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Muslim Heroes
on Screen
Daniel O’Brien
Muslim Heroes on Screen
 Daniel O’Brien

Muslim Heroes
on Screen
Daniel O’Brien
Southampton, UK

ISBN 978-3-030-74141-9    ISBN 978-3-030-74142-6 (eBook)

https://doi.org/10.1007/978-3-030-74142-6

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer
Nature Switzerland AG 2021
This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights of
translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar methodology now
known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information
in this book are believed to be true and accurate at the date of publication. Neither the
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Cover illustration: ARCHIVIO GBB / Alamy Stock Photo

This Palgrave Macmillan imprint is published by the registered company Springer Nature
Switzerland AG.
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
 Acknowledgements

I would like to thank:

Professor Michael Williams at the University of Southampton for pro-
viding valuable feedback during the early stages of this project;
Assistant Professor Ghassan Moussawi at the University of Illinois for
reviewing the introductory pages during the later stages of prepara-
tion; and
Gary Kramer for his heroic task of reading various chapter drafts and for
his comments that invariably sharpened my thinking.
Thanks also to Lina Aboujieb and Emily Wood at Palgrave Macmillan,
and Jasper Asir at Springer Nature.
Much gratitude to my parents, Susannah and Raymond O’Brien, who
indulged my childhood obsession with the films of Ray Harryhausen.
A final note of gratitude to the late Kerwin Mathews, whose portrayal
of Sinbad in The 7th Voyage of Sinbad provided the initial impetus for
this book.

v
 Contents

1 Introduction  1

2 Thieves of Bagdad: The Cinematic Metamorphosis of an

Islamicized Hero 33

3 The Voyages of Sinbad: From Hollywood Cartoon Stooge

to Global Fantasy Icon 67

4 Moutamin and the Mahdi: The Honourable Muslim

Ally/Enemy in El Cid and Khartoum117

5 Saladin: The West’s Favourite Muslim?145

6 Representing the Unrepresentable: Muhammad, The

Message, and South Park185

vii
viii Contents

7 Epilogue: ‘The baraka has not deserted me’—American

Expansionism and Muslim Resilience in The Wind and the
Lion205

Bibliography217

Author Index237

Subject Index245
 List of Figures

Fig. 1.1 The Adventures of Prince Achmed (1926) 10

Fig. 2.1 The Thief of Bagdad (1924) 43
Fig. 2.2 The Thief of Bagdad (1924) 45
Fig. 2.3 The Thief of Bagdad (1940) 54
Fig. 2.4 The Thief of Bagdad (1940) 55
Fig. 2.5 The Thief of Bagdad (1940) 56
Fig. 3.1 Invitation to the Dance (1956) 83
Fig. 3.2 The 7th Voyage of Sinbad (1958) 89
Fig. 3.3 The 7th Voyage of Sinbad (1958) 91
Fig. 3.4 Captain Sindbad (1963) 96
Fig. 3.5 The Golden Voyage of Sinbad (1973) 104
Fig. 3.6 The Golden Voyage of Sinbad (1973) 106
Fig. 3.7 Sinbad and the Eye of the Tiger (1977) 110
Fig. 4.1 El Cid123
Fig. 4.2 El Cid123
Fig. 4.3 Khartoum138
Fig. 4.4 Khartoum140
Fig. 5.1 The Crusades (1935) 159
Fig. 5.2 The Crusades (1935) 161
Fig. 5.3 King Richard and the Crusaders (1954) 165
Fig. 5.4 King Richard and the Crusaders (1954) 167
Fig. 5.5 Kingdom of Heaven (2005) 178
Fig. 6.1 The Message (1976) 197
Fig. 7.1 The Wind and the Lion (1975) 212
Fig. 7.2 The Wind and the Lion (1975) 213

ix
 CHAPTER 1

Introduction

Films drawing on Middle Eastern or Arabian tropes and characters have

been a recurrent aspect of Euro-American cinema since the silent era.
Many of these early productions feature heroes marked as both Western
and white, such as Rudolph Valentino’s The Sheik (1921). There is, how-
ever, a counter-tradition of protagonists who, though usually played by
actors of European descent, are explicitly portrayed as ‘Other’ to Euro-­
American audiences. Yet these characters exhibit few of the problematic
traits this label routinely confers. Whether derived from folklore, such as
Sinbad, or history, notably Saladin, these figures are often conflated with
a wider cycle of ‘Arabian Nights’ fantasies that highlight ‘exotic’ spectacle
and are generally regarded as either escapist entertainment of negligible
importance or pernicious examples of ‘brownface’ and/or ‘whitewash-
ing’. This book makes the argument that Euro-American screen depic-
tions of Sinbad, the Thief of Bagdad, and other Arab-identified heroes are
more complex and nuanced than such limited readings allow. This is espe-
cially the case in terms of the multitudinous, ever-shifting concepts and
assumptions that inform their Muslim identity as Western filmmakers cre-
ate it.1 My concern is not so much the accuracy of this conferred status,

1
In fact, the majority of the global Muslim population are Indian, Pakistani, Indonesian,
Malaysian, or Bangladeshi. Yet Euro-American cinema and media discourse in general have
made the terms ‘Arab’ and ‘Muslim’ virtually synonymous (cf. Shaheen 4; Gottschalk and
Greenberg 5).

© The Author(s), under exclusive license to Springer Nature 1

Switzerland AG 2021
D. O’Brien, Muslim Heroes on Screen,
https://doi.org/10.1007/978-3-030-74142-6_1
2 D. O’BRIEN

but the extent to and manner in which it imbues their overall representa-
tion that is notably at odds with the majority of screen Muslims who are
often rendered as bystanders, victims, or antagonists. I contend that these
characters, however Westernized, possess a cultural significance which
cannot be fully appreciated by Euro-American audiences—from whatever
interpretive vantage point—without reference to their distinction as
Muslim heroes and the associated implications and resonances of an
Islamicized protagonist.
At the risk of perpetuating Euro-American generalizations that sur-
round Islam, the latter is, at the very least, a complex, evolving network of
multi-faceted historical, geopolitical, cultural, and religious phenomena
which have been simplified, essentialized, and distorted in much Western
discourse. The post-9/11 tendency to (re)cast Islam as a retrograde, alien
ideology that threatens liberal democracies—which has roots in Medieval
European attitudes—shows little sign of abating (cf. Garcia 28; Dajani and
Michelmore 55; Morgan and Poynting 2). The Euro-American media
emphasis on exceptional negative stereotyping and open hostility renders
Islam in heavily ideologized, propagandized, and fictionalized terms that
offer minimal insight or analysis (cf. Said 1997: xlviii, lxx; Dajani and
Michelmore 53–4). I also draw on theories of Orientalism, popularized by
Edward Said’s seminal, if contested, 1978 study.2 Said argues that Europe
and America3 created a schismatic image of the ‘Orient’ as Other, con-
trasted and opposed to the Occidental world (2019: 1–2). ‘Orient’ in this
context refers to a perceived ‘geographical, cultural, linguistic, and ethnic
unit’, as constructed and reproduced by Western countries over the course
of centuries (2019: 50, 166, 201). Where Westerners are ‘rational, peace-
ful, liberal, logical’, what Said terms Arab-Orientals ‘are none of these
things’ (2019: 49) and, it seems, incapable of becoming so. In this

