In the quest to become immortal, humans have been experimenting ever since the prehistoric era. The legends and myths of transplants have inspired us to perform successful transplants today. Transplantation has revolutionized medicine by not just extending life but also increasing the quality of life.
The idea of transplantation of organs and vessel repair has been afloat since ancient times and has come a long way. “Mythology” is a study of myths about a particular subject that commenced in ancient history. “Comparative mythology” is the academic comparison of myths.
2000-3000 BC
According to Hindu mythology - the Shiva Puranas, Ganesha (Image 1) is a god with an elephant head. As the myth goes, Goddess Parvathi instructs her son Ganesha to guard the gates of Kailasa (abode of Lord Shiva and Goddess Parvathi), as she goes for a bath. Meanwhile, Lord Shiva arrives and tries to enter Kailasa. Ganesha stops Lord Shiva from entering Kailasa as instructed by his mother. This angers Lord Shiva who beheads Lord Ganesha in the fit of rage. Later on Lord Shiva realises his mistake and decides to perform a head and neck transplant on Lord Ganesha. After the transplant, Shiva is supposed to have given a drink “elixir” to Ganesha which could be extrapolated to modern day induction immunosuppression medicine.This is probably the oldest example of xenotransplant in the world. Lord Ganesha is also known as the “god of transplant surgery”.
Image 1 : Lord Ganesha
In another instance, Sati, wife of Lord Shiva attends Yajna (a spiritual process) performed by her father King Daksh. King Daksh insults Sati and her husband Lord Shiva during the Yajna. Sati, out of disappointment, jumps into the fire and sacrifices her life. This enrages Lord Shiva, who beheads his father-in-law, Daksh’s head.
Later on, after his anger subsides, he is persuaded by his well-wishers to perform head and neck surgery on Daksh. Lord Shiva obliges and transplants a goat's head onto Daksh. (Image 2)
Image 2: Daksh Prajapathi
In the present day, bovine pericardium is used to replace diseased human heart valves. Also, with the shortage of organs, research on xenotransplant using porcine kidneys is ongoing.
800 BC- 700 BC
An Indian physician, “Sushrutha” wrote “Sushruta samhita” which described approximately 1100 different types of diseases and various surgical techniques including autologous skin graft and reconstruction of the nose (Image 3). He is therefore called as “Father of Indian Medicine” and “Father of Plastic surgery.” His book provides the first written evidence of forehead flap rhinoplasty, which is practiced till today for reconstruction of the nose.
Image 3: Sushrutha performing surgery. Courtesy:ncsm.gov.in
700 BC - 500 BC
In Greek mythology, there are numerous examples of heroes, beasts, and gods who are human-like but with organs of different animals. These are called chimeric species. The word “Chimeric” is derived from Chimera. Chimera is a creature with a body of a lion, a snake-like tail, and a goat's head (Image 4). In the 5th Century BC, Chimera was found in Lycia, present-day Turkey. The sight of Chimera was considered to be a bad omen. It was a fire-breathing monster, which killed many cattle and was devastating for the land of Lycia. The King of Lycia ordered hero Bellerophon to kill it, thinking Chimera would kill him instead. However, the hero Bellerophon, with help of gods and Pegasus, another mythological creature with a body of horse and wings of an eagle, is believed to have killed Chimera.
407 BC - 310 BC
The Chinese surgeon Tsin Yue-Jen, performed a heart transplant under anesthesia induced by strong wine. According to some records, he switched the hearts of two soldiers and both of them survived post surgery. However, the reason for the transplant is unknown.
140 BC - 208 BC
Another Chinese surgeon, Hua-Tuo (Image 5) performed transplantation of abdominal organs under herbal anesthesia called “mafeisan” (which is considered as the first anesthetic in the world). The literal meaning of “mafeisan” is “cannabis boiling powder”.
Cao-Cao was a Chinese warlord, who was suffering from recurrent headaches possibly due to a brain tumor. Hua-Tuo treated Cao-Cao for a long time. Cao-Cao wanted Hua-Tuo to be his personal physician and stay with him. Hua-Tuo was a scholar and resented being his personal physician. He made excuses that his wife was ill and went back to his hometown. When Cao-Cao realized that Hua-Tuo’s wife was not ill, he ordered Hua-Tuo to be executed. With his execution, most of his precious work was burnt.
Image 5: Hua Tuo
4 BC - 30 or 33 AD
The Gospel of Luke describes Jesus Christ healing the right ear of a servant of the high priest, whose ear was cut off by one of the followers of Jesus during his arrest.
231-251 AD
Agatha was a Christian saint who had devoted her life towards service to mankind. She was a daughter of a rich, noble family. At the age of 15, Saint Agatha had vowed to remain a virgin and had refused repeated advances of marriage made by a Roman prefect, Quintianus. In despair, Quintianus, being a governor of the district, reported to the authorities that Agatha was a Christian during the persecution of Decius. Saint Agatha was jailed and tortured. Her breasts were mutilated. In the jail, Saint Peter came in her dreams and healed the cut-off breasts, which may have been a form of auto-transplantation. (Image 7) A few years later, she died as a martyr in jail.
Also in another instance, Saint Marc reimplanted the hand of a soldier severed in battle.
280 AD - 305 AD
Saint Cosmas and Damian were twin brothers born in the 3rd Century near present day Turkey. They were well versed with medicine and had healing powers. They served the populace for no fee.
Saint Cosmas and Damian transplanted a black leg from a recently dead Ethiopian man onto a white man with a “cancerous leg” in his dreams. Post-transplant, the patient recovered and was pain-free. Later on, the amputated cancerous leg was found near the cadaver of the Ethiopian man, whose one leg was missing. This is famous as the “miracle of Moors leg”. (Image 8)This instance was painted by many eminent ancient artists and the picture can be seen today in the museum at Stuttgart.The color of the leg attracted immense interest. Unfortunately, Emperor Diocletian forced the brothers to reject their practice and faith. Ultimately, he went on to torture and behead them. This story was written in the 13th-century book - “ Golden Legend” by Jacobus da Varagine.
Image 8: Miracle of the Moors leg. Courtesy: World digital library.
In the 18th Century, a Scottish scientist, John Hunter transplanted a premolar tooth and hence marked the era of modern transplantation. He was called the “Father of Experimental Surgery”. Also, Hunter is credited with coining the term “Transplant”.
As we can see, before the 20th Century the idea of transplant was predominantly technical, attaching severed limbs, nose, teeth and so on. The idea of immunology, rejection and anti-rejection methods developed predominantly from the 20th Century onwards.
Hence, ancient mythology is the basis for research in transplant and immunosuppression. It is a long journey across many eras and sacrifice of innumerable dedicated souls which is behind today's successful transplants.
Yet, there are many unmet challenges and unanswered questions which keep us searching and researching.
Dr. Mythri Shankar
Assistant Professor
Department of Nephrology
Institute of Nephrourology, Bengaluru
India
NSMC Intern, Class of 2021