Macabre Masks

The Templo Mayor, built between 1337 and 1487, was the political and religious heart of Tenochtitlán, the city-state in Valley of Mexico that became the capital of the Aztec empire starting from the 15th Century.
Since its remains were accidentally discovered in 1978, during the excavations for Mexico City’s subway, archeologists have unearthed close to 80 ceremonial buildings and an extraordinary number of manufacts from the Aztec (Mexica) civilization.

Among the most peculiar findings, there are some masks created from human skulls.
These masks are quite elaborate: the back of the skull was removed, probably in order to wear them or apply them to a headgear; the masks were colored with dye; flint blades and other decorations were inserted into the eye sockets and nostrils.

In 2016 a team of anthropologists from the University of Montana conducted an experimental research on eight of these masks, comparing them with twenty non-modified skulls found on the same site, in order to learn their sex, age at death, possible diseases and life styles. The results showed that the skull masks belonged to male individuals, 30 to 45-years old, with particularly good teeth, indicating above-average health. From the denture’s shape the anthropologists even inferred that these men came from faraway locations: Toluca Valley, Western Mexico, the Gulf coast and other Aztec towns in the Valley of Mexico. Therefore the skulls very likely belonged to prisoners of noble origins, excellently nourished and lacking any pathologies.

Human sacrifices at the Templo Mayor, for which the Aztecs are sadly known, were a spectacle that could entail different procedures: sometimes the victims were executed by beheading, sometimes through the extraction of the heart, or burned, or challenged to deathly combats.
The masks were produced from the bodies of sacrified warriors; wearing them must have had a highly symbolic value.

If these items survived the ravages of time, it’s because they’re made of bones. But there existed other, more unsettling disguises that have been inevitably lost: the masks made from the flayed skin of a sacrified enemy’s face.

The conquistador Bernal Díaz del Castillo described these skin masks as tanned to look “like glove leather” and said that they were worn during celebrations of military victories. Other masks, made of human skin, were displayed as offerings on temple altars, just as a number of the skull masks, reanimated by shell and stone eyeballs, noses, and tongues, were buried in offerings at the Templo Mayor. Because a defeated enemy’s former powers were believed to be embedded in his skin and bones, masks made of his relics not only transferred his powers to the new owner but could serve as worthy offerings to the god as well.

(Cecelia F. Klein, Aztec Masks, in Mexicolore, September 2012)

During a month-long ceremony called Tlacaxiphualiztli, “the Flaying of Men”, the skin of sacrified prisoners was peeled off and worn for twenty days to celebrate the war god Xipe Totec. The iconography portrays this god clothed in human skin.

Such masks, wether made of bone or of skin, have a much deeper meaning than the ritual itself. They play an important role in establishing identity:

In Aztec society a warrior who killed his first captive was said to ‘assume another face.’ Regardless of whether this expression referred literally to a trophy mask or was simply a figure of speech, it implies that the youth’s new “face” represented a new social identity or status. Aztec masks therefore must be understood as revelations, or signs, of a person’s special status rather than as disguises […]. In Nahuatl, the language spoken by the Aztecs, the word for face, xayacatl, is the same word used to refer to something that covers the face.

(Cecelia F. Klein, Ibid.)

Here is the interesting point: there’s not a single culture in the whole world which hasn’t elaborated its own masks, and they very rarely are simple disguises.
Their purpose is “the development of personality […], or more accurately, the development of the person [which] is a question of magical prestige“: the masks “are actually used among primitives in in totem ceremonies, for instance, as a means of enhancing or changing the personality” (Carl Gustav Jung, The Ego and the Uncoscious, 1928, p. 155).

Much in the same way, the decorated skulls of Templo Mayor are not so “exotic” as we might like to imagine. These manufacts are but a different declination of ideas we are quite familiar with — ideas that are at the very core of our own society.

