Sushruta, Ancient Indian Surgeon and Father of the Nose Job

If you were a petty criminal, a prisoner of war, or an adulterous woman in the ancient world, you might have had the tip of your nose cut off as a punishment [PDF]. But rather than walking around disfigured, if you had the means—and lived in ancient India—you might have had your nose reconstructed thanks to an ancient surgical method espoused by the Indian physician and surgeon Sushruta.

There's some debate around whether Sushruta was a real individual or a legendary figure. Said to have been the son of a sage who lived around 600 BCE, he's primarily known today for the classic treatise Sushruta Samhita, or Compendium of Sushruta. The treatise is considered one of the foremost achievements of Indian medicine, and went on to influence the West. Along with Charaka and Vagbhata—two other possibly legendary authors of key texts—Sushruta is honored in India as one of the "Triad of Ancients."

The Sushruta Samhita describes more than a thousand diseases (including a very early awareness of diabetes), and about 650 types of drugs. The text includes a special focus on surgery, which it considers the apex of the healing art. The roughly 300 surgical procedures it describes include cataract surgery, the removal of bladder stones, hernia repair, eye surgery, and Cesarean sections. The treatise also describes how to control bleeding, set broken bones, use wine and other drugs to anesthetize the patient, and employ large ants as wound clips (apparently, their strong mandibles can close a gash in lieu of stitches). The text also stresses the importance of cleanliness in both surgeons and their instruments—safeguards Europe wouldn’t adopt for the better part of two millennia.

But the most famous part of the text is its technique for repairing and recreating a nose, known today as reconstructive rhinoplasty. Sushruta recommended using a long, broad "leaf of a creeper" as a template for cutting a flap of skin from the cheek or forehead. After scarifying the flap with a knife, the skin was then placed over the missing nose, after which "the coolheaded physician should steadily tie it up with a bandage decent to look at," the text says. Two small pipes—reeds or tubes from the castor oil plant—were inserted into the nostrils to facilitate breathing. The nose was then dusted with medicinal powders, enveloped in cotton, and sprinkled with sesame oil.

An 1816 image from a nose surgery using the Indian method
An image from J.C. Carpue's "An account of two successful operations for restoring a lost nose," 1816

Sushruta’s knowledge took a long time traveling west. The Sushruta Samhita was translated into Arabic around the 8th century CE, and that version may have arrived in Europe before the Renaissance; Sushruta’s techniques were apparently known to surgeons in Italy in the 1400s and 1500s. The Indian method for repairing a nose was then lost to Western medicine for a couple of hundred years, although of course Indian surgeons continued to practice it.

Then, in 1793, two British surgeons observed the procedure being carried out on a cart driver who had been taken prisoner by a sultan in the Third Anglo-Mysore war, and an acquaintance of theirs published an account of the surgery in London's Gentleman's Magazine the following year. A British surgeon named Joseph Constantine Carpue read about the procedure, and practiced it on cadavers for 20 years before performing the operation (successfully) on a patient in 1814. His subsequent publication popularized the procedure in Europe, and by the 1830s the technique had made it to the United States.

Sushruta is widely honored in India today. The country boasts several statues of him, and his image is on the seal of the Association of Plastic Surgeons of India. A version of his procedure, often called the Indian method, is still one of the preferred ways of repairing noses around the world.

Lady Death: Lyudmila Pavlichenko, the Greatest Female Sniper of All Time

Soviet sniper Lyudmila Pavlyuchenko
Soviet sniper Lyudmila Pavlyuchenko
Ozerksy/AFP/Getty Images

For Lyudmila Pavlichenko, killing Nazis wasn't complicated. “The only feeling I have is the great satisfaction a hunter feels who has killed a beast of prey,” she once said of her job.

But Pavlichenko wasn’t just any soldier: She was the most successful female sniper in history, and one of the most successful snipers, period. As a member of the Soviet Army during World War II, she killed 309 Nazis, earning the sobriquet “Lady Death.” She also became a public figure who toured North America and Britain, befriended Eleanor Roosevelt, and spoke candidly about gender equality—especially when she was fed up with American reporters.

