,040 --> 00:07:51,960 Speaker 1: Baha the Elder are known as the Three Ancients, and 131 00:07:52,000 --> 00:07:54,920 Speaker 1: the three texts associated with them are known as the 132 00:07:54,960 --> 00:07:58,960 Speaker 1: Great Trilogy of Iurvedic Medicine or the Triad of the Ancients, 133 00:07:59,400 --> 00:08:01,600 Speaker 1: and a sent treas in which all of these works 134 00:08:01,600 --> 00:08:05,280 Speaker 1: were created is known as the Golden Age of ira Veta. Together, 135 00:08:05,640 --> 00:08:10,120 Speaker 1: these texts cover everything the general principles of medicine, anatomy 136 00:08:10,200 --> 00:08:16,080 Speaker 1: and physiology, pathology, diagnostics, therapeutics, and pharmacology, and they incorporate 137 00:08:16,120 --> 00:08:20,880 Speaker 1: eight branches of medicine typically described as general medicine, obstetrics 138 00:08:20,880 --> 00:08:27,520 Speaker 1: and gynecology, psychology, eyes, ears, nose and throat surgery, toxicology, 139 00:08:27,560 --> 00:08:31,240 Speaker 1: and reproductive and sexual health. All of this knowledge grew 140 00:08:31,240 --> 00:08:34,240 Speaker 1: out of medical traditions that had existed way before any 141 00:08:34,240 --> 00:08:36,960 Speaker 1: of these documents were written down. So these were traditions 142 00:08:37,000 --> 00:08:39,560 Speaker 1: that had either been passed down orally or written down 143 00:08:39,559 --> 00:08:42,480 Speaker 1: in texts that haven't survived. So as it's true and 144 00:08:42,520 --> 00:08:44,520 Speaker 1: the rest of the world, ira Veda grew out of 145 00:08:44,520 --> 00:08:48,839 Speaker 1: folk medical practices that were revised and formalized and systematized 146 00:08:48,920 --> 00:08:51,640 Speaker 1: through all of these and other texts, and we will 147 00:08:51,679 --> 00:08:57,600 Speaker 1: talk more about the Sashrewda Samita after a brief sponsor break. 148 00:09:02,679 --> 00:09:06,600 Speaker 1: In his compendium, the Shrewter writes that theory without practice 149 00:09:06,679 --> 00:09:09,439 Speaker 1: as like a bird with only one wing, and the 150 00:09:09,559 --> 00:09:12,040 Speaker 1: shrewdest of me to really reflects that belief. It is 151 00:09:12,080 --> 00:09:16,120 Speaker 1: a comprehensive text documenting both the theory and the practice 152 00:09:16,120 --> 00:09:19,760 Speaker 1: of ira Vedic medicine and surgery, including the origins of 153 00:09:19,760 --> 00:09:22,920 Speaker 1: ira Veda and guidance on how students should be inducted 154 00:09:22,960 --> 00:09:26,960 Speaker 1: into its study. Requirements for studying illur Veda were exact. 155 00:09:27,320 --> 00:09:30,080 Speaker 1: The cast system has started evolving by this point, and 156 00:09:30,120 --> 00:09:33,040 Speaker 1: medical students were expected to be of the highest or 157 00:09:33,080 --> 00:09:36,520 Speaker 1: twice born casts. They were also to be quote possessed 158 00:09:36,559 --> 00:09:41,400 Speaker 1: of a desire to learn, strength, energy of action, contentment, character, 159 00:09:41,640 --> 00:09:46,720 Speaker 1: self control, a good retentive memory, intellect, courage, purity of 160 00:09:46,760 --> 00:09:50,600 Speaker 1: mind and body, and a simple and clear comprehension command, 161 00:09:50,679 --> 00:09:53,480 Speaker 1: a clear insight into the things studied, and should be 162 00:09:53,520 --> 00:09:57,199 Speaker 1: found to have been further graced with the necessary qualifications 163 00:09:57,240 --> 00:10:00,600 Speaker 1: of thin lips, sin teeth, and thin tongue ung and 164 00:10:00,679 --> 00:10:05,280 Speaker 1: possessed of a straight nose, large, honest, intelligent eyes, with 165 00:10:05,320 --> 00:10:08,400 Speaker 1: a benign contour of the mouth, and a contented frame 166 00:10:08,440 --> 00:10:12,120 Speaker 1: of mind, being pleasant in his speech and dealings, and 167 00:10:12,280 --> 00:10:16,800 Speaker 1: usually painstaking in his efforts. A man possessed of contrary 168 00:10:16,840 --> 00:10:21,160 Speaker 1: attributes should not be admitted into the sacred precincts of medicine. 