2
For example, Humberto Garcia criticizes Said for the anachronistic application of an
East-West binary to the early modern period (xi), while Daniel Martin Varisco and Joshua
David Bellin note the objection to Said’s implication that Orientalist fantasy transcends his-
tory, seemingly impervious to individual, cultural, or geopolitical circumstances (Varisco
2007: 252; Bellin 75). Nickolas Haydock endorses Said’s ‘mutual implication of imperialism
and representation’ yet observes that the latter’s scholarly credentials ‘have been devastat-
ingly questioned by many’ (2008: 127n.13). My own small contribution is to query Said’s
citation of Western governments as ‘stabilizing influences’ (2019: 201), in terms of
Orientalism or any other field.
3
For the purposes of this book, the terms America and American refer to the United
States, unless otherwise stated.
 1 INTRODUCTION 3

scenario, only a Westerner can be entrusted to manage the Orient and to

know its totality (2019: 256). Thus, the Orient serves as both a validation
of colonial power, affiliated with knowledge, and an object of self-­
contemplation (cf. Said 2019: 1, 27, 32; Said 1997: xlix), while denying
the colonized any right or even ability of self-representation (cf. Said
2019: 32; Varisco 2007: 40, 290).
Furthermore, Europeans have repeatedly remoulded their identity and
shored up a sense of self via ongoing interaction with and reference to
non-Europeans (cf. P. O’Brien 16; Wade 38). This process remains ongo-
ing and new iterations of Orientalism, such as neo-Orientalism (Asef
Bayat) and fractal Orientalism (Ghassan Moussawi), address the further
complexities of continued colonialism. Islam in particular became a refer-
ence point, often framed in adverse terms, for the gradual construction
and assertion of European identity (cf. Jonker and Thobani 4). The
Muslim has been systematically and consistently Othered in religious, eth-
nic, and racial terms and consequently proved fundamental to shaping the
Western worldview, through the Reformation to the globalization era (cf.
Akbari 1; Blanks and Frassetto 2, 3; Jonker and Thobani 2).4 Simultaneously,
there has been considerable, if often unacknowledged, cultural similarity,
exchange, and assimilation (cf. Blanks and Frassetto 4; Morey and Yaqin,
207). In the American context, for instance, it is argued that Arab-Islamic
figures were appropriated by and woven into the fabric of American cul-
ture and collective consciousness during the nineteenth century, exerting
an influence on the national and personal imaginary (cf. Friedlander
363–4; Berman x–xi).
While this book is not intended as a study of Islam, I provide back-
ground material on this religious-ideological-political-sociocultural phe-
nomenon to anchor my arguments based around a series of film case
studies. My approach contextualizes characters and performers on various
levels—historical, economic, industrial, and racial—while examining their
reception in terms of media response. Primary research sources include
film-related journals such as Variety, Boxoffice, Monthly Film Bulletin, and
American Cinematographer, alongside more mainstream outlets, to
underpin my discussion of the films’ contemporary contexts, in terms of
both production and release. One of my methodological tools is textual

4
The situation is of course more complicated than this. For instance, Akbar S. Ahmed
states that hostile attitudes to Muslim men exist in India and even Pakistan, accompanied by
a comparable homogenizing essentialism (xvi).
4 D. O’BRIEN

analysis, and this book offers an in-depth study of a wide range of films,
many of which have not been examined previously in detail, especially in
terms of their Islamic content. I focus in part on the status of the protago-
nists in regard to narrative function and dialogue and visual factors, such
as costume, make-up, lighting, and framing. While relatively few of these
films are widely considered to be major contributions to cinema culture
and history, my analysis of particular roles and titles explores how Muslim
heroes have been deployed on the Western screen by a white, Christian-­
dominated industry across numerous eras.
If it is tempting to think of this relationship in terms of a symbiotic
interplay between West and East, Christian and Muslim, this approach
must be recognized as both problematic and inappropriate since Muslims
were largely absent from the case studies examined in this book. As noted,
the history of Euro-American Muslim representation is concerned largely
with self-identification and definition, rather than producing knowledge
of the Islamic world.5 Writing in 1997, Said stated that Western culture
and discourse had little place to contemplate, let alone articulate or por-
tray Islam in a sympathetic fashion (6). I argue that mainstream American
and European cinema has provided such a space, one where portrayals of
Muslims can be sensitive to cultural nuance and religious detail. These
depictions are often both conceived and received through an investigative
lens anchored in Orientalist framing, yet their modes of representation—
historical, romantic, or fantastic—may enable them to transcend its param-
eters and confines. Most of the Euro-American world, if not entirely
ignorant of Islam, will only ‘know’ it from a narrow, incomplete, and
biased interpretive viewpoint. Within this context, it is important to exam-
ine how and speculate on why some filmmakers depict Muslim figures as
heroic protagonists and the ways in which audiences may understand
them. In the following section I will outline Euro-American perceptions
and representations of Islam prior to the cinematic age. I then provide an
overview of the broader depiction of Muslims in film, a definition of the
term ‘hero’, and the criteria that signify ‘Muslim’ for these figures.
The term ‘Islam’ may be translated, or transliterated, as surrender or
submission, specifically to God’s will (cf. Gregorian 6). A monotheistic
Abrahamic faith originating in the Middle East, neither monolithic nor
wholly defined by its religious aspect, Islam can be characterized as a

5
As with Sir Richard Burton and his ‘studies’ of Muslim men’s sexualities during the nine-
teenth century.
 1 INTRODUCTION 5

multiethnic, highly influential civilization built and advanced by Muslims

(cf. P. O’Brien 12, 13), which also refracts the great diversity of Muslim-­
majority countries and the retention of national individuality (cf. Varisco
2005: 1, 8; Khattak 9; Jung 1). By and large, Euro-American cultures have
taken an essentialist, reductive approach to Islam that ignores national,
political, sectarian, or ethnic affiliations, regarding it as an aggressive com-
petitor, not least in military terms, and as a challenge to Christianity (cf.
Said 1997: 4–5).6 A Muslim may be defined as one who submits to God
(cf. Gregorian 6), though some maintain that this is a relatively modern
term, little used before the second half of the twentieth century (cf. Berger
20).7 The Qur’an8 can be characterized as a collection of discourses deliv-
ered by the Prophet Muhammad during the last two decades of his life. It
consists mainly of short passages of religious or ecumenical teaching, argu-
ments against opponents, commentaries on current events, and rulings on
social and legal matters, all taken as the word of God, as dictated to the
Prophet via the angel Gabriel (cf. Gibb 3).
From the Middle Ages into the early Renaissance, Christian commenta-
tors depicted Islam, in Said’s phrase, as ‘a demonic religion of apostasy,
blasphemy, and obscurity’ (1997: 5). Suzanne Conklin Akbari notes how
medieval literary cultures both rejected Islam and sought to integrate
aspects of it, citing Dante’s vision of paradise as drawing on the Mi’raj,
which recounts Muhammad’s night journey to Heaven and Hell (5, 262;
cf. Khattak 50; Southern 55).9 Islam was both dangerous and alluring,
officially an unassimilable anathema yet also enculturated, however