The relationship between the face (our identity and individuality) and the mask we wear, is a very ancient paradox. Just like for the Aztecs the term xayacatl could indicate both the mask and the face, for us too they are often indistinguishable.

The very word person comes from the Latin “per-sonare”, “to resound through”: it’s the voice of the actor behind his mask.
Greek tragedy was born between the 7th and 5th century BCE, a representation that essentialy a substitute for human sacrifices, as Réné Girard affirmed. One of the most recognized etimologies tells us that tragedy is actually the song of the scapgoat: an imitation of the ritual killing of the “internal stranger” on the altar, of the bloody spectacle with which society cleansed itself, and washed away its most impure, primiteve urges. Tragedy plays – which Athenians were obligated to attend by law, during Dionysus celebrations – substituted the ancestral violence of the sacrifice with its representation, and the scapegoat with the tragic hero.

Thus the theater, in the beginning, was conflict and catharsis. A duel between the Barbarian, who knows no language and acts through natural instinct, and the Citizen, the son of order and logos.
Theater, just like human sacrifice, created cultural identity; the Mask creates the person needed for the mise-en-scene of this identity, forming and regulating social interactions.

The human sacrifices of the ancient Greeks and of the Aztec both met the same need: cultural identity is born (or at least reinforced) by contrast with the adversary, offered and killed on the altar.
Reducing the enemy to a skull — as the Aztecs did with the tzompantli, the terrible racks used to exhibit dozens, maybe hundreds of sacrifice victims skulls — is a way of depriving him of his mask/face, of annihilating his identity. Here are the enemies, all alike, just bleached bones under the sun, with no individual quality whatsoever.

But turning these skulls into masks, or wearing the enemy’s skin, implies a tough work, and therefore means performing an even more conscious magical act: it serves the purpose of acquiring his strength and power, but also of reasserting that the person (and, by extension, society) only exists because of the Stranger it was able to defeat.

The Carney Landis Experiment

Suppose you’re making your way through a jungle, and in pulling aside a bush you find yourself before a huge snake, ready to attack you. All of a sudden adrenaline rushes through your body, your eyes open wide, and you instantly begin to sweat as your heartbeat skyrockets: in a word, you feel afraid.
But is your fear triggering all these physical reactions, or is it the other way around?
To make a less disquieting example, let’s say you fall in love at first sight with someone. Are the endorphines to be accounted for your excitation, or is your excitation causing their discharge through your body?
What comes first, physiological change or emotion? Which is the cause and which is the effect?

This dilemma was a main concern in the first studies on emotion (and it still is, in the field of affective neurosciences). Among the first and most influential hypothesis was the James-Lange theory, which maintained the primacy of physiological changes over feelings: the brain detects a modification in the stimuli coming from the nervous system, and it “interprets” them by giving birth to an emotion.

One of the problems with this theory was the impossibility of obtaining clear evidence. The skeptics argued that if every emotion arises mechanically within the body, then there should be a gland or an organ which, when conveniently stimulated, will invariably trigger the same emotion in every person. Today we know a little bit more of how emotions work, in regard to the amygdala and the different areas of cerebral cortex, but at the beginning of the Twentieth Century the objection against the James-Lange theory was basically this — “come on, find me the muscle of sadness!

In 1924, Carney Landis, a Minnesota University graduate student, set out to understand experimentally whether these physiological changes are the same for everybody. He focused on those modifications that are the most evident and easy to study: the movement of facial muscles when emotion arises. His study was meant to find repetitive patterns in facial expressions.

To understand if all subjects reacted in the same way to emotions, Landis recruited a good number of his fellow graduate students, and began by painting their faces with standard marks, in order to highlight their grimaces and the related movement of facial muscles.
The experiment consisted in subjecting them to different stimuli, while taking pictures of their faces.

At first volunteers were asked to complete some rather harmless tasks: they had to listen to jazz music, smell ammonia, read a passage from the Bible, tell a lie. But the results were quite discouraging, so Landis decided it was time to raise the stakes.