169 00:10:21,520 --> 00:10:25,680 Speaker 1: This text totals a hundred and eighty four chapters, documenting 170 00:10:25,720 --> 00:10:31,600 Speaker 1: more than a thousand medical conditions. Along with anatomy and physiology, pathology, diagnosis, 171 00:10:31,640 --> 00:10:37,800 Speaker 1: and treatment. It details diseases of the nervous system, including epilepsy, sciatica, torticolis, 172 00:10:37,920 --> 00:10:43,720 Speaker 1: and facial paralysis, along with other things like hemrhoids, urinary calculi, fistulis, 173 00:10:43,880 --> 00:10:48,680 Speaker 1: skin diseases, urinary tract diseases, scraw phula, and a whole 174 00:10:48,720 --> 00:10:53,240 Speaker 1: lot of eye diseases, including cataracts and descriptions for their 175 00:10:53,280 --> 00:10:58,840 Speaker 1: surgical removal. The Sashrewda Semita also details practical midwiffery, including 176 00:10:58,920 --> 00:11:03,280 Speaker 1: using forceps to ing difficult births, performing cesarean sections, and 177 00:11:03,320 --> 00:11:06,600 Speaker 1: removing fetuses that have died in the womb. It also 178 00:11:06,640 --> 00:11:10,680 Speaker 1: discusses embryology and fetal development, along with guidance about when 179 00:11:10,720 --> 00:11:14,120 Speaker 1: conception is most likely, and how to encourage conception of 180 00:11:14,160 --> 00:11:17,600 Speaker 1: a child of a particular sex. The text also includes 181 00:11:17,640 --> 00:11:22,520 Speaker 1: information about the circulatory system, including descriptions of the heart, hypertension, 182 00:11:22,640 --> 00:11:27,439 Speaker 1: and angina, which you may also say angina. It describes diabetes, 183 00:11:27,559 --> 00:11:30,680 Speaker 1: connecting it to frequent urination that passes large amounts of 184 00:11:30,720 --> 00:11:34,520 Speaker 1: sugar and is frequently associated with the patient's weight. There 185 00:11:34,520 --> 00:11:38,359 Speaker 1: are also pages and pages of treatments for fevers, diarrhea, 186 00:11:38,480 --> 00:11:45,400 Speaker 1: heart disease, tuberculosis, jaundice, fainting, alcoholism, vomiting, asthma, and worms. 187 00:11:45,440 --> 00:11:48,320 Speaker 1: Some of these treatments are more religious or spiritual, and 188 00:11:48,360 --> 00:11:51,400 Speaker 1: there are chapters on treating ailments brought on by demons 189 00:11:51,440 --> 00:11:55,800 Speaker 1: and superhuman influences, but many are also practical, and the 190 00:11:55,800 --> 00:12:00,320 Speaker 1: compendium includes a pharmacopeia of six hundred fifty drugs, including 191 00:12:00,360 --> 00:12:04,760 Speaker 1: nearly four hundred plants, substances, nearly sixty of animal origin, 192 00:12:05,000 --> 00:12:09,560 Speaker 1: and sixty four minerals. The Sashuda Semisa also describes how 193 00:12:09,600 --> 00:12:13,520 Speaker 1: to determine whether an illness is medical or surgical. S 194 00:12:13,640 --> 00:12:16,880 Speaker 1: Shrewda belief that surgery was critical to igraveda that it 195 00:12:17,000 --> 00:12:19,880 Speaker 1: was not something that should be reserved as a last resort. 196 00:12:20,120 --> 00:12:22,440 Speaker 1: And in some cases was the best and most efficient 197 00:12:22,440 --> 00:12:26,000 Speaker 1: way to bring relief to a patient. He describes three 198 00:12:26,280 --> 00:12:30,680 Speaker 1: hundred different surgical procedures divided up into eight categories, which 199 00:12:30,720 --> 00:12:38,400 Speaker 1: are incision, excision, scarification, puncturing, exploration, extraction, evacuation, and suturing. 