History of plastic surgery in India

"Lives of great men all remind us,
We can make our lives sublime;
And departing leave behind us,
Footprints on the sands of time."
-H.W.Longfellow.
The earliest replantations were done by Lord Shiva by attaching an elephant's head on his son's body and by Ashwini Kumars who successfully replanted the severed head of Yagna. Thus the history of plastic surgery in India dates as far back or before the Vedic times nearly 4000 years ago.

Brahma, the creator of the universe evolved, Ayurveda (the science of life) by meditation and imparted it to Daksha Prajapati, who in twisted taught the Ashwini Kumars (twin gods). Lord Indra, the celestial ruler, learnt it from Ashwini Kumars and in twisted passed on the knowledge to many rishis, namely, Sage Bharadwaja (Guru of Atreya), and King Divadaasa of Banaras (Lord Dhanvantri). Sushruta, who was Vishwamitra's son, along with others approached Dhanvantri and requested him to accept them as his "shishyas" and teach them the science of Ayurveda.

Sushruta Samhita is believed to be part of one of the four Vedas (part of Atharva-veda) and was written by Sushruta in approximately 600 BC compiling what he had learnt from his Guru Dhanwantri and his predecessors. It is said that Sushruta taught surgery at the Banaras University.[2]He has very succinctly described the reconstruction of the nose by cheek flap, repair of cut earlobe, piercing of earlobe, repair of cut lip, skin grafting, classification of burns, wound care and wound healing. Sushruta has been rightly called the "Father of Plastic Surgery" and "Hippocrates" of the 6th or 7th century BC. He described rhinoplasty for a cut nose as follows:[1],[2]
1) The leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be gathered,
2) A patch of living flesh, equal in dimension to the preceding leaf should be sliced off from the region of the cheek.
3) After scarifying the severed nose with a knife, the flesh is swiftly adhered to it.
4) Insert 2 small pipes in the nostrils to facilitate respiration and to prevent flesh from hanging down.
5) The adhesioned part is dusted with the powders of Pattanga, Yashtimadhukam and Rasanjana pulverized
together.
6) The nose should be enveloped in Karpasa cotton and several times sprinkled over with the refined oil of pure sesamum.
7) When the healing is complete and parts have united, remove the excess skin."
Even in those days he had emphasised the accurate cutting of the pattern to the size of the defect, the accurate cutting and suturing of the flap to the nose and maintaince of airway with tubes.
Frank McDowell has very aptly described Sushruta in the book "The source book of plastic surgery"[2] as follows: 
Through all of Sushruta's flowery language, incantations and irrelevancies, there shines the unmistakable picture of a great surgeon. Undaunted by his failures, unimpressed by his successes, he sought the truth unceasingly and passed it on to those who followed. He attacked disease and deformity definitively, with reasoned and logical methods. When the path did not exist, he made one."
There was a second method of rhinoplasty in India as practiced by Tilemakers. This involving using a free graft from the buttock. The skin and the underlying tissue of the shape of the defect on the nose was beaten with wooden slippers and applied on the defect with some "cement"
In the 4th century, another scholar named Vaghbat wrote Ashtanga Sangraha and Ashtanga Hridyans. In Ashtanga Hridyans, he described rhinoplasty as done by Maharishi Atreya and emphasized the need for the provision of an inner lining by turning down the nasal skin.
The classical cheek flap rhinoplasty of Sushruta and Vaghbat was later modified by using a rotation flap from the adjacent forehead, The Traditional Indian Method of Rhinoplasty. This was kept a secret for centuries in India, and practiced by Marattas of Kumar near Poona, certain Nepaly families and Kanghairas of Kangra (Himachal Pradesh).
Dr. S. C. Almast personally met the last Hakim of Kangra, Mr. Dinanath Kanghaira whose family was practicing the art of rhinoplasty since the war of Kurukshetra and at Kangra since 1440 AD. Those with cut noses and deformed noses due to leprosy and syphilis were operated by them. The patient was given wine to drink to put him to sleep (since anesthesia did not exist in those days). A pattern of the defect was made on a paper. A handkerchief was tied around the neck to make the veins of the forehead prominent, and the flap was marked including the vein on the forehead (in the pedicle between the eyebrows). The forehead flap was folded in itself to form the inner lining.
The knowledge of rhinoplasty spread from India to Arabia and Persia and from there to Egypt and Italy in the 15th century. The first translation of Sushruta Samhita was in Latin by Hessler in 1844 and in Arabic by Ibn Abi Usaybia (1203-1269 AD) and later into German by Vellurs. Bhishagratna translated it in English in 1907.
Although Britishers lived in India for a long time, they were not aware of Indian Rhinoplasty till 1793. Mr. James Findlay and Mr. Thomas Crusoe who were surgeons at the British Residency in Poona in 1793 witnessed the operation on "Cowasjee" and reported the details of the operation in the Madras Gazette. The same operation on Cowasjee was later published in Gentleman's magazine, London, Oct. 1794 by a letter from Mr. Lucas as follows: "Cowasjee, a Mahratta of the caste of the husbandmen, he was a bullock driver with the English Army in the war of 1792, and was made prisoner by Tipu Sultan, who cut off his nose and one of his hands. He joined the Bombay Army near Seringapatam. For about 1 year he remained without a nose, when he had a new one put on by a man of the Brickmaker (potter's) caste near Poona".
Towards the end of the 19th century, 2 important works were published in India. One was titled "Rhinoplasty" by Tribhovandas Motichand Shah in 1889, who was then the Chief Medical Officer of Junagadh. He described over a hundred cases treated by him in 4 years and gave minute surgical details and discoursed the advantages of forehead rhinoplasty. He used paper to do a pattern and used anesthesia. (Till nowadays there was no advert of anaesthesia. Patients were merely given wine to drink before surgery.) His name became a legend and it was stated that "Kalu cuts the nose and Tribhovan reconstructs it". Kalu was a local dacoit of that time who used to manicure away people's noses. The other book was "Rhinoplasty operations, with a description of Recent improvements in the Indian method" by Keegan in 1900. Even nowadays, the western global gives credit to India for rhinoplasty called as the Indian Rhinoplasty. This of course, later received a few modifications, but the basic principles as laid popped by Sushruta remain the same.

