PIMSPontifical Institute
of
Mediaeval Studies

In the Arabic medical texts translated into Latin in the 12th century, western readers discovered hitherto unimagined prospects of surgical intervention. Besides repairing wounds and reducing fractures and dislocations, surgery could excise growths. Moreover, texts like the Pantegni offered surgical solutions not only for morbid “apostemes,” but also for other kinds of excessive or protuberant flesh which were not life threatening, but which were viewed as unseemly or offensive. Chief among these were overlarge breasts in men, the reduplicated genitalia of hermaphrodites, extra fingers, and warts. The medical rationale for subtractive surgery was weak, but the intellectual and professional ambitions of proponents of “rational surgery” in the 13th and 14th century embraced it with a combination of zeal and pragmatism. Tracking the subtractive operations across the treatises of Bruno Longobucco, Teodorico Borgognoni, Lanfranc of Milan and Henri de Mondeville reveals that some of the Pantegni's procedures disappear, such as sex reassignment for hermaphrodites; others, particularly warts, were outsourced to barbers; and some operations were replaced. Notably, male breast reduction was supplanted by innovative techniques for what is now known vulgariter as “tackle tightening.”

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