6
David Tyrer argues that Muslim identities disrupt and implicitly challenge Western dis-
tinctions and categories relating to race, religion, and secularism, resisting Eurocentric clas-
sification (167, 168). Furthermore, specific historical geopolitical factors are often sidelined
in Western discourse on Islam, as with the late 1960s rise of militant piety, in countries such
as Egypt, Lebanon, and later Iran, as a reaction against secular modernity and the perceived
failures of socialism and Pan-Arabism (cf. Elgamri xi; McAlister 200).
7
Imam Dr. Abduljalil Sajid defines Muslims as an ethno-religious group who in Euro-
American discourse are often constructed or construed as a distinct race (1–2).
8
The title of this sacred text translates literally as ‘recitation’.
9
S.A. Nigosian stresses that the link can only be assumed rather than proven (81, 102,
128), while Annemarie Schimmel asserts that this possible influence ‘cannot be excluded’ as
the sources were well known in the medieval Mediterranean world (219; cf. Shalem 3). Karla
Mallette cites Miguel Asín Palacios’ monograph La escatología musulmana en la Divina
Comedia/Muslim Eschatology in the Divine Comedy (1919) as initiating this debate, while
stating that the author’s argument lacks ‘a plausible means of transmission of Islamic notions
of the afterlife to Dante’ (190).
6 D. O’BRIEN

superficially, on various levels (cf. Akbari 5; Shohat and Stam 58). Akbari
argues that the loaded term ‘Saracen’, frequently though not exclusively
applied to Muslims during the medieval era, manifested in European lit-
erature and cultural production as dark, malformed, and irredeemable (cf.
Blanks and Frassetto 3), yet also as white, well-proportioned, and assimi-
lable (Akbari 156). While the white European stood as the norm in medi-
eval discourses of masculinized bodily diversity, some Saracens came close
to matching him (160). For example, Baligant, in the French epic poem
La chanson de Roland/The Song of Roland (c.1040–1115), has an attrac-
tive, European-looking body (163). Thus, the supposed gulf between
Christian and Muslim could be problematized and implicitly challenged
within certain European cultural contexts.
The first significant Muslim presence in Europe remains a source of
contention. While the eighth century has been cited (cf. Obaid 12), others
maintain there was minimal Western awareness of Islam until the sixteenth
century, linked with the expanding Ottoman Empire (cf. Khattak 7–8).10
This era also marked a growing European interest in Islamic culture, man-
ifested in forms such as design, language, and theatre (cf. Khattak 50).
Hammood Khalid Obaid cites The Battle of Alcazar (1589), by George
Peele, as the first English play to feature a Moor in a major role, followed
by William Percy’s Mahomet and His Heaven (1601) (x). Obaid argues
that both works are topical constructions refracting contemporary local
and national issues and events; neither can be taken as representing exist-
ing knowledge of the Muslim Other (x). The Digby Mary Magdalene is a
late fifteenth-/early sixteenth-century play, where the redeemed Mary
converts pagans to Christianity (cf. Wade 22, 23). As Erik Wade notes, the
term ‘Muslim’ is not used, yet the heathens invoke Muhammad, and their
association with idolatry and carnality refracts Christian propaganda of the
era (31, 22–3, 30, 32–3). Islamic characters and motifs featured frequently
on the Elizabethan stage (Obaid 2), just as Protestant Queen Elizabeth I
established relations with Muslim Barbary states, especially Morocco, both
parties recognizing a common enemy in Catholic Spain (137; cf. Hawting
74).11 While Islam was favourably regarded, in part at least, by
10
Andrew Jotischky argues that for most Europeans, Muslims were a distant reality before
the twelfth century, with rare exceptions such as the Iberian Peninsula (26; see Chap. 4).
Furthermore, Islam as a religion was barely understood in the West (26).
11
Elizabeth I also made successful overtures to the Ottoman emperor Murad III, believing
the latter to rule the only military power capable of maintaining the balance of control in
favour of anti-Spanish factions (cf. Inalcik 330; Ansari 26).
 1 INTRODUCTION 7

Enlightenment figures such as Voltaire, by the late nineteenth century

much of the Muslim world had been colonized (cf. Khattak 133). In this
context, many Western stereotypes developed to be employed and per-
petuated more or less unconstrained and unchallenged, even within
Muslim countries (cf. Khattak 133).12 Ilyse R. Morgenstein Fuerst identi-
fies the 1857 Indian rebellion as the point when the hugely diverse Muslim
communities came to be defined by the British ruling elite as homoge-
nized, racialized, minoritized13 religious actors, and as subjects of empire
who must submit to imperial power (3, 7, 8, 49–50, 132). Furthermore,
they were regarded as possessing inherent, intractable, yet transmittable
traits that included the potential for jihad, a theological, textual, and legal
category here reduced to a violent religious fundamentalism (7, 12).14
Events from the 1970s, including oil disputes, the Iranian Revolution,
and the American hostage crisis,15 consolidated and calcified the predomi-
nant Western view of Islam as being a fixed set of premodern attitudes and
beliefs16 unaffected by the multiplicity of contextual factors in play since its
foundation in the seventh century (cf. Said 1997: l, 36; Dajani and
Michelmore 57–60; Ansari 389; Elgamri xi; Mamdani 18; Gottschalk and
Greenberg 124). This attitude has been encapsulated as a modern expres-
sion of medieval perceptions that advances Western political, military, and
industrial interests (cf. Dajani and Michelmore 55; Elgamri 5; Arjana and
Fox 3). Karen F. Dajani and Christina Michelmore address the idea of a
manufactured ‘Green Peril’,17 in the form of a threatening Islamic funda-
mentalism (55). The latter replaced the Soviet Red Peril at the behest of
the American foreign-military policy establishment, as an effective means

12
Addressing the British context, Humayun Ansari identifies a new sense of cultural supe-
riority emerging in the early nineteenth century; a combination of colonialism, stereotyping,
and technological advantage fed a prejudice towards non-white and/or non-Christian peo-
ples as mental and moral inferiors (59–60).
13
Defined by Morgenstein Fuerst as ‘the systematic process by which a ruling elite denies
one group access to power through local, national or […] imperial politics’ (50).
14
Jihad may be broadly defined as a struggle or striving, external and internal, to achieve a
praiseworthy goal in line with Divine precept.
15
Melani McAlister argues that these events led to Islam becoming the major signifier of
‘the imagined geography’ of the Middle East, rather than oil wealth, Arabs, or Christian
Holy Lands (200). The dominant American perspective reconfigured this political-religious
phenomenon into ‘the essential character of an entire region’ (200).
16
Often assumed to be also antimodern (cf. Mamdani 18).
17
A term attributed to Jules Régis Debray (cf. Mamdani 21), a French journalist and
academic.
8 D. O’BRIEN

of mobilizing popular support for defence expenditure and American

interventionism (55). Mahmood Mamdani notes how this menace is sup-
posedly even more fearsome than the USSR as it lacks ‘rational self-­
restraint’ (21), deriving from fanaticism rather than calculated geopolitical
powerplay.18 Khambiz GhaneaBassiri argues that, in times of crisis, national
unity may be sustained and strengthened ‘by ascribing undesirable values
to religious out-groups’, Muslims being an obvious and familiar target
(70).19 These attitudes and assumptions have been refracted, in various
forms and to varying degrees, in Euro-American film production.