200 00:12:38,960 --> 00:12:43,559 Speaker 1: The text also lists a hundred and thirty different surgical instruments, 201 00:12:43,800 --> 00:12:46,160 Speaker 1: most of them named for the birds and other animals 202 00:12:46,160 --> 00:12:50,679 Speaker 1: that they physically resemble. The techniques include using medicated wine 203 00:12:50,760 --> 00:12:55,200 Speaker 1: and cannabis is anesthesia, using the mandibles of black ants 204 00:12:55,240 --> 00:12:59,640 Speaker 1: to suit your wounds, applying leeches after surgery to prevent clotting, 205 00:13:00,080 --> 00:13:04,640 Speaker 1: and correctly dressing and bandaging surgical sites to prevent infections. 206 00:13:04,960 --> 00:13:07,880 Speaker 1: Is also a teaching book, and so Shrewda's students spent 207 00:13:08,160 --> 00:13:11,080 Speaker 1: six years studying before they could practice on their own, 208 00:13:11,520 --> 00:13:15,120 Speaker 1: and their surgical practice included really extensive use of what 209 00:13:15,240 --> 00:13:18,280 Speaker 1: you might describe as skills labs. Although some of their 210 00:13:18,280 --> 00:13:22,320 Speaker 1: practice used cadavers or animal carcasses, they also used a 211 00:13:22,440 --> 00:13:27,120 Speaker 1: lot of non animal substitutes for practice that include practicing 212 00:13:27,200 --> 00:13:32,360 Speaker 1: incisions on gourds and practicing probing using pieces of worm 213 00:13:32,400 --> 00:13:36,840 Speaker 1: eaten or rotten wood. They practiced bladder surgeries on animal 214 00:13:36,840 --> 00:13:40,280 Speaker 1: bladders or leather bags filled with water, and they practiced 215 00:13:40,480 --> 00:13:44,680 Speaker 1: vent as section using water lily stalks. Students also studied 216 00:13:44,720 --> 00:13:48,760 Speaker 1: anatomy through dissection, although due to cultural taboos, this wasn't 217 00:13:48,800 --> 00:13:53,920 Speaker 1: generally performed with knives, so Shrewda instead recommended submerging cadavers 218 00:13:53,960 --> 00:13:56,880 Speaker 1: in water and examining the layers of the body as 219 00:13:56,920 --> 00:14:01,520 Speaker 1: the tissues decomposed. So Shrewda supple mented the anatomical knowledge 220 00:14:01,520 --> 00:14:05,120 Speaker 1: from these cadaver studies with what he learned while performing surgery. 221 00:14:05,480 --> 00:14:09,079 Speaker 1: Sashuda's most famous surgical category, and the one that earned 222 00:14:09,160 --> 00:14:13,280 Speaker 1: him the name the Father of plastic surgery, was rhinoplastic. 223 00:14:13,880 --> 00:14:17,080 Speaker 1: In this period of Indian history, people lost their noses 224 00:14:17,160 --> 00:14:20,320 Speaker 1: for a lot of different reasons, including battlefield injuries in 225 00:14:20,440 --> 00:14:24,160 Speaker 1: late stage syphilis, but cutting off a person's nose was 226 00:14:24,200 --> 00:14:27,520 Speaker 1: also used as a punishment, especially in cases of adultery, 227 00:14:27,800 --> 00:14:32,280 Speaker 1: sex crimes, and witchcraft. Women were particularly affected by this, 228 00:14:32,360 --> 00:14:35,920 Speaker 1: since they were often punished for adultery regardless of whether 229 00:14:36,040 --> 00:14:38,960 Speaker 1: or not they were ultimately found guilty. We mentioned the 230 00:14:39,040 --> 00:14:43,840 Speaker 1: Mahabarata earlier. India's other major epic, the Romana, describes Prince 231 00:14:43,960 --> 00:14:47,680 Speaker 1: Lexhmana cutting off the nose of ladies surpanaka as punishment 232 00:14:47,800 --> 00:14:52,440 Speaker 1: and then arranging its reconstruction