He began to show his subjects pornographic images. Then some medical photos of people with horrendous skin conditions. Then he tried firing a gunshot to capture on film the exact moment of their fright. Still, Landis was having a hard time getting the expressions he wanted, and in all probability he began to feel frustrated. And here his experiment took a dark turn.

He invited his subjects to stick their hand in a bucket, without looking. The bucket was full of live frogs. Click, went his camera.
Landis encouraged them to search around the bottom of the mysterious bucket. Overcoming their revulsion, the unfortunate volunteers had to rummage through the slimy frogs until they found the real surprise: electrical wires, ready to deliver a good shock. Click. Click.
But the worst was yet to come.

The experiment reached its climax when Landis put a live mouse in the subject’s left hand, and a knife in the other. He flatly ordered to decapitate the mouse.
Most of his incredulous and stunned subjects asked Landis if he was joking. He wasn’t, they actually had to cut off the little animal’s head, or he himself would do it in front of their eyes.
At this point, as Landis had hoped, the reactions really became obvious — but unfortunately they also turned out to be more complex than he expected. Confronted with this high-stress situation, some persons started crying, others hysterically laughed; some completely froze, others burst out into swearing.

Two thirds of the paricipants ended up complying with the researcher’s order, and carried out the macabre execution. In any case, the remaining third had to witness the beheading, performed by Landis himself.
As we said, the subjects were mainly other students, but one notable exception was a 13 years-old boy who happened to be at the department as a patient, on the account of psychological issues and high blood pressure. His reaction was documented by Landis’ ruthless snapshots.

Perhaps the most embarassing aspect of the whole story was that the final results for this cruel test — which no ethical board would today authorize — were not even particularly noteworthy.
Landis, in his Studies of Emotional Reactions, II., General Behavior and Facial Expression (published on the Journal of Comparative Psychology, 4 [5], 447-509) came to these conclusions:

1) there is no typical facial expression accompanying any emotion aroused in the experiment;
2) emotions are not characterized by a typical expression or recurring pattern of muscular behavior;
3) smiling was the most common reaction, even during unpleasant experiences;
4) asymmetrical bodily reactions almost never occurred;
5) men were more expressive than women.

Hardly anything that could justify a mouse massacre, and the trauma inflicted upon the paritcipants.

After obtaining his degree, Carney Landis devoted himself to sexual psychopatology. He went on to have a brillant carreer at the New York State Psychiatric Institute. And he never harmed a rodent again, despite the fact that he is now mostly remembered for this ill-considered juvenile experiment rather than for his subsequent fourty years of honorable research.

There is, however, one last detail worth mentioning.
Alex Boese in his Elephants On Acid, underlines how the most interesting figure of all this bizarre experiment went unnoticed: the fact that two thirds of the subjects, although protesting and suffering, obeyed the terrible order.
And this percentage is in fact similar to the one recorded during the infamous Milgram experiment, in which a scientist commanded the subjects to inflict an electric shock to a third individual (in reality, an actor who pretended to receive the painful discharge). In that case as well, despite the ethical conflict, the simple fact that the order came from an authority figure was enough to push the subjects into carrying out an action they perceived as aberrant.

The Milgram experiment took place in 1961, almost forty years after the Landis experiment. “It is often this way with experiments — says Boese — A scientis sets out to prove one thing, but stumbles upon something completely different, something far more intriguing. For this reason, good researchers know they should always pay close attention to strange events that occur during their experiments. A great discovery might be lurking right beneath their eyes – or beneath te blade of their knife.

On facial expressions related to emotions, see also my former post on Guillaume Duchenne (sorry, Italian language only).