Screening Muslims
Case studies aside, space does not allow for more than a partial survey of
Euro-American films that feature Muslim settings and characters. I will
confine myself here to examples from the late silent era, when cinema was
well established as an industrial and cultural entity, then discuss some later
titles before engaging with debates over films produced from the 1980s
onwards. With these provisos in mind, it can nevertheless be stated that
the history of Muslim screen representation is marked by an enduring
ambivalence, whatever the period or location. For instance, the German
film Der müde Tod/Destiny (1921), partly set in ‘the city of the faithful’20
during ‘The Holy Month of Ramadan’,21 depicts the muezzin call to
prayer and an imam22 with his Qur’an. Other Muslims, however, are
shown as blade-wielding fanatics who thirst for infidel blood. The caliph
likens the Christian in love with the ruler’s sister to ‘a mangy dog’ and has

18
Mamdani states that any actual peril from this source is a direct legacy of the American
attempt in the mid-1980s ‘to harness extreme versions of political Islam in the struggle
against the Soviet Union’ (119). Groups trained and sponsored by the CIA acquired three
key operative tools: terror tactics, holy war as political ideology, and transnational recruit-
ment (163). The long-term effects of this policy are vividly illustrated in the Franco-
Mauritanian film Timbuktu (2014), where a multinational jihadist force delivers strictures via
loudhailer yet exhibits little grasp of Islam—the troops are more interested in European
soccer teams—and is largely concerned with misogynist subjugation.
19
GhaneaBassiri also claims that the United States in particular has employed this strategy
as a pattern of governance ‘that has often obfuscated the political and economic sources of
the crisis to the benefit of the state’ (70).
20
Mecca? Bagdad?
21
The annual commemoration of the Prophet Muhammad’s first revelation.
22
An Islamic leadership role that is centred on the local mosque while also extending to the
wider community.
 1 INTRODUCTION 9

him buried up to his neck. A more nuanced approach is found in Les contes
de mille et une nuits/The Tales of a Thousand and One Nights (1921), a
French production with a cast and crew consisting largely of Russian émi-
grés.23 The Muslim heroine, a shipwrecked princess, is shown at prayer,
her bowed head touching the sand. Stranded in a brutish pagan land,
where belief in Islam is a capital crime, the princess is saved by the king’s
son, who was secretly converted to the faith by the vizier who raised him.
This depiction of Islam allows for miracles, or at least divine intervention,
as when a written message descends from heaven, decreeing ill-fortune for
the king and his people if the prince is harmed. Having scorned this divine
warning, the entire court is turned to stone. The prince’s climactic rescue
of the princess is aided by heavenly fire which appears at his invocation.
Evoking a Euro-American literary trope of persecuted Christian lovers
(e.g., The Last Days of Pompeii, 1834; Quo Vadis, 1896),24 The Tales of a
Thousand and One Nights appears to depict Islam as the One True Faith,
and thereby displacing Christianity, though any potential controversy is
mediated by the explicitly fantastical setting. On a more personal level,
themes of persecution and exile would have held especial resonance for
Russian nationals who had recently fled the new communist regime.
Das Wachsfigurenkabinett/Waxworks (1924) includes an episode based
around the Bagdad caliph Haroun al Raschid. As played by Emil Jannings,
a major German film star, he is a semi-comic figure, short and overweight,
with his bulk emphasized by a vast bulbous turban. A polygamist with
hundreds of wives, he prioritizes sexual exploits, pursuing a baker’s wife.
The put-upon baker finds sanctuary seated within the arc of an Islamic
crescent on a domed rooftop. Whatever the significance of this image,
religious or otherwise, the resolution highlights Haroun’s dubious patron-
age rather than Muslim values. The German animated film Die Abenteuer
des Prinzen Achmed/The Adventures of Prince Achmed (1926) has been
cited for its respectful treatment of Islam (cf. Shaheen 46). The film exhib-
its such Muslim-inflected tropes as a banner bearing a crescent moon and
a star, along with calls to prayer from minarets. However, a caliph’s oath,
‘By the beard of the Prophet’, is problematic, suggesting a trivialization,
or ignorance, of the religious context. Prince Achmed’s invocation of
Allah’s grace is linked with female capitulation to patriarchal control, often

23
The edition under review is an abridgement prepared for home viewing, entitled The
Arabian Nights. The original version is believed lost.
24
Both books had been adapted into films several times by the early 1920s.
10 D. O’BRIEN

cited in Euro-American discourse as a prime example of Muslim subjuga-

tion. The penultimate shot of the film, in its surviving version, is a long
view of four muezzins calling from towers, as the sun rises in the distance,
the men raising their arms then bowing (Fig. 1.1). This image is associated
with the restoration of normalcy and order, which could be read as an
endorsement of Islam. The final shot, framing Achmed with his family and
fiancée, may be interpreted as affirming this perspective, yet the adven-
tures depicted manifest little sense of an Islamic milieu.
The Hollywood-produced The Desert Song (1929) is a white saviour
narrative that depicts Muslims and their religion as fundamentally alien to
the West, or at least France, birthplace of the masked hero. The latter
serves as the leader of Moroccan Riffs, without their suspecting his true
identity. This implies an inherent superiority over a people who, it seems,
cannot comprehend the basic Western virtues, let alone embrace them.
Conversely, Ali Baba and the Forty Thieves (1944), one of Universal’s
series of Arabian Nights spectacles (see Chap. 2), offers a clear wartime

Fig. 1.1 The Adventures of Prince Achmed (1926)

 1 INTRODUCTION 11

parallel: better to die resisting tyranny than face a living death under the
foot of an oppressor. At the end, the Mongol flag emblematizing the
occupation of Bagdad is replaced by a green flag bearing Arabic script and
a crescent moon. Whatever the intentions of the filmmakers, this imagery
both invokes Islam and links it with deliverance and freedom. Later
American examples refract a conservative retrenchment whereby Islam is
casually trivialized, if not openly condemned. The Desert Hawk (1950), set
in ancient Persia, associates the Muslim faith with sexually available young
women, described as the ‘fairest flowers of Islam’. The eponymous hero
invokes the Qur’an and Allah to protest his romantic and marital fidelity,
yet at this point he is posing as the film’s archvillain, whose own appeals to
Islamic ideals are blatantly bogus. Counterexamples to this approach are
discussed in the case study chapters.
One of the more notable depictions of a historical Muslim protagonist
is Lion of the Desert (1980), the second and last feature film directed by
Moustapha Akkad, who made the birth-of-Islam epic Al-Risalah/The
Message (1976, see Chap. 6). Like its predecessor, Lion of the Desert was
Libyan financed, yet the production drew heavily on Euro-American per-
sonnel both sides of the camera. Hollywood actor Anthony Quinn plays
Omar Mukhtar, a Libyan Bedouin, who from 1911 to 1931 led the resis-
tance against occupying Italian forces. Associated from his first scene with
Islam, the Qur’an, and education, Mukhtar is calm and understanding,
finishing class early so that his pupils may watch street entertainers. His
insistence on making one final point25 underlines the conviction and deter-
mination that mark both his religious observance and his abilities as a mili-
tary leader. Walking through the burnt-out ruins of his home village,
Mukhtar question his decisions while holding a singed Qur’anic tablet,
which emblematizes both the dangers the rebels face on a daily basis and
the values which make these risks and sacrifices worthwhile. It is notable
that the politically savvy Mukhtar looks beyond Islam to further his cause,
seeking international recognition of the struggle for freedom. He refuses
to be lectured on Islamic doctrine by a condescending Italian bureaucrat
and knows that the honourable peace sought by his compatriots is impos-
sible under Fascist colonialism. Concerned with nation, ethnicity, and
tribe, Mukhtar is defined and represented largely through his religious
identity. A scene where he addresses his men in a cave evokes the Prophet

