Nobody nose

Leonardo Fioravanti was a celebrated – and later infamous – Italian doctor of the sixteenth century. You’ll find little information about him online, which is a shame, because his was a fascinating career. Like many Renaissance thinkers he did not restrict his investigations to one field but ranged widely across the arts and sciences, from philosophy to astrology, biology to alchemy.

Fioravanti portrait
Leonardo Fioravanti (1517–88)

According to Galenic doctrine the human body was full of humours, but when Fioravanti attended public dissections he ‘never saw phlegm, choler, melancholy, or vital spirits, or any of those fabulous things that the physicians dream up.’ Rejecting what he had been taught, he spent the rest of his career in an unsuccessful search for a panacea, a remedy for all ills.

Fioravanti was shunned by much of the medical establishment for his heretical views. But he was a charismatic figure, and always had his supporters. His surviving works leave no doubt that he was a man of strong opinions, and not above misleading his readers if it suited him. As Fioravanti’s biographer William Eamon records in his book The Professor of Secrets:

I found myself frowning in disbelief at how brazenly he [Fioravanti] would exaggerate, hide, or make the same facts serve different ends as the occasion suited him.

So Fioravanti was not necessarily a reliable narrator; but he also may have been the first surgeon to record a successful operation to reattach a severed part of the body. In a book on surgery first published in 1570, he tells this extraordinary tale. This translation was published in London in 1651, in a compilation of Fioravanti’s works entitled Three Exact Pieces of Leonard Phioravant:

nose cut off

In that time when I was in Africa, there happened a strange [thing] and that was this:

A certain gentleman, a Spaniard that was called Signor Andreas Gutiero, of the age of 29, upon a time walked in the field, and fell at words with a soldier, and began to draw.

By which Fioravanti means that he drew his sword from its scabbard; Signor Gutiero did not produce paper and pencil and start to sketch.

The soldier, seeing that, struck him with the left hand, and cut off his nose, and there it fell down in the sand.

Fioravanti witnessed this argument and its dramatic denouement – so was on hand to treat the unlucky loser. He immediately bent down to recover the severed nose, in the hope that he might be able to reattach it. Naturally he intended to clean it first:

Then I happened to stand by and took it up, and pissed thereon to wash away the sand, and stitched it on again very close, and dressed it with our balsamo artificiato.

Yup, he urinated on a severed body part before reattaching it. Was this a sensible thing to do? It’s quite possible that in the circumstances it was the best way of cleaning it. While human urine isn’t actually sterile (as doctors believed until quite recently), it is less alive with bacteria than untreated water from an African stream or the drinking bottle of a sixteenth-century soldier.

The balsam artificiato (‘artificial balm’) was Fioravanti’s own concoction. Elsewhere in the book he gives detailed instructions for preparing it. The ingredients include turpentine, gum Arabic, cloves, cinnamon, nutmeg and ginger, which were to be mixed, left to rest for a week and then carefully distilled. Several fractions would then be driven off successively; one of the later (and therefore heavier) liquids thus extracted was the ‘artificial balm’, which Fioravanti says should be ‘kept as a precious jewel’:

The artificial Balm is a miraculous liquor, for if any have the stitch in the side, and take two scruples thereof, it presently will help him. It is also good against the cough, and catarrh, and coldness in the head and stomach, and for wounds in the head… And to be short, I know no disease, neither hot, nor yet cold, but that this Balm doth good unto…so that I have found in this precious liquor such great virtues that I am not able to declare them all.

Quite a recommendation. This miraculous substance was placed around the wound, and a dressing placed over the nose to keep it in place:

I bound it up, and so let it remain eight days, thinking that it would have come to matter; nevertheless, when I did unbind it, I found it fast conglutinated…

i.e., united.

…and then I dressed it only once more, and he was perfectly whole, so that all Naples did marvel thereat, as is well known, for the said Signor Andrea doth live yet and can testify the same.

That simple story is, it transpires, the earliest recorded case of a severed nose being reattached. And here’s the second oldest. In a book published in 1679, the Danish physician Henrik Møinichen records an incident that had taken place more than half a century earlier, in 1625:

Antonius Molinetti testified in a public lecture at Padua that his father, a famous Venetian surgeon, had reattached the nose of a criminal which had been cut off in public as a punishment: it was taken to him in the middle of a warm loaf, and he immediately sutured it back on.

This story and Fioravanti’s are the earliest two reports of free grafting – the reattachment of body parts previously severed from the body – in the medical literature. It is, of course, impossible to be sure that either of them really happened. But the details are so colourful (the warm bread! the pissing!) that many readers probably won’t care.

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