The author, a Senior Research Associate in Surgery at University College London, divides the discussion chronologically and logically starting with mythological transplantation in the ancient world in the Prologue, then chapters dealing with skin in the ancient world and dark ages when noses were often reconstructed after being lost in conflicts (and later from syphilis), then Blood, first from animal to animal, then from animal to humans, then Teeth, then Organs -kidneys and hearts. There are no separate chapters for the numerous other organs that are now routinely transplanted, including livers, lungs, corneas, pancreases, islet cells, heart valves (usually from pigs), corneas, bowels, bone marrow, and stem cells. And the old adage that xenotransplantation (transplanting animal organs into humans) is just around the corner and always will be is no longer true, with some limited successes.
Many pioneers in transplantation were masters of self deception, seeing the impossible results that they hoped to see, such as the success of Europeans grinding up and eating dried skin of Egyptian mummies restoring their youthful appearances. The power of the placebo effect was not widely appreciated until the 1950s.They skirted issues of ethics such as the cruelty of vivisection, the economics of sale of organs, and use of organs from executed prisoners, some of which still plague transplant medicine in places.
In the mid 1600s there was intense rivalry between the English and the French over animal to human blood transfusion with opponents of interfering with the natural life forces symbolized by blood in both groups. Rivalry for the fame to be first continues to plague and impede progress in most areas of most sciences.
“ But 17th century transfusions were never supposed to provide a replacement for lost blood. The blood itself, still entangled with ancient humoral and religious ideas, was rather a vehicle for something “intangible and unquantifiable like youth, meekness or strength.”
Old vigorous philosophical debates about vitalism vs mechanical explanations of life that have wide implications are discussed in some detail here. Is the soul separate from the body? Pessimistic Hobbesian views of men lacking authoritarian control, even of their thought processes, living lives that were “solitary, poor, nasty, brutish, and short” crept into all developing fields of science with restrictions handed down through rigid hierarchy and church dogma, limiting what one was permitted to research or even think about.
“…during this time we went from seeing ourselves as essences to seeing ourselves as compositions.” Who “owns” my body?
The 54 page long chapter on teeth provides an intro to the world of the history of dentistry, first with dispensing of the belief in the nonexistent tooth worm as the cause of all dental problems. The cosmetic use of transplanted teeth from animals, poor children, and serfs to enhance the smile of both French and English social climbers in the early 1700s, presages the frowned-upon modern practice of selling organs for pecuniary gain. The 18th century also was when the separation of dentistry from mainstream medicine became established. Many “tooth drawers” were charlatans of various dubious backgrounds, performing extractions in public displays for profit. In view of these ethical considerations, the fact that few dental transplants worked seems irrelevant.
The fame and esteem of the collaborators Alexis Carrel of the famous Carell vascular patch fame and Charles Lindbergh in developing an organ perfusion pump, the precursor of the heart lung machine, is marred by their 1936 mutual enthusiasm for Nazism, racism, and eugenics.
I encountered dozens of familiar names from the history of medicine, going back to Galen, and learned details about them never taught in my history of medicine course. I was a tad disappointed that there was only one sentence about liver transplantation, the most technically challenging of all transplants.
I once met the late haughty, egocentric, playboy, Christiaan Barnard on his 1969 world lecture tour, touting his as the first human heart transplant, and got to know the humble and gracious Sir Roy Calne at liver conferences and on his visits to his illustrious former trainee, my colleague, Dr. Bill Wall at Western.
This is a very enlightening scholarly book on a subject dear to my heart. (Oops! There is one of many ingrained phrases falsely identifying the heart is the seat of emotions.)
⭐️⭐️⭐️⭐️
Thanks, Alana.
The Passionate Reader 