25
The importance of balance in all things, illustrated by the spectacles poised on
Mukhtar’s finger.
12 D. O’BRIEN

Muhammad’s similar refuge during the journey from Mecca to Medina

(see Chap. 6). Having been captured, his ritual prayer is witnessed by a
‘decent’ Italian officer who is well aware of his own side’s moral and spiri-
tual bankruptcy. Mukhtar’s sentence of death is calmly received as a return
to God and he is framed on the gallows, Qur’an in hand for a final reading.
A medium close-up emphasizes not so much the rope around his neck as
a last prayer, Mukhtar content to die at the hands of his enemies in the
service of a just cause.
The science-fiction film Pitch Black (2000) is unusual for its genre in
featuring a major character explicitly identified as a Muslim. Black actor
Keith David plays Imam,26 one of several spacecraft passengers who crash
land on a desert planet only to find their lives in further peril. Turbaned,
bearded, and robed, Imam is dismissed by the film’s antihero, Riddick
(Vin Diesel), as ‘some hoodoo holy man’.27 Leading his young followers
in prayer, Imam is on hajj or pilgrimage. He exhibits both optimism and
faith, finding signs from Allah where Riddick sees only self-interest and
brute survival. The location of water is treated as a cause for celebration.
Prayer rugs and beads have positive connotations, in contrast to their
depiction in many American films.28 Imam states that hajj refers to self-­
knowledge as well as knowledge of Allah. In this sense, he and his fellow
survivors are now on the same hajj, whatever their religious beliefs or lack
thereof. Iman serves as a trusted member of the group, in contrast to fugi-
tive convict Riddick, and in some ways is treated as just another person
trying to make the best of a bad situation. He speculates that the creatures
which threaten them operate largely by sound and rightly cautions his fel-
low humans that the phase of darkness referenced in the film’s title will be
long lasting. While it would be a stretch to argue that Imam’s Muslim
faith facilitates the redemption of Riddick, he does at least guide the latter
towards alternative ways of thinking which contribute to both men’s
deliverance. In the sequel, The Chronicles of Riddick (2004), Imam is inte-
grated into both the public and domestic space, as community leader and
family man. Faced with alien invasion, he recruits Riddick’s help and draws
enemy troops away from his wife and daughter. Devout in the face of

