Rhinoplasty and “Pizza effect”

Most of the readers are unaware that just a few decades ago, Pizza was looked down upon as a food item in Italy, the native place of Pizza. Italian immigrants to America packaged it as a delicacy of Italian cuisine, first to Americans, and then exported it to Italy. Ironically, it is considered as an up-market food item in the same very Italy today. This gave rise to the term ‘Pizza effect’. The term ‘Pizza effect’ was coined by the late Swami Agehanand Bharati. Born as Leopold Fisher in a Christian family, he worked as a professor at Syracuse University for thirty years. Gifted with a sharp and analytical mind, he fell in love with the vibrant nature of Hinduism. This term is used to denote the process by which cultural exports are transformed and reimported to their culture of origin, or the way in which a community’s self-understanding is influenced by (or imposed by, or imported from) foreign sources.

Let us learn another term; Rhinoplasty. It is the name given to the surgical procedure of reshaping, changing, or attaching the nose to a patient. What is the relation between these two terms, belonging to different fields, one to sociology and the other to medical science?

Well, Everything.

Most of our countrymen have been forced to believe that modern medical science is a gift of Europeans and/or Americans, including plastic surgery. But the facts are just the opposite. The following is an excerpt from the diary of a British doctor, one Dr. H.Scott, dated 1st January 1794.

In a conversation that I had some time ago with Captain Irvine of this presidency who had come to Bombay on some business from Poona where he is stationed, my curiosity was much raised by the account he gave me of a practice that is not uncommon among the Gentoos (Hindus) of putting new noses on people who have had them out cut. He told me that he first came to the knowledge of this from a sepoy who had his nose cut off by Tippoo during the last War (Tipu Sultan was utterly barbaric to all non muslims). In consequence of it he had become an invalid in the Company's pay which he received every month from Captain Irvine. One day he came to Captain Irvine and begged his permission to go for a certain time to some distance that he might get a new nose, for he said that his wife could not bring herself to like him in his present situation. Captain Irvine thought at first that he wished to impose on him, but the man assured him that he was speaking only the truth and that he would shew him one of his friends who some time before had received a new nose. He accordingly brought him and Captain Irvine had reason to believe the story for he saw a nose which altho' not actually so perfect as if it had been formed by nature was yet sufficiently agreeable to the eye. Captain Irvine learned at the same time from Mr. Findlay the Company's surgeon with the Resident that the sepoy had some time before been with him to beg to have a new nose put on but Mr. Findlay had assured him that such a practice was not known among the Europeans. Captain Irvine gave the sepoy leave of absence and in some weeks afterwards he came back to Poonah with a pretty good nose. It was somewhat too roundand uniform but such as would not be taken notice of for being disagreeable. All the gentlemen in the Company's service at Poona were witnesses of this change. When Captain Irvine came to Bombay which was soon after the operation, the sepoy still wore plugs, I believe of cotton, in his new nose. There was a discharge from some slight ulceration within it, nor had the part acquired entirely the natural heat of the body. It appeared otherwise to be well joined and healthy and the man had acquired great security in his late acquisition.

This conclusively proves that the science of Plastic surgery was not known to the European world till the eighteenth century. On the other hand, it was a practice from ‘times immemorial’ for Hindus.

Further Dr. H.Scott writes:

As I wished much to be further acquainted with this curious subject I wrote to my friend Mr Findlay concerning it and I cannot do better than send you a copy of his own words in answer.

"On the second instant I was favoured with your last letter wherein you express a strong desire of having some facts collected respecting the custom in this country of putting noses on those who have lost them. It affords me pleasure to inform you that we have ascertained in the most satisfactory manner that individuals or rather families of a certain cast of people in Hindostan have from time immemorial been acquainted with and practise the art of putting on noses, and I have ample grounds to believe that the operation is in general successful. I have at this moment before me two Mahrattas pensioners of the Bombay Government, whom I saw on their arrival here from Syringaputtam in may or june 1792 without noses. These two men have now their faces decorated with noses of a natural size and tolerable shape which are firmly united and receive nourishment from the stumps of their original noses. These two facts which have fallen under the observation of all the gentlemen of this Residency as well as my own afford sufficient testimony on this subject; but the following proof may be deemed still more satisfactory.