by royal physicians. Having one's 233 00:14:52,560 --> 00:14:55,840 Speaker 1: nose cut off was of course an embarrassing and disfiguring 234 00:14:55,920 --> 00:14:59,320 Speaker 1: form of punishment. It made it really obvious to everyone 235 00:14:59,440 --> 00:15:01,360 Speaker 1: that you had been and punished for a crime, or 236 00:15:01,400 --> 00:15:04,680 Speaker 1: at least suspected of one, in a very public way. 237 00:15:04,720 --> 00:15:07,400 Speaker 1: And this is also tied up in cultural ideas about 238 00:15:07,440 --> 00:15:10,160 Speaker 1: the face and the nose and what they expressed about 239 00:15:10,160 --> 00:15:13,120 Speaker 1: a person's worth and renown. I mean, we read that 240 00:15:13,160 --> 00:15:15,520 Speaker 1: whole thing earlier in which people who are going to 241 00:15:15,560 --> 00:15:19,200 Speaker 1: study Aurveda, we're supposed to have straight noses. So also 242 00:15:19,200 --> 00:15:22,480 Speaker 1: think about the whole concept of losing face. So there 243 00:15:22,560 --> 00:15:25,680 Speaker 1: was a lot of demand for a way to reconstruct 244 00:15:25,760 --> 00:15:28,880 Speaker 1: a person's nose after they had lost it. Sa Shrewda 245 00:15:29,000 --> 00:15:32,640 Speaker 1: documented a method of rhinoplasty that involved using a flap 246 00:15:32,640 --> 00:15:35,800 Speaker 1: of skin from the cheek, keeping a small attachment to 247 00:15:35,880 --> 00:15:39,040 Speaker 1: the cheek during healing. Here's how it is described in 248 00:15:39,080 --> 00:15:43,520 Speaker 1: the Sashrewda Samhita. First, the leaf of a creeper long 249 00:15:43,600 --> 00:15:45,960 Speaker 1: and broad enough to fully cover the whole of the 250 00:15:46,040 --> 00:15:49,400 Speaker 1: severed or clipped off part should be gathered, and a 251 00:15:49,440 --> 00:15:52,800 Speaker 1: patch of living flesh equal in dimension to the preceding 252 00:15:52,880 --> 00:15:56,560 Speaker 1: leaf should be sliced off from down upward from the 253 00:15:56,600 --> 00:16:00,160 Speaker 1: region off the cheek, and after scarifying it with a 254 00:16:00,240 --> 00:16:04,720 Speaker 1: knife swiftly adhering to the severed nose, then the cool 255 00:16:04,800 --> 00:16:08,200 Speaker 1: headed physicians should steadily tie it up with a bandage 256 00:16:08,280 --> 00:16:11,360 Speaker 1: decent to look at and perfectly suited to the end 257 00:16:11,400 --> 00:16:14,520 Speaker 1: for which it has been employed. The physicians should make 258 00:16:14,560 --> 00:16:17,080 Speaker 1: sure that the adhesion of the severed parts has been 259 00:16:17,120 --> 00:16:20,760 Speaker 1: fully affected, and then insert two small pipes into the 260 00:16:20,800 --> 00:16:25,320 Speaker 1: nostrils to facilitate respiration and to prevent the adhesion flesh 261 00:16:25,600 --> 00:16:29,560 Speaker 1: from hanging down. The Sashrewda Semita then describes dusting the 262 00:16:29,640 --> 00:16:33,680 Speaker 1: area with powders made from licorice, red sandal wood, and barberry, 263 00:16:34,000 --> 00:16:36,760 Speaker 1: and then wrapping it in cotton soaked with sesame oil. 264 00:16:37,120 --> 00:16:39,560 Speaker 1: It also describes what to do if the skin from 265 00:16:39,560 --> 00:16:43,120 Speaker 1: the cheek doesn't adhere properly to the nose, and how 266 00:16:43,160 --> 00:16:47,000 Speaker 1: to handle various other complications during the healing process, including 267 00:16:47,000 --> 00:16:49,640 Speaker 1: what to do if the reconstructed nose is not the 268 00:16:49,720 --> 00:16:52,960 Speaker 1: right length. After healing and this was not so shrewd 269 00:16:52,960 --> 00:16:55,840 Speaker 1: as only technique that would be described as plastic surgery. 