Henry Tonks and the Faceless Boys

I have wrote in the past about how plastic surgery was originally born during the Great War as reconstructive surgery. If a soldier missing an arm or a leg was indeed a familiar figure, the introduction of new weapons during the world conflict led to the appearance of a kind of wounds precedently almost unheard of: the gueules cassées, “disfigured faces”.
Helmets were able to protect the head from granade splinters, but not the face; therefore field hospitals began to receive an unimaginable number of soldier whose faces had been blown away in large portions by the explosions.
It was an injury rarely discussed in the press, where the more iconic and patriotic image of the veteran amputee was considered more suitable, but the numbers speak for themselves: within English troops alone, 41.000 amputations were carried out, as opposed to the 60.500 men who suffered head or eye injury.
One had a higher probability of finding himself without a face rather than without legs.

Practically on every front, experimental procedures were adopted to reconstruct faces destroyed by shrapnel or burned by mustard gas.
In January 1916, at the military hospital in Aldershot, England, pioneer surgeon Harold Gillies encountered doctor Henry Tonks, who was serving as a temporary lieutenant in the Royal Army Medical Corps.

Henry Tonks was a doctor and an artist: besides being part of the Royal College of Surgeons, he also taught drawing and anatomy at the Slade Academy.

Soldiers were sent back from the front in desperate conditions, and  Tonks had the feeling that he could not handle, from a professional and humane point of view, such a catastrophe. As he himself confessed in a letter: “I have decided that I am not any use as a doctor“. And in another letter he recounted: “the wounds are horrible, and I for one will be against wars in the future, you have no right to ask men to endure such suffering. It would not matter if the wounds did well but they are practically all septic“.
And as the war progressed, things did not improve. After the Somme offensive, on July the 1st 1916, more than 2.000 patients flooded the hospital: “men without half their faces; men burned and maimed to the condition of animal“.

Thus, when Gillies asked Tonks to document his reconstructive operations by portraying the patients’ faces before and after surgery, Tonks happily accepted, as he was certainly more at ease in the artistic dimension.
To draw portraits could seem redundant, as photographs of the disfigured soldiers were already being taken, but both doctors were convinced that the cold-hearted objectiveness of film could be misleading in respect to the tactile and expressive qualities of a painting.

Thanks to his collaboration with Gillies, Henry Tonks produced a seried of facial wound portraits which still today stands unsurpassed for its emotional impact, scientific interest and subtlety of representation.
Sure, these pastel portraits had first of all a didactic intent, and the author himself did not wish them to be seen by the general public. And yet these works show a complexity that transcends their function of medical illustrations.

To understand how Tonks worked on his subjects, we have an extraordinary fortune: in some cases, the archives still have both his pastel portraits and the medical photographs. We can therefore watch, side by side, two images of the same patient, one recorded on film and the other one composed by the charcoal and colors of the artist.

Comparing Tonks’ drawings with the photographic shots, what emerges is the abstraction operated by the artist, which is meant to remove any hint at the patient’s suffering or interiority. These are accurate works, detached and at the same time compassionate, focusing mainly on the open wound, depicted with an almost “tactile” precision through the stratification of color (a consequence of the artist’s surgical training).
And yet the uncanny quality of these drawings lies in their absolutely modern ambiguity.
What could by all means be a portrait of a normal male face — ordinary traits, well-groomed hair, a knotted tie — becomes somehow “sabotaged” by the presence of the wound. It is as if our gaze, wondering over the painting’s surface, could register all these common details, just to be short-circuited the moment it meets the scandal of the injury. An inconceivable monstrosity, which appears impossible to integrate with the rest of the image.
It is then inevitable for us to fall back to the eyes of the portrayed subject, to his gaze fixed upon us, and to wonder about its impenetrable meaning.

Another peculiarity is the use of pastel, a medium considered “feminine” in respect to more virile, lively oil color or tempera; a choice that in this case allows for the lacerations of the flesh to be rendered in a softer and more tolerable way. What’s more, thanks to the lighter tone of these colors, Tonks provides his subjects with a delicate beauty and tenderness that no photograph could have ever captured.
These portraits seem as vulnerable as the mutilated youth they represent.