Pavlichenko was born in 1916 in Bila Tserkva, a village near Kiev, Ukraine, then part of the Russian Empire. As a girl, she was boisterous and competitive. In her early teens, she moved with her parents—a government employee and teacher—to Kiev. After hearing her neighbor’s son brag about his shooting skills, she joined a local shooting club. “I set out to show that a girl could do as well [as him],” she later explained. "So I practiced a lot."

Besides being an amateur sharpshooter, the teenaged Pavlichenko worked in an arms factory. At around 16 years old, she married a doctor and gave birth to a son, Rostislav, but the marriage was short-lived. She then went on to study history at Kiev University starting in 1937, while also enrolling in a sniper school on the side.

When German forces invaded the Soviet Union in 1941, Pavlichenko felt called to action. She left school, hoping to volunteer for the Red Army’s 25th Rifle Division.

The only problem? She was a woman. At the time, women in the Soviet military were largely relegated to support roles—not combat ones [PDF].

Army leaders initially wanted Pavlichenko to be a nurse. After some pleading with a registrar, she was able to join as a sniper because of her training. However, a lack of guns meant that she at first helped dig trenches instead. She wrote in her memoirs, “It was very frustrating to have to observe the course of battle with just a single grenade in one’s hand." Eventually, a colleague wounded by a shell splinter passed his rifle over to Pavlichenko when he was too injured to use it. Weeks later, she shot two Romanian soldiers a quarter-mile away, which served as a “baptism of fire,” she later wrote, and led to her being accepted by her comrades as a full-fledged sniper.

Soviet sniper Lyudmila Pavlichenko in 1942
Lyudmila Pavlichenko in 1942
Ozerksy/AFP/Getty Images

Pavlichenko became one of over 2000 female Soviet sharpshooters who eventually fought in World War II (although female soldiers were still just 2 percent of the Red Army's total number). Pavlichenko killed hundreds of enemy combatants in Odessa, Moldavia, and Sevastopol. “We mowed down the Hitlerites like ripe grain,” she later said. Eventually promoted to sergeant and lieutenant, she spent months in battle killing scouts, officers, and at least 36 enemy snipers from Germany and other Axis countries.

Pavlichenko was so determined that even shell shock and multiple wounds from enemy fire didn’t deter her. Neither did bribes: After German soldiers learned of her shooting prowess, they tried to turn her against her country by offering chocolate and the promise of an officer rank in the German army. When she didn’t fall for it, Germans threatened to tear her into 309 pieces, her number of confirmed kills. The offer reportedly delighted her, since it meant her tally was widely known—yet her resolve didn't waver.

But after shrapnel hit Pavlichenko in the face in the summer of 1942, Red Army leaders withdrew her from combat and assigned her to train novice snipers. She was also given another role: wartime propagandist.

In late 1942, Pavlichenko traveled to the United States to galvanize support for sending more American troops to Europe. One of her first stops was the White House, which she became the first Soviet citizen to visit. She met with President Franklin Roosevelt and Eleanor Roosevelt, and the sniper and the first lady hit it off: Eleanor Roosevelt invited Pavlichenko on a tour of the country to talk about her experiences in combat.

Speaking through a translator to crowds that sometimes swelled to thousands, Pavlichenko discussed her childhood and triumphs as a sniper. “I am 25 years old and I have killed 309 fascist occupants by now,” she reportedly told one group in Chicago. “Don’t you think, gentlemen, that you have been hiding behind my back for too long?”

The American press, however, had trouble taking Pavlichenko seriously. They described her as a "Girl Sniper," and focused on her physical appearance, disparaging her bulky green army uniform and minimal makeup. Instead of asking about her skills with a rifle, reporters questioned her about nail polish, hair styles, and whether female Soviet soldiers could wear makeup in battle. “There is no rule against it,” she replied. “But who has time to think of her shiny nose when a battle is going on?”