270 00:16:56,520 --> 00:16:59,640 Speaker 1: As one example, he also wrote about using skin flaps 271 00:16:59,640 --> 00:17:03,200 Speaker 1: to read construct missing or damaged ear lobes. But this 272 00:17:03,280 --> 00:17:07,120 Speaker 1: method of rhinoplasty lasted for millennia after so Shrewda's death, 273 00:17:07,480 --> 00:17:10,200 Speaker 1: and it's why he's known as the father of plastic surgery. 274 00:17:10,680 --> 00:17:12,600 Speaker 1: We will talk about his legacy in the world of 275 00:17:12,600 --> 00:17:23,960 Speaker 1: plastic surgery after another quick sponsor break. The shrewdest method 276 00:17:24,080 --> 00:17:28,320 Speaker 1: of rhinoplasty continued to be practiced in India for centuries 277 00:17:28,359 --> 00:17:31,200 Speaker 1: after his death. But because this the Shrewdest Samza was 278 00:17:31,240 --> 00:17:35,360 Speaker 1: written in Sanskrit on things like birch, bark and palm leaves, 279 00:17:35,400 --> 00:17:38,160 Speaker 1: the knowledge of how to do it didn't really move 280 00:17:38,320 --> 00:17:40,200 Speaker 1: out of India and into the rest of the world 281 00:17:40,200 --> 00:17:44,480 Speaker 1: really quickly. It does appear that Indian physicians traveled to 282 00:17:44,520 --> 00:17:47,399 Speaker 1: other parts of the world, though for example, Alexander the 283 00:17:47,440 --> 00:17:51,160 Speaker 1: Great had Indian physicians at his court and also attempted 284 00:17:51,160 --> 00:17:55,720 Speaker 1: to conquer India. It is possible that Indian physicians influenced 285 00:17:55,720 --> 00:17:59,640 Speaker 1: the later work of people like Hippocrates and Galen. That's 286 00:17:59,640 --> 00:18:02,639 Speaker 1: the shrewd A Samita was also translated into Arabic. In 287 00:18:02,680 --> 00:18:05,840 Speaker 1: the eighth century, after the Arab conquest of the Indian 288 00:18:05,880 --> 00:18:09,760 Speaker 1: province of sind Europeans got their first glimpse of Indian 289 00:18:09,800 --> 00:18:14,200 Speaker 1: rhinoplasty during the Third Anglo Mysore War. A porter named 290 00:18:14,280 --> 00:18:17,160 Speaker 1: Kawasji was working for the British and he and four 291 00:18:17,200 --> 00:18:21,679 Speaker 1: others had been taken prisoner by Tippoo Sultan's soldiers. While imprisoned, 292 00:18:21,720 --> 00:18:24,760 Speaker 1: all five men had their noses and one hand cut off, 293 00:18:25,240 --> 00:18:28,080 Speaker 1: and they were eventually freed and later granted pensions by 294 00:18:28,080 --> 00:18:31,399 Speaker 1: the British East India Company. For the curious. Yes, that 295 00:18:31,520 --> 00:18:34,879 Speaker 1: is the same Tippoo Sultan whose rocket stash we talked 296 00:18:34,880 --> 00:18:39,600 Speaker 1: about in Unearthed earlier. A couple of weeks ago, about 297 00:18:39,600 --> 00:18:42,199 Speaker 1: a year later, a British officer was in a market 298 00:18:42,240 --> 00:18:44,359 Speaker 1: and met a merchant with a scar on his nose, 299 00:18:44,800 --> 00:18:47,119 Speaker 1: and the officer asked about that scar, and the merchant 300 00:18:47,160 --> 00:18:48,960 Speaker 1: said that he'd had his nose cut off as a 301 00:18:48,960 --> 00:18:52,760 Speaker 1: punishment for adultery. He said his nose had been repaired 302 00:18:52,760 --> 00:18:55,600 Speaker 1: by someone who did this procedure all the time, and 303 00:18:55,640 --> 00:18:57,840 Speaker 1: we don't know anything about the person who did this 304 00:18:57,920 --> 00:19:01,159 Speaker 1: reconstruction other than that he was scribed as a potter 305 00:19:01,359 --> 00:19:04,960 Speaker 1: or a brickmaker. When the officer came back with this story, 306 00:19:05,080 --> 00:19:07,639 Speaker 1: the British decided to pay for the five men