Suzannah Biernoff, in her wonderful essay Flesh Poems: Henry Tonks and the Art of Surgery (from which I stole most of the information for this post — you can read it in Visual Culture in Britain, n. 11, 2010) defines Henry Tonks’ works as “anti-portraits, in the sense that they stage the fragility and mutability of subjectivity rather than consolidating the self portrayed“.

Henry Tonks’ studies are set apart from classic medical illustration by virtue of this research of a particular beauty. They do not recoil from the horror they intend to portray, but cover it with a veil of elusive sensuality, in which a face becomes the sign of the uncertainty of existence, and a symbol of the cruelty Man inflicts upon himself.

Street Monkeys

In Jakarta, capital of Indonesia, urban overpopulation entails extreme poverty. In order to survive, people have to come up with new ways of gathering attention. When Finnish photographer Perttu Saska saw what was going on at the corner of every street, he decided to document it in a series entitled A Kind of You.

Lolita130x105cm-

Painija130x105cm

peikko130x110cm

These monkeys are exhibeted at traffic lights or in the alleys, dressed up in baby clothes and forced to wear doll’s heads that give them an unsettling, almost human appearance. They are trained to ask for charity, and sometimes to enact sad little performances like riding a small bike, or applying makeup while looking in a mirror.

Keinuja130x105cm-1

70x55cm2

70x55cm1

40x50cm-1-1

The phenomenon of topeng monyet (“masked monkeys”) is certainly not a sight to behold: various animal rights associations are fighting to save the 350 macaques that are exploited, undernourished, often abused and locked up inside minuscule cages every night, in appalling sanitary conditions. There have already been some good results, as reported on this article.

110x85cm-6

110x90cm-8-1

110x85cm-4-1

110x85cm-2

70x55cm3-1

But Saska’s photographs have the merit of raising questions not only on animal cruelty. The little monkeys, chained by their neck, with their dirty and torn clothes, with those doll heads (probably found in a dump), look like a grotesque and transfixed version of their owners: poor people, choked by the chains of misery, who live by their wits because there’s nothing else to do.

Saving the monkeys is important and righteous; it’s difficult to see how the ones on the other end of the leash will be saved.

Jokeri130x110cm-1

Halfface130x105cm-7-A-Kind-of-You-2-1

130x160cm-A-Kind-of-You2

110x85cm-1-1

This is what is really disturbing in Saska’s work: the feeling we are actually looking in a mirror, at “a kind of you”.

110x85cm-5

Here is Perttu Saska‘s official website.

(Thanks, Stefano!)

Il volto e l’emozione

Quando nel 1806 Guillaume-Benjamin Duchenne nacque a Boulogne in una famiglia di umili pescatori, la prima cosa che fece sua madre, stringendolo al petto, fu sorridere. Non poteva sapere che il sorriso che le illuminava il volto sarebbe stato chiamato dagli studiosi sorriso Duchenne, proprio in onore di suo figlio.

In realtà, oltre che al sorriso, il nome Duchenne è ancora oggi legato a varie atrofie, distrofie e paralisi muscolari da lui individuate e studiate, così come a uno strumento chirurgico per l’asportazione di campioni di tessuti vivi da lui inventato: ma la sua fama è legata principalmente alle ricerche sulla neurofisiologia dell’emozione. Partendo dalle ricerche galvaniche, Duchenne mise a punto uno stimolatore elettrico faradico che, applicato a determinati punti della pelle, stimolava i muscoli sottostanti con enorme precisione. Praticamente questa tecnica (non invasiva) si basava sull’uso di elettrodi molto appuntiti che appoggiati all’epidermide facevano passare una piccola scossa elettrica, indolore ed estremamente localizzata. In questo modo riuscì a catalogare per primo tutti i muscoli della faccia umana, e non soltanto.