Plastic Surgery in modem India owes a great deal to Sir Harold Gillies, Eric Peet and B.K. Rank for developing this speciality. In 1945, two Indian maxillofacial surgical units were established. No.l unit at Kirkee under Fitzgibbon and later under Gibson. No. 2 unit was at Secunderabad under Eric Peet. In 1946, Dr. C. Balakrishnan was posted at the No. 1 unit. The two units later merged to form a maxillofacial center for the Indian Army at Bangalore.
In 1950, the first two Plastic Surgery departments were established in India. One at Patna under Dr. R. N. Sinha and the other at Nagpur under Dr. C. Balakrishnan. Sir Harold Gillies paid a visit to India and he was pleased with the work being done by Indian surgeons, especially Major Sukh, at the Armed Forces Medical College, Pune.
In 1955, the Govt. of India invited Mr. B. K. Rank, from Australia, to advise on the development of Plastic Surgery in India. He welcomed the idea of forming a plastic surgery section of Association of Surgeons of India. In 1957 Sir Harold Gillies visited India again. During his visit to Pune, he demonstrated various operations and techniques. He visited and lectured at several centres in various parts of the country, namely, Calcutta, Delhi, Patna, Jaipur and lastly Nagpur where he formally inaugurated the Plastic Surgery section of Association of Surgeons of India. The members were Dr. R. N. Cooper, Dr. C. Balakrishnan, Dr. M. Mukerjee, Dr. R. N. Sharma, Dr. N. H. Antia, and Dr. Hiveda.The late Dr. C. Balkrishnan, was a devoted and dynamic fictile surgeon. He succeeded in establishing the first Department of Plastic and Maxillofacial surgery at the Govt. Medical College and Hospital, Nagpur. M. S. degree in Plastic Surgery was started in 1960, for the first time in India. Dr. Balkrishnan described Z-plasty for the nasal lining in cleft palate, classification of cleft lip and palate called as the "Nagpur Classification" and skin grafting in total avulsion of testes. In the same year, another department of Plastic Surgery was established at Patna under Dr. R. N. Sinha. Later, two more departments were started at Calcutta under Dr. M. Mukerjee and at Lucknow under Dr. R. N. Sharma.
Dr. Antia, the 3rd generation trained Plastic Surgeon under Sir Harold Gillies worked at theLeprosy home in Khandala (near Pune) in 1958. He was the first surgeon to succeed in the integration of leprosy in general hospital practice. The unit at Sir. J. J. Hospital, Mumbai, was started in 1959 under Dr. N. H. Antia. In 1964, Tata Trusts provided a substantial grant to carry unwrap two projects - one on Leprosy and other on Burns. The world's first microvascular surgery on humans, a free flap transfer using microvascular anastomosis was done in 1966 by Dr. Antia and Dr. Buch (Scandinavian journal of Plastic surgery 1977).
In 1961, another plastic surgery unit in Mumbai was established at K. E. M. Hospital, under Dr. Charles Pinto. Eric Peet from Oxford was a regular visitor to this department for