Pavlichenko soon tired of the questions. As she explained to one interviewer:

"I am amazed at the kind of questions put to me by the women press correspondents in Washington. Don't they know there is a war? They asked me silly questions such as do I use powder and rouge and nail polish and do I curl my hair? One reporter even criticized the length of the skirt of my uniform, saying that in America women wear shorter skirts and besides my uniform made me look fat. This made me angry. I wear my uniform with honor. It has the Order of Lenin on it. It has been covered with blood in battle. It is plain to see that with American women what is important is whether they wear silk underwear under their uniforms. What the uniform stands for, they have yet to learn."

Comparing gender equality in the U.S. and Soviet Union, she also told crowds: “Now [in the U.S.] I am looked upon a little as a curiosity, a subject for newspaper headlines, for anecdotes. In the Soviet Union I am looked upon as a citizen, as a fighter, as a soldier for my country.”

Pavlichenko eventually returned to the Soviet Union to continue training other snipers, after other publicity stops in Canada and Great Britain. Despite a relatively privileged position as a heroic figure there, she struggled with the lasting effects of her injuries and personal demons: alcoholism, what today we might call post-traumatic stress disorder, and the memories of a romantic partner who had died on the frontlines, in her arms, in early 1942.

When the war ended, Pavlichenko earned her history degree from Kiev University and worked as a historian for the Soviet Navy. In 1957, she reunited with Eleanor Roosevelt when the former first lady visited Moscow and stopped by Pavlichenko’s apartment. While the pair were at first reserved in the presence of a Soviet minder, Pavlichenko soon made an excuse to pull Roosevelt into another room. She reportedly threw her arms around the former first lady while the pair reminisced about their experiences 15 years earlier.

Pavlichenko died in Moscow in 1974, at age 58. The Soviet Union honored her with multiple medals and two postage stamps. A joint Ukrainian-Russian feature film, Battle for Sevastopol, was made about her in 2015, and her memoirs, Lady Death: The Memoirs of Stalin's Sniper, was published in English for the first time earlier this year. Pavlichenko also lives on in Woody Guthrie's 1942 song, “Miss Pavlichenko.” It includes the lyrics:

Miss Pavlichenko's well-known to fame
Russia's your country, fighting is your game
The world will always love you for all time to come,
300 Nazis fell by your gun
.

Mary Frith, 17th-Century London's Smoking, Thieving, Foul-Mouthed "Roaring Girl"

One of early modern Britain's most memorable underworld characters, Mary Frith flouted convention at every turn. Far from being the weak, timid woman who stayed at home taking care of children as Elizabethan ideals demanded, she took to the streets and stage, making a spectacle of herself that earned both official opprobrium and not a little public admiration.

Mary was making a name for herself while she was barely out of her teens. Born circa 1584 near St. Paul's Cathedral in London as the only child of a shoemaker and a housewife, she acquired a reputation as a tomrig (tomboy) or hoyden (boisterous girl) in her neighborhood. The Newgate Calendar—a series of 18th- and 19th-century criminal biographies named for Newgate prison in London—would later relate:

"She was above all breeding and instruction. She was a very tomrig or hoyden, and delighted only in boys' play and pastime, not minding or companying with the girls. Many a bang and blow this hoyting procured her, but she was not so to be tamed, or taken off from her rude inclinations. She could not endure that sedentary life of sewing or stitching; a sampler was as grievous to her as a winding sheet [burial shroud]; and on her needle, bodkin and thimble she could not think quietly, wishing them changed into sword and dagger for a bout at cudgels."

By age 16, Mary had already kicked off her career as a thief. She was arrested on August 26, 1600, suspected of having nicked someone's purse at Clerkenwell in central London. Two other girls were arrested for the crime as well, suggesting the three were working as a gang. Though Mary confessed at the subsequent trial, she was found not guilty, and it wasn't long before she was busted again for theft: In March of 1602, she was prosecuted for having taken "a purse with XXVs [25 shillings] of Richard Ingles."