26
The character is not otherwise named. Some coverage refers to him as Abu al-Walid,
though this name does not appear on the credits for this film or its sequel.
27
Hoodoo may refer to traditions of Black American spirituality, esoteric knowledge, or
folk magic, though the film does not pursue this angle.
28
See for instance Executive Decision (1996), discussed below.
Another random document with
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282.—Prothesis applied to face 207
Subcutaneous Hydrocarbon Protheses
283.—Circulation of the head (author) Facing 210
284.—Eckstein insulated syringe 232
285.—Quinlan paraffin heater 232
286.—Author’s electrothermic paraffin heater 244
287.—Smith paraffin heater 246
288 a, 288 b.—Microphotograph, showing
fibromatosis Facing 258
289.—Author’s drop syringe 265
290.—Author’s all-metal syringe 266
291.—Smith’s all-metal syringe 267
292, 293.—Anterior superior third nasal deficiency
and correction thereof 289
294, 295.—Anterior median third nasal deficiency and
correction thereof 292
296, 297.—Anterior inferior third nasal deficiency and
correction thereof 294
298 a, 298 b.—Anterior superior and inferior third
nasal deficiency and correction thereof 301
299, 300.—Anterior total nasal deficiency and
corrections thereof 303
301.—Untoward effect of paraffin injection about
lobule and anterior nasal line 311
302, 303.—Profile view, showing correction of antero-
lateral deficiency about chin 330
304, 305.—Frontal view, showing correction of antero-
lateral deficiency about chin; also correction of
deficiency of cheeks 332
Rhinoplasty
306.—Deficiency of superior and middle third of nose 342
307.—Post-ulcerative deformity of superior third of
nose 342
308.—Loss of right ala, lobule and columna 342
309.—Loss of lobule, inferior septum and columna 342
310.—Ulcerative loss of right median lateral skin of
nose 343
311.—Loss of nasal bones, partial dorsum, lobule and
septum 343
312.—Destruction of nasal bones with dorsum and
lobule intact 343
313.—Total loss of nose 343
314, 315, 316.—Koomas method of rhinoplasty 353
317.—Graefe method of rhinoplasty 353
318, 319, 320, 321.—Delpech method of rhinoplasty 354
322, 323.—Lisfranc method of rhinoplasty 355
324.—Labat method of rhinoplasty 356
325.—Keegan method of rhinoplasty 356
326.—Duberwitsky method of rhinoplasty 357
327.—Dieffenbach method of rhinoplasty 357
328.—Von Ammon method of rhinoplasty 358
329.—Auvert method of rhinoplasty 358
330.—Von Langenbeck method of rhinoplasty 359
331, 332.—Petrali method of rhinoplasty 360
333.—Forque method of rhinoplasty 361
334.—D’Alguie method of rhinoplasty 361
335.—Landreau method of rhinoplasty 361
336.—Von Langenbeck method of rhinoplasty 361
337.—Von Langenbeck method of rhinoplasty 362
338.—Szymanowski method of rhinoplasty 362
339.—Nélaton method of rhinoplasty 365
340.—Heuter method of rhinoplasty 365
341.—Bürow method of rhinoplasty 365
342.—Szymanowski method of rhinoplasty 366
343, 344.—Serre method of rhinoplasty 367
345, 346.—Maisonneuve method of rhinoplasty 369
347, 348, 349.—Dieffenbach arm-flap method 373
350.—Szymanowski arm-flap method 375
351.—Fabrizi arm-flap method 376
352, 353.—Steinthal thoracic flap method 377
354, 355.—Volkman method of rhinoplasty 379
356.—Keegan method of rhinoplasty 380
357, 358.—Verneuil method of rhinoplasty 380
359, 360.—Thiersch method of rhinoplasty 381
361, 362.—Helferich method of rhinoplasty 382
363, 364.—Sedillot method of rhinoplasty 383
365.—Berger arm-flap method 385
366.—Berger retention apparatus 385
367, 368.—Szymanowski rhinoplasty method 386
369.—König rhinoplasty method 391
370.—Von Hacker rhinoplasty method, arrangement
of frontal flap to allow chiseling 392
371.—Von Hacker rhinoplasty method, making osteo-
periostic support 392
372.—Von Hacker rhinoplasty method, bone-lined flap
in position 392
373, 374.—Rotter rhinoplastic method 394
375, 376.—Schimmelbusch frontal flap method 395
377, 378.—Helferich rhinoplasty method 397
379, 380, 381.—Krause rhinoplasty method 399
382.—Nélaton rhinoplasty method 400
383.—Nélaton rhinoplasty method, making bony
support 400
384.—Nélaton rhinoplasty method, cutting through
bony plate 401
385.—Nélaton rhinoplasty method, disposition of
frontal flap 401
386.—Israel method, forearm flap 402
387.—Israel method, position of forearm to place flap 403
388.—Nélaton method, outlining frontal flap 407
389.—Nélaton method, locating cartilage strip 408
390.—Nélaton method, excision of cartilage strip 409
391.—Nélaton method, placing of cartilage strip 410
392.—Nélaton method, bringing down frontal flap 411
393.—Nélaton method, placing frontal flap 411
394, 395.—Steinhausen partial rhinoplasty method 412
396, 397.—Neumann partial rhinoplasty method 413
398, 399, 400.—Later Neumann partial rhinoplasty
method 415
401.—Bardenheuer method, shape of flap 416
402.—Bardenheuer method, disposition of flap 416
403.—Ollier method first step 417
404.—Ollier method, second step 418
405.—Ollier method, position nasal bone occupies 418
406.—Von Langenbeck method, first step 419
407.—Von Langenbeck method, showing separation
and elevation of nose flaps 419
408.—Nélaton method, first step 421
409.—Nélaton method, making lower nasal flap 421
410.—Nélaton method, forming base of nose 422
411.—Nélaton method, ultimate disposition of flap 422
412.—Bayer-Payr restoration of lobule, first step 425
413.—Bayer-Payr restoration of lobule, disposition of
flaps 425
414.—Bayer-Payr restoration of lobule, placing of
pedicles after division 425
415.—Ch. Nélaton method, attachment of forearm
flap 426
416.—Ch. Nélaton method, forearm flap in position,
lateral flaps 426
417.—Ch. Nélaton method, disposition lateral flaps 426
418.—Denonvillier method, making of flap for ala 428
419.—Denonvillier method, disposition of flap for
anterior pedicle ala 428
420.—Denonvillier method, making of flap for ala,
posterior pedicle 428
421.—Denonvillier method, disposition of flap for ala, 428
 posterior pedicle
422, 423.—Mutter method of restoration of ala 429
424, 425.—Von Langenbeck method of restoration of
ala 430
426.—Busch method of restoration of ala 430
427.—Dieffenbach method of restoration of ala 431
428.—Dupuytren method of restoration of ala 431
429.—Fritz-Reich method of restoration of ala 431
430, 431, 432, 433.—Sedillot method of restoration of
ala 432
434, 435.—Nélaton method of restoration of ala 433
436, 437.—Bonnet method of restoration of ala 434
438, 439.—Weber method of restoration of ala 434
440.—Thompson mucosa flap 435
441, 442.—Thompson method of restoration of ala 435
443, 444.—Blandin method of restoration of ala 436
445, 446.—Von Hacker method of restoration of ala 436
447, 448.—Kolle method of restoration of ala 437
449.—Denonvillier method of restoration of ala 438
450, 451, 452.—Von Hacker method of restoration of
ala 439
453.—König method of restoration of ala 440
454, 455.—Kolle method of restoration of ala 441
456, 457.—Kolle method of restoration of lobule 442
458, 459.—Blandin method of restoration of
subseptum 444
460, 461.—Dupuytren method of restoration of
subseptum 445
462.—Serre method of restoration of subseptum 445
463, 464.—Dieffenbach method of restoration of
subseptum 446
465.—Heuter method of restoration of subseptum 446
466.—Szymanowski method of restoration of
subseptum 446
467, 468.—Szymanowski method of restoration of 447
 subseptum
Cosmetic Rhinoplasty
469 a, 469 b.—Monk method of correction of angular
nose 450
470, 471, 472.—Median nasal incision for angular
nose 451
473, 474.—Kolle method of lateral incision for angular
nose 452
475, 476.—Kolle chisel set 453
477.—Kolle metal mallet 453
478, 479.—Kolle method of correction of retroussé
nose 454
480, 481.—Kolle method of correction of broad lobule 456
482, 483.—Kolle method of correction of elongated
lobule 458
484.—Kolle method of correction of elongated lobule
and base of nose after excision 460
485.—Kolle method of correction of elongated lobule
base of alæ and lobule 460
486, 487.—Kolle plaster cast of lobule operation 461
488, 489.—Kolle plaster cast of lobule operation 462
490, 491.—Kolle plaster cast of lobule operation 463
492, 493.—Kolle plaster cast of lobule operation 464
494, 495.—Gensoul method of correcting broad nasal
base 465
496, 497.—Kolle method of correction of broad nasal
base 465
498, 499.—Linhardt method of reduction of thickened
alæ 466
500, 501.—Dieffenbach method of reduction of
thickened nose 467
Electrolysis in Dermatology
502.—Electric wet cell 470
503.—Series connection of cells 472
504.—Shunt rheostat connection 473
505.—Cell selector 474
506.—Cell selector and battery connection 474
507.—Milliampèremeter 475
508.—Direct current wall plate 475
509.—Wall-plate connections 475
510 a.—Portable wet cell apparatus 476
510 b.—Portable dry cell apparatus 477
511.—Sponge electrode 478
512.—Arm electrode 478
513, 514.—Electrolytic needle holders 479
515.—Interrupting current needle holder 479
516.—Needle holder with magnifying glass 479
517.—Epilating forceps 481
518.—Electrolysis method for destroying growths 483
519.—Multiple needle electrode 484
520.—Kolle electric apparatus for tattooing scars 487
Case Recording Methods
521.—Nose stencil 492
522.—Method of making nose plaster cast 494
PLASTIC AND COSMETIC
SURGERY
 CHAPTER I
HISTORICAL