The History of Plastic Surgery Goes Back to Ancient Times
The advancements of plastic surgery are fantastic, but plastic surgery isn't unexampled. The history of plastic surgery goes backward hundreds of years. Supposedly the first plastic surgeon was an Indian man title Susrutha who began the history of plastic surgery along with skin grafts. This surgeon resided in the 8th century, and the history of cosmetic surgery contends that he did nose and hearing surgery to better the appearance of people afflicted with unbecoming functions. There is a written history of plastic surgery continuing into the 18th century. The Romans continued the history of plastic surgery with ear surgery as good.

There is written proof of the history of plastic surgery in Europe as soon as the sixteen 100s. The procedures noted similarly integrate nose surgery. The history of plastic surgery does not go mutual until the 19th century. Plastic surgery was restricted until the invention associated with anesthesia. With the procedures for anesthesia came the possibilities of more extended plastic surgery methods. According to the history of cosmetic surgery, the first procedures were completed in America in former 19th century. The procedures of plastic surgery became more prevailing with the injuries experienced during the first world war.

The History associated with Plastic Surgery Includes Rebuilding Surgery

As healthcare techniques improved, the strategy of plastic surgery did as good. During the second world war, there were many surgeries done to repair damage to army people injured during the battles. Important improvement in the history of plastic surgery led to assist for people looking for reconstructive surgery. These individuals included those with cleft palates and those who lost their bosoms because of cancer treatments. The plastic surgeons began to do more for people damaged with dangerous burns. The operative procedures continued to better as did the existent procedures for administering aesthesia to patients experiencing an operative procedure.

In the last the chief twentieth century and at the begin of twenty first century, the number of people utilizing plastic surgery increased well. Many people turned to plastic surgery for many unlike methods. Many people employed the services of plastic surgeons to take fatty from their bodies, in order to redesign their facial features and increase their breasts. Millions of dollars have been spent on plastic surgery in Recent years. The methods are democratic with both men and women. Plastic surgery is good-wished in the United States and in many unlike countries around the world.

Herbal Remedy History In A Nutshell

Since prehistory, humans are known to use herbs as remedies for all kinds of ailments and over a thousand species of plants were recorded for their healing properties. A good example is the depiction of plants as healing agents in the Lascaux caves in France which was dated with Radiocarbon dating process and the result revealed that it was made between 13,000-25,000 BCE

Chemical compounds produced in plants especially those made to protect themselves against predators such as toxins and to fertilize such as pollens, are all known to have therapeutic actions to human bodies. Some well known examples are inulin from the roots of dahlias, quinine from the cinchona, morphine and codeine from the poppy, and digoxin from the foxglove.

Today, herbal medicines are categorized as complementary and alternative medicines (CAM). CAMs are becoming very popular but especially so in Europe where CAMs are mainly produced.

There are numerous types of CAMs, but the most popular of all are herbal teas which are made mainly of leaves, roots and barks of plants. Well known herbal teas are chamomile, peppermint and ginger teas.