Mary's father's brother was a minister and, noticing his niece's penchant for trouble, reportedly arranged a spot for her on board a ship headed for the New World. But Mary refused to make the trip: It's said that she jumped overboard while the ship was still in the harbor and swam back to shore. After that, she resolved to never go near her uncle again, and began hanging out in the seedier areas of London. She made a decent living there as a pickpocket, and over the course of her career, reportedly had her hand burned at least four times—a then-common punishment for theft.

Soon, Mary's occupation led her to acquire a nickname: She was known on the streets as Moll Cutpurse, for the purse strings she slashed. Moll was a double entendre: Not only was it a nickname for Mary, it also was a term for a disreputable young woman, e.g., a gangster's moll.

It was around this time that Mary started wearing men's clothing, a practice she continued for the rest of her life. Although doing so was unusual, Mary wasn't the only woman of her day who wore men's garb; it was something of a fad among young, lower-class women who frequented London's theaters and brothels in the 1600s. These ladies, colloquially called Roaring Girls—a play on roaring boys, males who would holler at and bully passers-by—were also known to crop their hair and carry swords, as Mary did.

But Mary's choice of clothing carried consequences—King James was incensed by the cross-dressing fad—and on Christmas Day of 1611, she was arrested and sent to Bridewell Prison. She was tried for "wearing indecent and manly apparel." After her sentence was served, she was made to wear a white sheet at the open-air pulpit of St. Paul's Cross during the Sunday sermon, which was meant to humiliate her. Mary wasn't the least bit ashamed, though, as recorded in her claimed autobiography (although the extent to which she wrote these words herself is debated by historians):

"They might as soon have shamed a Black Dog as Me, with any kind of such punishment; for saving the reverence due to those who enjoined it, for a half-penny I would have Traveled to all the Market Towns in England with it, and been as proud of it as that Citizen who rode down to his Friends in his Livery-Gown and Hood."

By then Mary had become a figure of local notoriety. In fact, two plays had already been written with her as the protagonist: John Day's The Madde Pranckes of Mery Mall of the Bankside in 1610 and The Roaring Girl or Moll Cutpurse by Thomas Middleton and Thomas Dekker the following year (a theatrical hit in which she made a cameo, possibly becoming the first English woman to perform in a public theater). Of the public penance at St. Paul's in 1612, the writer John Chamberlain penned to Dudley Carlton: "She wept bitterly and seemed very penitent, but it is since doubted she was maudlin drunk, being discovered to have tippled of three-quarts of sack [white fortified wine].”

So generally unashamed was Mary that—according to legend—when her friend the showman William Banks dared her to ride about three miles from Charing Cross to Shoreditch dressed as a man on his famous dancing horse, Marocco, she accepted the bet of 20 pounds—but not before she got herself a trumpet and a banner, just to make sure no one missed her. Mary later said that as she rode, she pretended to be "Squiresse to Dulcinea of Tobosso," and that the journey was a lark until she reached Bishopsgate, with a mile left to go, whereupon:

" … passing under the Gate a plaguey Orange Wench knew me, and no sooner let me pass her, but she cried out! Mal Cutpurse on Horseback, which set the people that were passing by, and the Folks in their Shops a hooting and hollowing as if they had been mad; winding their cries to this deep note, 'Come down thou shame of Women or we will pull thee down.'

"I knew not well what to doe, but remembering a Friend I had, that kept a Victualling House a little further, I spurred my Horse on and recovered the place, but was hastily followed by the rabble, who never ceased cursing of me, the more soberer of them laughing and merrily chatting of the Adventure …

"So came late into Shoreditch, where I paced the same way back again to the winning of my Wager, and my great Content, to see my self thus out of danger, which I would never tempt again in that nature."