Utilizzando soggetti paralizzati, per essere sicuro che nessun movimento fosse volontario, Duchenne cominciò ad interessarsi al modo in cui i muscoli facciali vengono utilizzati per trasmettere emozioni. A seconda che siamo arrabbiati, felici, annoiati, spaventati, il nostro volto esprime questi stati d’animo con un complesso insieme di movimenti muscolari; Duchenne riuscì a “comporre” e catalogare queste espressioni emozionali con il suo apparecchio stimolatore ed essendo un appassionato di fotografia riuscì anche a documentare queste ricerche con una eccezionale serie di immagini.

Questo suo studio sulla fisiologia muscolare durò vent’anni, la missione di una vita. Fra le varie sorprese incontrate nel corso degli esperimenti, Duchenne trovò anche qualcosa che, per quanto non abbia un profondo valore scientifico, è rimasta una delle scoperte più curiose legate alla sua ricerca: la differenza fra un sorriso sincero e uno falso.

Duchenne si accorse che, quando stimolava elettricamente i suoi soggetti, non riusciva a ottenere da loro un sorriso convincente. Cosa mancava? Provò quindi a provocare con gli elettrodi un sorriso sul volto di un soggetto, e immediatamente dopo apostrofarlo con una battuta spiritosa, per confrontare quali muscoli si muovessero nel sorriso “indotto” e in quello spontaneo. E di colpo, capì.

Quando sorridiamo per cortesia (ma in realtà siamo annoiati), oppure per ingannare chi ci guarda facendogli credere che siamo felici, tutti i muscoli attorno alla bocca si attivano in maniera molto simile al sorriso naturale. Questo sorriso “bugiardo” difetta però di qualcosa:  sono i muscoli intorno agli occhi e alle sopracciglia, scoprì Duchenne, che si muovono soltanto se il sorriso è sincero e genuino. Provò quindi che il detto “ridere con gli occhi” era meno metaforico del previsto.

Nonostante i suoi metodi poco ortodossi, Duchenne rivoluzionò la conoscenza scientifica: è ricordato come uno dei più grandi medici del XIX Secolo e come il fondatore della neurologia. Se lo sapesse sua madre, come credete che sorriderebbe?

(Grazie, Marco!)

Il Povero Edward

Edward Mordake (o Mordrake) è uno dei più celebri freaks di sempre, e questo anche se la sua effettiva esistenza non è mai stata provata.

La sua vicenda, infatti, si colloca in pieno ‘800, agli albori della storia clinica, ed è stata tramandata attraverso racconti popolari e folkloristici, ma mai documentata nei testi medici. Ancora oggi la sua triste vita ispira artisti e cantautori, perché ci parla del corpo come prigione, come inferno personale.

Edward, racconta la leggenda, nacque ereditiero di una delle più nobili stirpi inglesi. Era un giovane sereno, solare e grazioso, eccellente studioso e musicista delicato. Ma Edward aveva un pesante fardello da portare: sul retro della sua testa, sulla nuca, aveva una seconda faccia.

Questo suo gemello non completamente formato poteva ridere e piangere, e seguiva con lo sguardo le persone che entravano nella stanza. Le sue labbra continuavano incessantemente a muoversi, come se la faccia bisbigliasse qualcosa, anche se nessuno udiva la sua voce.

Ma pochi sapevano quale fosse la terribile verità: quando calava la notte, e tutti se ne andavano, Edward rimaneva da solo con il suo “fratello”, e cominciavano i tormenti. La seconda faccia era infatti crudele e malvagia, come un gemello demoniaco. Di notte, si dice, sussurrava ad Edward parole “che stanno soltanto all’Inferno”. Rideva quando Edward singhiozzava per la disperazione.