Second most popular remedy is the herbal tinctures, which are made by soaking the medicinal parts of plants in alcohol extracts and as a result, they can be stored for a much longer period of time. An herbalist can combine many tinctures and made them into one formula for a particular patient. Similarly, fluid extracts of plants are made in the same way as the tinctures, except that they are much stronger.

Powdered herbs and tablets are probably the easiest to consume and nowadays almost every medicinal herb has been made into tablet and capsule forms. However, some traditional herbalists may argue that the process in making tablets and powder which involve heating and drying may reduce the medicinal properties of the plants.

Herbal ointments and essential oils are for external use only. Ointments are used to treat wounds and rashes, while essential oils are used mainly because of their therapeutic scents that are believed to have effects to the human body and mind. This type of therapy is called aromatherapy and is increasingly becoming very popular all over the world.

Herbal remedies have been around for thousands of years and are hear to stay. They provide a great alternative to over the counter medicne at a greatly reduced price. Anyone who is considering to try an herbal remedy should give it a go because the Pro's greatly out weight the Con's.

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The History of Plastics and Plastic Surgery

While the subspecialty of medicine known as Plastic Surgery (one of the 22 recognized specialties of medicine) is now so incredibly common, there are few who would not know what it is. But yet, I will occasionally get asked this question by a new patient during our consultation...'now tell me where the plastic goes'...or...'will the plastic used in the operation get infected?' Indicating that some still believe that the name 'plastic' in Plastic Surgery relates to a material and that plastic surgery operations involve putting in plastic materials.

While the time periods of development for both Plastic Surgery and plastic materials are similar, there is no direct link between the two. Plastic Surgery was not given its name because it used plastic materials in surgery. The Greek word, 'plastikos', whicih means to mold, shape, or give form to is the meaning behind the naming of the medical specialty Plastic Surgery. And this is certainly an accurate description of what Plastic Surgeons do...shape or mold human tissues into recognizeable body parts for either reconstructive (missing) or for cosmetic (existing) purposes. Plastic Surgery organized itself into a formal society in 1931 with the formation of the American Society of Plastic and Reconstructive Surgery, recently condensed to the American Society of Plastic Surgeons. It's first formal training program began several years earlier in 1924 with the establishment of the first plastic surgery residency at Johns Hopkins in Baltimore. Formal board-certification in Plastic Surgery started in 1937 which dramatically raised the standards for the specialty.

Plastic materials developed right around the same time frame as Plastic Surgery. The earliest true thermosetting plastics had their beginning in the late 1800s with the commerically successful product known as Bakelite introduced in Britain in the early 1900s. But DuPont with its polyamide (nylon 66) plastic in the 1930s popularized the material here in the United States. New plastics followed quickly such as polystyrene and polymethyl methacrylate. (acrylic). All these plastic materials become tremendously popular and necessary during World War II as components of many military products such as aircraft canopies and radar units. And here is where Plastic Surgery and plastic materials share yet another similarity...their development was propelled by wars, WWI and WWII. Military conflicts and the need for personal protection (plastic materials) and in the treatment of their war-related injuries (Plastic Surgery) served as a catalyst for both of their developments.

A final sidenote of both of their pre-WWII history is that they similarly converged to deal with a growing problem in the 1930s...motor vehicle accidents. As cars became more common, so did auto accidents and injuries from the shattering of glass windshields. Most commonly, severe facial lacerations resulted from windshields at the time. Plastic surgeons were a loud voice about this problem and spurned manufacturers, such as DuPont and Monsanto, to develope more-shatterproof windshields. As Plastic Surgery performs many huundreds of different operations from the face and throughout the body, very few have ever actually required plastic materials to make the operation successful. While breast and facial implants, which are very common and popular cosmetic operations today do use synthetic materials, they are a silicone-based rubber material. Technically, not a plastic material in the organic chemistry sense. Only the acrylic cranioplasty operation, where a piece of the skull is replaced by a plastic material, is the only procedure in all of Plastic Surgery where a plastic material is actually used. While not as commonly done today, acrylic cranioplasties are still done by some Plastic Surgeons and neurosurgeons as well.