Medizinische Ästhetik: Kosmetik und plastische Chirurgie zwischen Antike und früher Neuzeit (review)

The history of aesthetic (cosmetic) surgery is both a well-plowed and a fallow field. The huge bibliographies compiled since the nineteenth century have well prepared the ground: any scholar who enters the field has a canon of texts available at his or her finger tips. Thus a wide number of historical studies of this surgical specialty covering the "modern" period (i.e., from the eighteenth century to the present) have appeared over the past decade, including two books by this reviewer: Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery (1998) and Making the Body Beautiful: A Cultural History of Aesthetic Surgery (1999). Yet there is one area of scholarship that has been clearly understudied—namely, the history of aesthetic surgery from the ancient world to the early modern period.

Mariacarla Gadebusch Bondio's new book on "medical aesthetics" remedies this gap. This is the first serious, systematic study of the meaning of "beauty" in Galenic and post-Galenic medicine based on a serious look at the history of reconstructive and aesthetic surgery in this world. The study is exhaustive. Beginning with the legacy of Greek medicine, Bondio seeks to show the centrality of notions of beauty in the context of defining the "normal." Her more detailed work on "Renaissance" medicine (which is the core of the book) builds on the reception of these concepts. With detailed chapters on the "ars decoratoria," looking at the works of Falloppio, Mercurilae, and Minadoi, she seeks to establish a pattern of aesthetics within early modern medicine. In this she is very successful. In teasing out inherent differences in positions from the claims for a "natural" beauty in Falloppio to the relativism of beauty in Minadoi, she shows how these positions seem to prefigure the better-known debates on beauty in the Enlightenment. By far the most striking application of these debates is in a short chapter on the aesthetics of obesity (pp. 120–25) that reads almost too much like a rehash of our contemporary medical debate on beauty and fat bodies.

Bondio's survey of the "ars reparatoria"—the surgical reconstruction of the body and the reconstitution of individual "happiness"—is by far the most sophisticated work on Gaspare Tagliacozzi and his reception in decades. Here, in full disclosure, I must reveal that she takes on my claim, and that of early twentieth-century historians of aesthetic surgery, that the syphilis "epidemic" of the early modern period fueled the interest in (and caused the suppression of) the surgical techniques championed by Tagliacozzi. She quite correctly notes that the manuals of surgery do not make express reference to the symptoms of this disease as the core motivation for surgical intervention ("You have no nose! We know what you were doing that you have no nose!"). In defense of my position, I might note that very rarely is an etiology of the "wound" noted in handbooks of early modern surgery; they are, for the most part, technical manuals of "how to" do specific procedures. Given that syphilis from its initial (re)appearance (I am covering both claims as to its origin) in the sixteenth century was highly stigmatized, it is of little surprise that once it had mutated and did not cause death relatively quickly, interventions to ameliorate the results of the infection were not publicly advertised. Yet it is clear from the popular, nonmedical literature that the surgical intervention (the flap graft) that Tagliacozzi popularized (but did not invent) was understood as the "remedy" for such visibility. Both my position and that of Bondio are possible readings of the historical record: mine in light of the general, popular reading of the reception of the disease, and Bondio's in light of her reading of the technical literature. In general her book represents such historiographic debates with accuracy and fairness. It is a...