It seems almost incredible that at this late day so little is generally

known to the surgical profession of the beautiful and practical, not to
say grateful, art of plastic or restorative surgery, successfully
practiced even by the ancients.
The progress of the art has been much interrupted. It is only the
later methods of antisepsis, which have so greatly added to general
surgery, that have placed it firmly upon the basis of a distinct and
separate art in surgical science.
To Aulus Cornelius Celsus, a Latin physician and philosopher,
supposed to have lived in the time of Augustus, we owe the first
authentic principles of the science. He was a most prolific writer and
an urgent worker. After having introduced the Hippocratic system to
the Romans he became known as the Roman Hippocrates. His best-
known work handed down to us is the “De Medicina,” the first edition
of which, divided into eight books, appeared in Florence in 1478. The
seventh and eighth volumes, designated the “Surgical Bible,” contain
much valuable data in reference to opinions and observations of the
Alexandrian School of Medicine.
In considering plastic operations about the face (Curta in auribus,
labrisque ac naribus) he writes, “Ratio curationis ejus modi est; id
quod curtatum est, in quadratum redigere; ab interoribus ejus angulis
lineas transversas incidere, quæ citeriorem partem ab ulteriore ex
toto diducant; deinda ea quæ resolvimus, in unum adducere. Si non
satis junguntur, ultra lineas, quas ante fecimus, alias dua lunatas et
ad plagam conversas immittere, quibus summa tantum cutis
diducatur, sic enim fit, ut facilius quod adducitur, segui possit, quod
non vi cogendum est, sed ita adducendum ut ex facili subsequatur;
et dimissum non multum recedat.”
 Centuries elapsed before a clear understanding of the above was
deduced. Several analyses have been advanced, those of O. Weber
and Malgaigne being the most generally accepted.
As shown in Fig. 1 the method advanced is one for the restoration
or repair of an irregular defect about the face in which two transverse
incisions forming angular skin flaps, dissected from the underlying
tissue, are advanced, joining the denuded free ends.
Should there be a lack of tissue to accomplish perfect coaptation a
semilunar incision beyond either outer border is added, as shown in
Fig. 2, which permits of greater traction, leaving two small
quatrespheral areas to heal over by granulation:
 Fig. 1.—Celsus Incision for Restoration of
Defect.

Fig. 2.—Celsus Incision to Relieve Tension.

This is the oldest known reference to plastic surgery of times

remote.
 From the Orient, however, Susrata in his Ayur-Veda, the exact
period of which is unknown, discloses the use of rhinoplastic
methods.
For centuries following, and throughout the middle ages, the art
seems to have waned and remained practically unknown, as far as is
shown in the literature of that period.
A revivalist first appeared about the middle of the fifteenth century
in the person of Branca, of Catania, a Sicilian surgeon, who about
1442 established a reputation of building up noses from the skin of
the face (exore). His son Antonius enlarged upon his methods and is
said to have utilized the integument of the arm to accomplish the
same result, thus overcoming the extensive scarring of the face
following the elder’s mode. He seems to have been the first authority
employing the so-called Italian rhinoplastic method. He is also known
to have ventured, more or less, successfully in operations about the
lips and ears.
Balthazar Pavoni and Mongitore repeated these methods of
operative procedure with more or less success and the brothers
Bojanis acquired great celebrity at Naples in the art of remodeling
noses.
Vincent Vianeo followed the work of the above.
But, somehow, the heroic efforts of these men dropped so much
into oblivion that Fabricius ab Aquapende, in writing of the
rhinoplastic work of the brothers Bojani, of Calabria, says: “Primi qui
modum reparandi nasum coluere, fuerunt calabri; deinde devenit ad
medicos Bononienses.”
That Germany was interested at an early date is shown in the
admirable work of a chevalier of the Teutonic Order, Brother Heinrich
Von Pfohlspundt, who wrote a book on the subject entitled “Buch der
Brundth Ertznei,” with a subtitle, “Eynem eine nawe nasse zu
mache.” His volume appeared in 1460, about the time of Antonio
Branca, of whose methods he was ignorant, claiming to have
learned the art from an Italian who succored many by his skill.
 Between the years of 1546 and 1599 Kaspar Tagliacozzi,
Professor at Bologna, followed the art of rhinoplasty. His pupils
published a book at Venice, describing his work in 1597, entitled “De
Corturum chirurgia per insitionem,” which established the first
authentic volume in restorative surgery. His operation for restoring
the entire nose from a double pedicle flap taken from the arm was
declared famous and the operation he then advocated still bears his
name.
The great Ambroise Pare knew little of rhinoplasty except what he
learned from hearsay. As an instance, he relates in 1575 that “A
gentleman named Cadet de Saint-Thoan, who had lost his nose, for
a long time wore a nose made of silver and while being much hurt by
the criticisms and taunts of his acquaintances heard of a master in
Italy who restored noses. He went there and had his facial organ
restored, and returned to the great surprise of his friends, who
marveled at the change in their formerly silver-nosed friend.”
Now again came a century of forgetfulness, the scientific world
taking no cognizance of the work done until, suddenly, in 1794, a
message came from Poonah, India, to the effect that an East Indian
peasant named Cowasjee, a cowherd following the English army,
was captured by Tippo Sahib, who ordered the prisoner’s nose to be
amputated. His wounds were dressed and healed by English
surgeons. Shortly after this the victim of this odd mode of
punishment was befriended by the Koomas, a colony of potters, or,
as others claim, a religious sect, who knew how to restore the nose
by means of a flap taken from the forehead. They operated on him
and restored his nose much to the surprise of Pennant, who reported
the case in England.
Shortly following this, and in the same year, cases of similar nature
are described in the Gentlemen’s Magazine (England), and
Pennant’s “Views of Hindoostan.”
In 1811 Lynn successfully accomplished the operation in a case in
England, and in 1814 Carpue published his results in two cases
successfully operated by him by the so-called Hindoo method.
 France now took up the art of rhinoplasty. Delpech introduced a
modification of the method of the Koomas in 1820, while Lisfranc
performed the first operation of this nature in Paris in 1826.
In 1816 Graefe, of Germany, took up the work of Tagliacozzi but
modified his method by diminishing the number of operations.
Bünger, of Marburg, thereupon, in 1823, successfully made a
man’s nose by taking the necessary tegument from the patient’s
thigh.
A still later modification in the art of rhinoplasty was that of Larrey,
who in 1830 overcame a large loss about the lobule of the nose by
taking the flaps to restore the same from the cheeks.
Among the better advocates of reparative chirurgery were
Dieffenbach, v. Langenbeck, Ricard, v. Graefe (1816), Alliot, Blandin,
Zeis, Serre, and Joberi, while Thomas D. Mutter, in 1831, published
the results he obtained in America—his co-workers being Warren
and Pancoast.
Although Le Monier, a French dentist, as early as 1764 originally
proposed closure of the cleft in the soft palate, no one attempted to
carry out his suggestion until in 1819 the elder Roux, of Paris,
performed the operation. The following year Warren, of Boston,
independently decided upon and successfully did an improved
operation to the same end.
During the years 1865-70 Joseph Lister distinguished himself in
the discovery and meritorious employment of carbolic acid as a
means of destroying, or at least arresting, infectious germ life, the
principle of which, now so fully developed, has advanced the
obtainable surgical possibilities inestimably.
The credit of first collecting data of plastic operations belongs to
Szymanowski, of Russia. In his magnificent volume of surgery
(1867), he embodies a somewhat thorough treatise on restorative
surgery, leaving the subject to be treated more fully and
independently, as it should be, to some other enthusiastic surgeon
specialist. His work is the result of careful study of such operations
on the cadaver, a method much to be recommended to the
prospective or operating plastic surgeon.
Several years later, 1871, Reverdin added a valuable method to
the still incomplete art, by introducing the now well-known circular
epidermal skin grafts for covering granulating surfaces. Thiersch
improved this method in 1886 by showing that comparatively large
pieces of skin could be transplanted. Wolfe, of Glasgow, had also
been successful in utilizing fairly large skin grafts.
Krause, however, improved upon all of these methods by
transplanting large flaps of skin without detaching the subcutaneous
tissue, a procedure which causes more or less injury to the graft in
other methods, and by his method overcoming the subsequent
contraction, heretofore a bad feature when the skin-grafted area had
healed.
“The results of most plastic operations have been as satisfactory
as the most sanguine could hope for or the most critical expect,”
says John Eric Erichsen.
Many important additions have been made in the past few years—
the outcome of untiring attempt and skill. Czerny replaces part of an
amputated breast with a fatty tumor taken from the region of the
thigh. Glück successfully repairs a defect in the carotid artery with
the aid of a piece of the jugular vein. Glück, Helferich, and others
have advocated implanting muscular tissue taken from the dog into
muscular deficiencies in the human, due to whatever cause.
The transplantation of a zoöneural section into a defect of a nerve
in the human was successfully accomplished by Phillippeaux and
Vulpian.
Glück, who later restored a sciatic nerve in a rabbit by the
transplantation of the same nerve taken from a hen, went so far as to
restore a 5-cm. defect of the radial nerve of a patient by the
employment of a bundle of catgut fibers, fully establishing the
function of the nerve within a year’s time.
Guthrie has successfully replaced the organs and limbs of animals
and has actually transplanted the heads of two dogs.
 The transplantation of a toe, to make up a part of a lost finger, is
proposed by Nicoladoni. Van Lair hints at the possibility of removing
a part or a whole organ immediately before death to repair other
living organs.
Von Hippel has successfully implanted a zoöcorneal graft from a
rabbit upon the human eye, and Copeland has taken the corneal
graft from one human and transplanted it upon the cornea of another
to overcome opacity.
The transplantation of pieces of bone to overcome a defect of like
tissue has been fully investigated by Ollier, v. Bergman, J. Wolff,
MacEwen, Jakimowitsch, Riedinger, and others. They discovered
that a graft of bone, with or without its periosteum, can be made to
heal into a defect when strict antisepsis is maintained.
Von Nussbaum was the first to introduce the closing of an osseous
defect by the use of a pedunculated flap of periosteum.
Poncet and Ollier employed small tubular sections of bone, while
Senn has obtained excellent results from the use of chips of aseptic
decalcified bone.
Hahn succeeded in implanting the fibula into a defect of the tibia.
On the other hand, cavities in the bones have been successfully
filled by Dreesmann and Heydenreich with a paste of plaster made
with a five-per-cent carbolic-acid solution, and at a later period by the
employment of paraffin (Gersuny) and iodoform wax, as advocated
by Mosetig-Moorhof.
The thyroid glands taken from the sheep, it is claimed, have been
successfully implanted in the abdomen of individuals whose thyroid
glands had been lost by disease or otherwise.
Protheses of celluloid compound or gutta-percha and painted to
resemble the nose or ear have been introduced with grateful result.
Metal and glass forms have been used to replace extirpated testicles
or to take the place of the vitreous humor of the eye (Mule).
Sunken noses have been raised with metal wire, metal plates,
amber, and caoutchouc. Metal plates have been skillfully fitted into
the broken bony vault of the cranium.
Lastly comes Gersuny’s most valuable method of injecting paraffin
compounds subcutaneously for the restoration of the contour of
facial surfaces and limbs, which is rapidly taking the place of
extensive plastic transplantory and the much-objected-to metal and
bone-plate operations for building up depressed noses and other
abnormal cavities.
And the end of possibilities is not yet reached. The successful
plastic surgeon has become an imitator of nature’s beauty to-day.
His skill permits of many almost unbelievable corrections of
defects that would otherwise evoke the pity and too often the
aversion of the onlooker, especially if these occur in the faces of
those that have become marred in birth or age, by accident or
disease. Withal, it is a noble, generous art, worthy of far more
extensive use than it now enjoys.
The above fragmentary references include a number of plastic
possibilities. They are introduced only in the sense of general
interest to the cosmetic surgeon, the special and detailed subject
matter herein given under the various divisions have to do only with
plastic and cosmetic operations about the face.
 CHAPTER II
REQUIREMENTS FOR OPERATING

