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Carpue’s An Account of Two Successful Operations caused the rebirth of plastic surgery in 1816 over 200 years after the first plastic surgery book was written by Tagliacozzi. Tagliacozzi’s book was pirated with both authorized edition and unauthorized editions having been published in 1597. In his book, Carpue reviewed the literature including Tagliacozzi’s work. Carpue had Charles Turner, engraver-in-ordinary to the King prepare his books illustrations. Comparing Turner’s engraving with those in the original and pirated editions of Tagliacozzi’s book shows that Turner duplicated the pirated edition. The author discovered a pirated edition at St. Bartholomew’s Medical College Library in 1971 that was signed by Carpue and shows how by comparing the illustrations in it with those in Carpue’s book that this was the working copy used by Turner. In 1819 Carpue gave this book to a “B. Turner Jr.” who probably was Turner’s teenage son who later became a surgeon. In 2011 the author discovered an authorized version of Tagliacozzi’s book signed by Carpue at the Lilly Library in Indiana. These books are important links in the history of plastic surgery.
Incunabula are defined as artifacts from the beginning of a period. Bibliophiles define incunabula as books printed before 1501. When plastic surgeons think of incunabula our thoughts turn to surgical instruments such as Gillies’ own needleholder or McIndoe’s own forceps. Incunabula can take other forms, as have two recently discovered incunabula linked to the birth of modern plastic surgery.
Gaspare Tagliacozzi, Professor of Medicine at Bologna, wrote the first text devoted to reconstructive plastic surgery — De Curtorum Chirurgia per Insitionem. Tagliacozzi made no claim of originality in describing techniques for nasal, ear and lip reconstruction. Rather he laid claim to and deserved credit for being the first to describe these methods in print.
The mid-sixteenth century had seen the rise of the Protestant reformation whose doctrine had been spread by the printed word. Concerned by this, the Catholic Church intervened and required that all books be reviewed and approved by the Inquisition before publication.
The Inquisition maintained its authority long after Tagliacozzi died in 1599. For example, not even twenty years after Tagliacozzi’s book was published, Galileo was censured by the Inquisition for his heliocentric view of the universe.
Once a book was approved by the Inquisition a statement to that effect had to appear on its title page along with an official license to print on the obverse page. Despite publishers lacking freedom to publish what they wanted without interference from the Church, another type of publishing freedom prevailed — intellectual piracy. There were no strictly enforced copyright laws and dishonest publishers could pick the intellectual fruits of others without having to pay royalties or fear fines. This fate befell Tagliacozzi and his publisher Gaspare Bindoni Jr., for in the same year 1597, and same city Venice, as his officially approved book was published so too was the pirated version produced by Roberto Meietti.
Only the most audacious pirate charges the same price for his product as the authentic version. Meietti was not that audacious. His book was not an exact duplicate of Bindoni’s. Indeed he proudly placed his name on the title page. Not wishing to run afoul of the Inquisition, Meietti did not attempt to duplicate its seal of approval.
The enterprising pirate creates an inferior product and charges a lower price than the original in order to make his product seem like a bargain. To still earn a healthy profit in the face of a lower price, the pirate must lower his production costs. Meietti lowered his production costs by cutting corners. He used thinner, lower quality paper with narrower margins and smaller fonts so he could squeeze more text on to each page. Thus a complete pirated version had only 148 pages compared to 189 pages in the original.
Meietti’s illustrations were rougher and less detailed than those in the original as can be seen in the accompanying figures (Figure 1, Figure 2).
Figure 1Figure 8 from the Bindoni (authentic) edition 1597. Note the scenery in the window and the folds in the curtain, bed linen and valance. The external ear has a clearly visible antihelical fold, concha and tragus. (Author’s copy.)
Figure 2Figure 8 from the Meietti (pirated) edition 1597. Only a few clouds are visible in the window and the folds of the curtain, bed linen and valance have less detail. The external ear is rudimentary. (Courtesy Queen Mary University of London Library.)
Joseph Constantine Carpue was a scientist, anatomy teacher and surgeon in London. He had previously published books on muscle anatomy and on the effects of galvanic stimulation on muscles. In 1814 Carpue evaluated two British officers with nasal losses and as a scientist and surgeon began preparations for plastic surgery’s first prospective clinical trial. As there was no anaesthesia in Carpue’s time, he had to be as quick as possible so he practiced on 11 cadavers. To document the changes in his patients’ appearance, he had Charles Turner draw his patients before and after surgery. Turner was an associate of the Royal Academy of Art who served as engraver-in-ordinary to the king, and he was best known as the engraver who created mezzotints of J.M.W. Turner’s paintings for popular consumption.