to 307 00:19:07,680 --> 00:19:11,320 Speaker 1: have their noses reconstructed. And there might have been some 308 00:19:11,400 --> 00:19:14,879 Speaker 1: benevolence at work here, but it was almost certainly also 309 00:19:14,960 --> 00:19:19,080 Speaker 1: to demonstrate the British East India Company's generosity and to 310 00:19:19,119 --> 00:19:22,480 Speaker 1: reinforce the idea that Tipoo Sultan's army was using brutal 311 00:19:22,560 --> 00:19:26,840 Speaker 1: methods against the British too. British officers observed the procedure 312 00:19:26,920 --> 00:19:30,359 Speaker 1: at least once, and they documented what they saw. This 313 00:19:30,400 --> 00:19:33,600 Speaker 1: description of the procedure was printed in the Madras Gazette 314 00:19:33,640 --> 00:19:37,960 Speaker 1: in se quote, A thin plate is fitted to the 315 00:19:38,000 --> 00:19:40,040 Speaker 1: stump of the nose, who is to make a nose 316 00:19:40,080 --> 00:19:43,200 Speaker 1: of good appearance. Then it is flattened and laid on 317 00:19:43,240 --> 00:19:46,800 Speaker 1: the forehead. A line is drawn around the wax, which 318 00:19:46,840 --> 00:19:50,280 Speaker 1: is then of no further use, and the operator then 319 00:19:50,359 --> 00:19:54,360 Speaker 1: dissects off as much skin as it covered, leaving undivided 320 00:19:54,440 --> 00:19:58,720 Speaker 1: a small slip between the eyes. This slip preserves the 321 00:19:58,760 --> 00:20:02,400 Speaker 1: circulation to and union has taken place between the new 322 00:20:02,480 --> 00:20:05,439 Speaker 1: and old parts. The sick of tricks of the stump 323 00:20:05,480 --> 00:20:08,480 Speaker 1: of the nose is not paired off, and immediately behind 324 00:20:08,560 --> 00:20:11,880 Speaker 1: this raw parted through the skin, which passes round both 325 00:20:12,000 --> 00:20:15,239 Speaker 1: land goes along the upper lip. The skin is now 326 00:20:15,280 --> 00:20:18,440 Speaker 1: brought down from the forehead, and being twisted half round, 327 00:20:18,880 --> 00:20:22,760 Speaker 1: its edge is inserted into the incision. A little terra 328 00:20:22,840 --> 00:20:26,480 Speaker 1: japonica is softened with water and being spread on slips 329 00:20:26,480 --> 00:20:29,240 Speaker 1: of cloth. Five or six of these are placed over 330 00:20:29,280 --> 00:20:33,480 Speaker 1: each other to secure the joining. No other dressing, but 331 00:20:33,600 --> 00:20:37,000 Speaker 1: this cement is used for four days. It is then 332 00:20:37,040 --> 00:20:40,320 Speaker 1: removed and the cloths dipped in gee a kind of butter, 333 00:20:40,480 --> 00:20:44,479 Speaker 1: are applied. The connecting slip of skin is divided about 334 00:20:44,800 --> 00:20:47,560 Speaker 1: the twenty five days, when a little more dissection is 335 00:20:47,640 --> 00:20:51,440 Speaker 1: necessary to improve the appearance of the nose. For five 336 00:20:51,520 --> 00:20:54,520 Speaker 1: or six days after the operation, the patient is made 337 00:20:54,560 --> 00:20:56,800 Speaker 1: to lie on his back, and on the tenth day 338 00:20:57,119 --> 00:20:59,720 Speaker 1: bits of soft cloth are put into the nostrils to 339 00:20:59,840 --> 00:21:05,920 Speaker 1: key sufficiently open. This operation is always successful. The artificial 340 00:21:05,960 --> 00:21:08,639 Speaker 1: nose is secure and looks nearly as well as the 341 00:21:08,720 --> 00:21:12,200 Speaker 1: natural one. Nor is the scar visible on the forehead 342 00:21:12,440 --> 00:21:15,720 Speaker 1: very observable after a length of time. So there are 343 00:21:15,760 --> 00:21:18,720 Speaker 1: some tweaks, but this is really similar to the Stretta's 344 00:21:18,760 --> 00:21:21,800 Speaker 1: method of rhinoplastic from