THE OPERATING ROOM

The ideal operating room for the plastic surgeon need not
necessarily be large, since it requires less work to render it aseptic.
Furniture and possibly amphitheater accommodation are always a
means of infection unless scrupulously cleansed, a task of time,
difficult at best.
The room should be provided with large windows, with facilities for
the introduction of the air from without. Two doors, and those well
fitted, are all the room should have—but one being used, if possible.
The Walls.—The walls should be of plaster, smoothly laid and well
painted, so that they may be readily washed down with antiseptic
solutions—a daily morning rule. Glass or tiled walls are much used
now and add considerably to the appearance and safety of the room,
as plaster in time will crack, while the paint, owing to the heat of
sterilizers or steam, often creeps and blisters, exposing an absorbing
surface which readily wears down, exposing parts inaccessible for
even acute cleanliness.
The Floors.—The floors of these rooms are now usually laid with
tile mosaic or marble or a composition resembling linoleum. The
base should be curved and all corners sloped off to improve
drainage and to keep off dust and dirt.
Skylight.—A skylight of metal and glass is a valuable accessory. It
should be fixed or never permitted to be opened during an operation.
Disinfection.—Spraying the room with an antiseptic is hardly
necessary, since all germ life descends to the floor and can best be
removed by washing with a 1-1000 bichlorid solution.
 Should it be necessary to perform an unusually extensive
operation in a private house, the room must be cleared of all
furniture, pictures, drapery, and carpet. After plugging up the
crevices in the windows and doors it should be well fumigated either
with sulphur candles, as now commonly furnished, or, better, with
formaldehyd.
The superiority of formaldehyd as a disinfecting agent is now well
established. An illustration of an apparatus, largely doing away with
the difficulties and dangers encountered in the use of the older and
ordinary styles of the pressure or nonpressure type, is shown in Fig.
3. The main difficulty with these has always been their almost
inaccessibility for cleansing purposes, and in such where this is not
the case, the size of the aperture has been made so small that the
inside could not be reached. In the pressure apparatus the tops are
bolted on, making them exceedingly difficult to remove, with the
result that the necessary cleaning was not properly attended to. The
corrosive action of formaldehyd gas is such that under these
conditions any apparatus would soon become useless.
In the type shown a single clamp arrangement is used (a). By the
turning of the hand screw (b) two planed metal faces (the upper
surface of the boiler and under surface of the cover) are brought
together and sealed. When the cover (c) is removed the entire inside
of the boiler is in sight and can be thoroughly cleansed, which should
be done each time the apparatus is used. The pipes through which
the formaldehyd gas passes after generation are arranged so that
they can be taken off and cleaned.
 Fig. 3.—Formaldehyd Disinfecting Apparatus.

The gas is generated in the boiler (d) and passes out from the top,
down through the pipe (e), and from thence through a series of pipes
(f) underneath the boiler, which are subjected to direct heat from the
lamp (g). By this means the gas becomes superheated, the