In 1816 Carpue published the results of his clinical trial in “An account of two successful operations for restoring a lost nose from the integuments of the forehead, in the cases of two officers of his majesty’s army: to which are prefixed, historical and physiological remarks on the nasal operation; including descriptions of the Indian and Italian Method”.
An account of two successful operations for restoring a lost nose from the integuments of the forehead, in the cases of two officers of his majesty’s army: to which are prefixed, historical and physiological remarks on the nasal operation; including descriptions of the Indian and Italian method.
To best illustrate Tagliacozzi’s work Carpue had Turner duplicate Tagliacozzi’s figure of his patient wearing a harness.
Note the similarities between Turner’s illustration (Figure 3) and the same figure in the 1597 Meietti edition. It is highly unlikely that an engraver as talented as Turner would omit details from an engraving he had been asked to duplicate and take the identical liberties as had the engraver for Meietti’s pirated edition. It is most likely that Carpue gave Turner the pirated edition from which to copy Tagliacozzi’s case.
Gnudi and Webster believed that Carpue had borrowed Thomas Grenville’s copy of Tagliacozzi as that copy, now found in the British Library, contains a letter from a Major Renell in the book for “his studies [Renell’s] of Tagliacozzi’s work”. This is unlikely for two reasons. First, the letter refers to Carpue in the third person; second, Grenville’s copy was an original Bindoni version. [See discussion Gnudi and Webster pp. 318–9].
Figure 3Charles Turner’s engraving from Carpue 1816. The degree of detail matches the Meietti not the Bindoni edition. Note that the valances in both the Turner and Meietti each have 10 vertical elements but no oblique elements, as does the Bindoni edition. (Author's copy.)
Freshwater MF to Webster JP. Letter August 11, 1971. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 179, Folder 19.
It is now in the Queen Mary’s, University of London Library. There is an inscription on the verso of the front leaf that reads “Mr B Turner Jr from his friend JC Carpue June 6 1819” (Figure 4). A signature on the recto of the front leaf also was dated June 6 1819 (Figure 5).
Figure 4Inscription on the verso side of the front leaf of the St. Bartholomew’s copy of the Meietti. It reads: “Mr B Turner Jr from his friend JC Carpue June 6 1819”. (Courtesy, Queen Mary University of London Library.)
Figure 5Inscription on the recto side of the front leaf of the St. Bartholomew’s copy of the Meietti. It reads: “C.B. Turner 6/6.19.” (Courtesy, Queen Mary University of London Library.)
A search of all registries and rolls of physicians and surgeons who practiced in England in the early 19th century did not yield the name of any Charles Turner or B. Turner Jr. But according to the Dictionary of National Biography, Charles Turner married Anne Maria Blake and they had a son named Charles who became a surgeon. He was born in 1803 and died in 1826.
The 2004 online version of the Dictionary of National biography gave Charles Turner’s birth and death years; the 1909 print edition did not name him but stated that he was a surgeon.
The signature in Figure 5 is probably that of Charles Blake Turner who went by the name C. Blake Turner Jr to distinguish himself from his father. It is ironic that the link between Tagliacozzi and Carpue was a pirated version of the former’s book.
If Carpue gave away his working copy of Tagliacozzi’s book, did he own another? This year, by doing a Google search of “Tagliacozzi” images I located an authentic version of Tagliacozzi’s book with Carpue’s signature on the title page. It is at the Lilly Library of Indiana University having been donated by J.K. Lilly, Jr. Its provenance is unknown (Figure 6).
Figure 6Title page of the Bindoni (authentic) edition 1597. Note Carpue’s signature in the upper left corner. The two lines of red text above the publishers seal are the Inquisition’s permission. (Courtesy, The Lilly Library, Indiana University, Bloomington, Indiana)
An account of two successful operations for restoring a lost nose from the integuments of the forehead, in the cases of two officers of his majesty’s army: to which are prefixed, historical and physiological remarks on the nasal operation; including descriptions of the Indian and Italian method.
Freshwater MF to Webster JP. Letter August 11, 1971. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 179, Folder 19.
☆Meeting Information: Presented in part as an e-poster the 16th Congress of the International Confederation of Plastic Reconstructive and Aesthetic Surgery, Vancouver May 2011.
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