A drawing of Mary Frith from the title-page of The Roaring Girl
Wikimedia Commons // Public Domain

Part of Mary's fame also came from the fact that she smoked a pipe, which was considered exclusively a man's pursuit in the 1600s. It became her signature, and today she's thought of as England's first female smoker. Hanging around tobacco shops seems to have inspired another of her salacious-for-the-era hobbies: playing the lute in public. In 1611, she even debuted on the lute at the Fortune Theater playing bawdy songs.

Around the age of 30, Mary seems to have made a move toward settling down. She married Lewknor Markham (possibly a son of Gervase Markham, a noted author of poetry and cookbooks) in 1614. But historians think it was probably a ruse, set up to give her a means of defending herself in court when she was defamed as a spinster. Although it was often said that women who dressed in men's clothing were "sexually riotous," according to later biographies Mary herself purportedly had no interest in sex, be it with men or women.

After spending years in and out of jail for petty theft, Mary also began working as a fence—a buyer and seller of stolen goods—which was a much less dangerous job than being a pickpocket. She set up a pawn shop of sorts in her house, where she’d store her purchases, then sell them back to their original owners at a profit. She also supposedly acted as a pimp, finding young women for men as well as male lovers for married women, sometimes using her own house as a brothel. From these gigs, she amassed a healthy income and invested it in her home, which has been described as “surprisingly feminine” and was decked with mirrors all over, to stroke her vanity. She employed three full-time maids and kept mastiffs and parrots, doting especially on the dogs—each one had its own bed with sheets and blankets, like a human's.

But working as a fence may have grown boring for Mary, because during the early 1640s she supposedly made another career switch, becoming a highway-woman who held up travelers at gunpoint. Despite her decades-long criminal lifestyle, she also supposedly became a Royalist, siding with the king and against the Parliamentarians in the English Civil War. In her purported autobiography, she claims to have genuflected before the king when other "Saucy Rogues" wanted him dead, and brags that she was the "onely declared person in our street against the Parliament." Whether she truly supported the monarchy is a subject of debate—some historians believe the story is nothing more than posthumous myth-making, while others argue it's largely accurate, and that she may have supported the monarchy because they "were not as inclined to legislate morality."

Mary doesn't seem to have worked as a highway-woman for long (if she did at all), and disappeared from public view for several years. In 1644, at aged 60, she was released from Bethlem Hospital, a.k.a. Bedlam, London's famous psychiatric asylum, having been allegedly cured of insanity.

She died of dropsy (now known as edema) on July 26, 1659. The Newgate Calendar said of her death: "Moll being grown crazy in her body, and discontented in mind, she yielded to the next distemper that approached her, which was the dropsy; a disease which had such strange and terrible symptoms that she thought she was possessed, and that the devil had got within her doublet."

Her will, written as Mary Markham, lists several benefactors, none of which were her husband (he may have died earlier). She also adopted a practice that was common for widows and spinsters of the time, naming a woman to execute her will—in this case, her niece Frances Edmonds. She was buried in the churchyard of St. Bride's on Fleet Street, having instructed Edmonds to pay extra for her to be interred among the rich and prestigious. Although it was destroyed in the Great Fire of London in 1666, her marble headstone reportedly bore an epitaph by the poet John Milton, who was a fan of hers:

"Here lies, under this same marble,
Dust, for Time's last sieve to garble;
Dust, to perplex a Sadducee,
Whether it rise a He or She,
Or two in one, a single pair,
Nature's sport, and now her care.
For how she'll clothe it at last day,
Unless she sighs it all away;
Or where she'll place it, none can tell:
Some middle place 'twixt Heaven and Hell
And well 'tis Purgatory's found,
Else she must hide her under ground.
These reliques do deserve the doom,
Of that cheat Mahomet's fine tomb
For no communion she had,
Nor sorted with the good or bad;
That when the world shall be calcin'd,
And the mixd' mass of human kind
Shall sep'rate by that melting fire,
She'll stand alone, and none come nigh her.
Reader, here she lies till then,
When, truly, you'll see her again."

However, like much of her life, the true story of her epitaph may never be known.

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