thousands of years before, except that 345 00:21:21,840 --> 00:21:24,360 Speaker 1: it uses a flap of skin from the forehead rather 346 00:21:24,400 --> 00:21:27,040 Speaker 1: than the cheek, And we don't really know how or 347 00:21:27,080 --> 00:21:30,480 Speaker 1: when surgeons in India made this shift from a cheek 348 00:21:30,480 --> 00:21:33,840 Speaker 1: flap to a forehead flap, and the centuries leading up 349 00:21:33,840 --> 00:21:36,680 Speaker 1: to the late eighteenth century, rhinoplasty had become a really 350 00:21:36,680 --> 00:21:40,600 Speaker 1: closely guarded family secret, being handed down orally rather than 351 00:21:40,640 --> 00:21:44,720 Speaker 1: written down. An account of this reconstruction, almost identical to 352 00:21:44,760 --> 00:21:47,280 Speaker 1: the one that I just read, ran in the Gentleman's 353 00:21:47,280 --> 00:21:51,760 Speaker 1: Magazine of London in October of sevent In the years 354 00:21:51,800 --> 00:21:56,080 Speaker 1: after that, British surgeon Joseph Constantine Carpew began trying the 355 00:21:56,119 --> 00:22:00,600 Speaker 1: same procedure. He actually carried out London's first rhinoplastic using 356 00:22:00,640 --> 00:22:05,240 Speaker 1: a forehead flap in eighteen sixteen. The word rhinoplastic first 357 00:22:05,280 --> 00:22:09,480 Speaker 1: appeared in writing in English in eight and plastic surgery 358 00:22:09,640 --> 00:22:14,160 Speaker 1: followed in eighteen thirty seven. That year, North America's first 359 00:22:14,200 --> 00:22:18,240 Speaker 1: forehead flap rhinoplasty was performed in Boston. The use of 360 00:22:18,280 --> 00:22:21,399 Speaker 1: a forehead flap to reconstruct a nose has continued to 361 00:22:21,440 --> 00:22:24,560 Speaker 1: be known as the Indian method, there is also an 362 00:22:24,560 --> 00:22:28,359 Speaker 1: Italian method, refined by gas Bar Tagli Kazzy in the 363 00:22:28,400 --> 00:22:32,600 Speaker 1: sixteenth century. The Italian method used a flap of skin 364 00:22:32,840 --> 00:22:36,360 Speaker 1: from the upper arm, requiring the patient to have their 365 00:22:36,440 --> 00:22:39,160 Speaker 1: arm bandaged up above their head for about twenty days 366 00:22:39,240 --> 00:22:42,000 Speaker 1: until their arms skin had attached from the nose and 367 00:22:42,040 --> 00:22:45,280 Speaker 1: could be detached from their arm. So you kind of 368 00:22:45,320 --> 00:22:47,400 Speaker 1: have your elbow out in the front of your head 369 00:22:47,480 --> 00:22:52,439 Speaker 1: like a big beak. Honestly, this seems very cumbersome and 370 00:22:52,640 --> 00:22:56,840 Speaker 1: inconvenient and uncomfortable to me, But that was the Italian 371 00:22:56,920 --> 00:23:00,159 Speaker 1: method of rhinoplasty. I wonder if the idea was that 372 00:23:00,280 --> 00:23:04,520 Speaker 1: there was some benefit to using that skin that facial 373 00:23:04,600 --> 00:23:07,040 Speaker 1: skin may not have offered. I mean, to me, and 374 00:23:07,080 --> 00:23:09,600 Speaker 1: I'm completely lay person, I have no knowledge, but to me, 375 00:23:09,680 --> 00:23:12,920 Speaker 1: going with the forehead skin, which on most people is 376 00:23:13,000 --> 00:23:16,119 Speaker 1: much thinner and has less subcutaneous fat versus cheek seems 377 00:23:16,119 --> 00:23:18,840 Speaker 1: like a weird transition. But but I don't know what 378 00:23:18,880 --> 00:23:21,639 Speaker 1: the requirements are. So if anyone out there is a 379 00:23:21,640 --> 00:23:24,760 Speaker 1: plastic surgeon, school me, because I want to know, they 380 00:23:24,800 --> 00:23:27,359 Speaker 1: may also have been wanting to avoid the potential of 381 00:23:27,400 --> 00:23:30,480 Speaker 1: having two scars on a person's