"Through Sir Charles Mallet's obliging influence Mr Cruso and I were permitted to see the operation performed on the 26 ultimo by a man of the Koomar cast ( a class of Hindoos chiefly employed in making the common earthenware of this country) who, with an old razor borrowed on the occasion, dissected with much composure a portion of the frontal integuments from the pericranium of the patient and grafted it, a new operation to us in surgery, on the stump of the original nose. He there retained it, by a cement without the aid of stitches sticking plaster, or bandages. The patient is at present in good health and high spirits. An adhesion has taken place seemingly in every part; when it is perfected and cuatrized I shall give you a particular history of the operation and subsequent treatment". (Poona 12 December 1793.)

The above is all the information that I have yet procured concerning the restoration of noses. It must be understood only of the soft and not the bony part of the nose; so much of it I suppose as a knife can readily remove; for this has been a common punishment with the despots by whom this country has been ruled. The cement, by which the old and new parts are kept together till they unite, appears to be a desideratum in our surgery. I cannot discover wherefore the skin is not taken from a more ignoble and a less conspicuous part than the forehead. I should suppose that a piece of skin would but ill supply the place of the septum and the other cautilages of the nose, its muscles, membrane & c ; but so far as appearance is concerned, and this must be acknowledged to be a consideration of great moment, it makes an excellent substitute.

Altho' this operation of the Gentoos is supported by the analogy of some well known facts there are people I doubt not who will call in question the truth of this relation. I beg leave to repeat that two of the Company's surgeons Mr Findlay and Mr Cruso both men of eminence in their profession have actually seen the operation performed and the sepoys who are mentioned above are known to all the gentlemen of the Residency at Poona. You are very welcome Sir to make use of my name in any way you may chuse to mention this singular operation for I am perfectly assured of the unquestionable honour as well as of the good sense of those from whom I have received the accounts.

H.ScottBombay, Jany 1, 1794.

If any further proof for this age old tradition of advanced surgery of our forefathers, one can read it from the comments of another eminent Briton. He was J. C. CARPVE, F.R.S. Member of Royal College of Surgeons, London. In 1816, he wrote:

This art is practised by the Koomars, a caste of Hindoos. Some religious ceremonies are first performed. Betel and arrack are put into the patient's hands, and he is then laid on his back, his arms stretched along his sides, on the ground, and he is ordered, on no pretence whatever, to use his arms during the operation; and they impress him with this idea, that it cannot be successful unless he complies strictly with this injunction."

On undertaking the first of the two cases to be hereafter narrated, I was induced to make such personal inquiries as were within my reach in this country, concerning the Indian method, I did myself the honour to write to Sir Charles Mallet, who had resided many years in India, and who obligingly confirmed to me the report, that this had been a common operation in India, from time immemorial; adding, that it had always been performed by the caste of potters or brickmakers, and, that though not invariably, it was usually successful. Mr. James Stuart Hall, a gentleman who was many years in India, assured me, that he had seen the operation performed, and that it was of tedious length. From Dr. Barry, of the India service, I learned, that he also had seen the operation; that it occupied an hour and a half, and was performed with an old razor, the edge of which, being continually blunted in dissection was every moment re-set. Tow was introduced to support the nose, but no attempt to form nostrils, by adding a septum, was made. I am obligingly informed by Major Heitland, of the India service, that in India, several years ago, in the time of Hyder Ali, Mr. Lucas, an English surgeon, was, in several instances, successful in the operation, which he copied from the Hindoo practitioners.

Is it not surprising that since the times of the great sages Charak and Sushrut, the ‘shalya chikitsa’ was preserved by our ancestors for more than two thousand years? And here we are, just about two centuries later, admiring the Europeans and Americans as the custodians of the sciences. This is a classic case of the Pizza effect. Hope we get rid of it soon.