face. But I did 382 00:23:30,520 --> 00:23:33,119 Speaker 1: not look into it in detail because the picture of 383 00:23:33,160 --> 00:23:35,840 Speaker 1: the person with their arm bandaged with their elbow like 384 00:23:35,880 --> 00:23:38,119 Speaker 1: a big old beak, It's just so comical that I 385 00:23:38,160 --> 00:23:40,800 Speaker 1: couldn't get past it. Kind of love it. Well, design 386 00:23:40,840 --> 00:23:43,080 Speaker 1: clothes just for that. It'll be great, uh. In the 387 00:23:43,160 --> 00:23:47,439 Speaker 1: late nineteenth century, the Seshruda Samita was also translated into Latin. 388 00:23:47,960 --> 00:23:50,879 Speaker 1: Between nineteen o seven and nineteen sixteen, it was translated 389 00:23:50,880 --> 00:23:55,720 Speaker 1: into English by coverage Kunja Labasha Gratna, who consolidated the 390 00:23:55,760 --> 00:23:59,200 Speaker 1: works original five volumes down to three and those are 391 00:23:59,200 --> 00:24:02,520 Speaker 1: all online at archive dot org. Can go read them 392 00:24:02,520 --> 00:24:06,960 Speaker 1: all yourself and see lots of diagrams of surgical instruments. 393 00:24:06,960 --> 00:24:09,199 Speaker 1: There are a lot of them. Do you have listener 394 00:24:09,200 --> 00:24:12,600 Speaker 1: mail to read yourself? My view? I have a quick 395 00:24:13,080 --> 00:24:17,280 Speaker 1: follow up to the ongoing saga of Charles Dickens Multiple Households. 396 00:24:17,560 --> 00:24:21,159 Speaker 1: This is from our Facebook from Kristen and Kristen says heyo. 397 00:24:21,400 --> 00:24:24,320 Speaker 1: I just listened to the first sojourn or Truth episode 398 00:24:24,359 --> 00:24:27,360 Speaker 1: and have an alternate answer to the listener mail question. 399 00:24:27,880 --> 00:24:31,080 Speaker 1: This past December, I read The Man Who Invented Christmas 400 00:24:31,119 --> 00:24:35,560 Speaker 1: by Leah Standford and learned that Dickens was constantly having 401 00:24:35,600 --> 00:24:38,600 Speaker 1: to send his parents money to keep them afloat due 402 00:24:38,600 --> 00:24:42,040 Speaker 1: to their terrible financial management. This could have been the 403 00:24:42,160 --> 00:24:46,600 Speaker 1: multiple households answer as well. Keep up the fantastic work ladies. 404 00:24:47,119 --> 00:24:50,439 Speaker 1: Thank you, Kristen. Apparently Charles Dickens was just paying for 405 00:24:50,480 --> 00:24:52,520 Speaker 1: a whole lot of people to keep their lives afloat 406 00:24:53,000 --> 00:24:57,639 Speaker 1: by busy guy. Fortunately, by that point he was making 407 00:24:57,920 --> 00:25:01,480 Speaker 1: more money than immediately after American tour that we talked 408 00:25:01,480 --> 00:25:05,800 Speaker 1: about back at Christmas time. So thank you for sending 409 00:25:05,840 --> 00:25:08,119 Speaker 1: us that note on Facebook. 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You can come to our website that 415 00:25:21,320 --> 00:25:24,480 Speaker 1: is missed in History dot com and find a searchable 416 00:25:24,560 --> 00:25:27,320 Speaker 1: archive of all the episodes we've ever done show notes 417 00:25:27,320 --> 00:25:29,600 Speaker 1: of all the episodes Holly and I have done together. 418 00:25:29,720 --> 00:25:32,199 Speaker 1: The show notes for this episode will include links to 419 00:25:32,280 --> 00:25:35,800 Speaker 1: all of those historical documents that you can read detailing 420 00:25:36,119 --> 00:25:38,760 Speaker 1: the origins of Ira Veta. You can also find out 421 00:25:38,760 --> 00:25:41,320 Speaker 1: our website, a link to find out about our trip 422 00:25:41,400 --> 00:25:44,240 Speaker 1: to Paris that we're taking this June. 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