La storia si conclude invariabilmente in modo drammatico: a 23 anni, Edward si uccide, reso folle dall’incessante e sadico bisbigliare della sua seconda faccia. Alcuni dicono che si avvelenò, altri che si impiccò, altri ancora che si sparò in testa (dritto fra gli occhi del malefico “gemello”). Alcune varianti della storia specificano che lasciò scritto come desiderio che la seconda faccia venisse distrutta prima della sua inumazione, “perché non continui i suoi osceni bisbigli anche nella mia tomba”.

La versione più popolare della storia è raccontata nel testo del 1896, Anomalies and Curiosities of Medecine, ed è per molto tempo stata considerata inattendibile, per via dell’arricchimento dovuto ai decenni di passaparola. Alcune versioni della storia sostengono addirittura che la seconda faccia di Edward fosse quella di una bellissima e maligna ragazza – cosa ovviamente impossibile perché tutti i gemelli parassiti sono dello stesso sesso. Quindi Edward Mordake è davvero soltanto una leggenda?

[youtube=http://www.youtube.com/watch?v=bWwSXpyyDMQ]

Questo è Chang Tzu Ping. Scoperto tra la fine degli anni ’70 e l’inizio degli ’80 da un gruppo di militari americani; aveva una seconda faccia consistente di una bocca, una lingua rudimentale, qualche dente, un pezzo di scalpo, e le vestigia di occhi, naso e orecchie. Fu portato negli Stati Uniti dove la sua seconda faccia venne asportata chirurgicamente. Una volta ritornato al suo paese natale, in Cina, “Chang dalle due facce” finalmente potè vivere serenamente con gli altri abitanti del villaggio, non più terrorizzati, e non si seppe più nulla di lui.

Casi come questi ci fanno dedurre che forse un briciolo di realtà, esagerata poi dalla sensibilità popolare, fosse presente anche nella storia del Povero Edward.

Concludiamo con la ballata dedicata a Mordake dal nostro beniamino, Tom Waits.

[youtube=http://www.youtube.com/watch?v=xrbddZuN_8Q]

Gueules cassées

La Prima Guerra Mondiale fu un vero e proprio massacro. Ma il peggio non venne per chi restò sotto il fuoco delle prime mitragliatrici, o per chi rimase vittima dei gas o delle bombe. Molti furono così fortunati da salvarsi, e così sfortunati da tornare a casa con ferite assolutamente agghiaccianti. I ritardi nei soccorsi non fecero che peggiorare la situazione dei feriti, che spesso non si ripresero più integralmente.

Una categoria particolare di reduci con ferite di guerra è costituito dalle cosiddette gueules cassées, termine francese che significa pressappoco “facce fracassate”. Erano i militari che avevano riportato estese ferite al volto, e che erano per così dire “impresentabili” e dunque difficilmente reintegrabili nella società. Per la prima volta nella storia, però, la medicina aveva i mezzi per cercare di ovviare a questi incidenti. Stiamo parlando, qui, degli esordi pionieristici della chirurgia plastica ricostruttiva del maxillo-facciale. Sulla base di queste prime esperienze i chirurghi furono in grado di sviluppare un’esperienza che, affinatasi nel tempo, permette oggi di restituire una vita quasi normale a persone sfigurate. (È triste ammetterlo, ma questi soldati fecero anche inconsapevolmente da cavia per quelle tecniche che successivamente portarono alla chirurgia estetica vera e propria, quella delle labbra al silicone, del lifting o dei seni rifatti).

In questo blog abbiamo già parlato di terapie piuttosto crudeli relative agli albori della medicina. Quello che colpisce sempre nel riesaminare a distanza di quasi un secolo queste tecniche mediche primitive, è la scarsa considerazione che i medici sembravano avere della sofferenza del paziente. Confrontate i tentativi odierni di essere sempre meno invasivi, delicati, poco intrusivi, con queste tecniche antiquate: il dolore era qualcosa che andava sopportato, punto e basta, mentre i dottori cercavano di salvarti la pelle o migliorarti la vita.

Prendiamo ad esempio i sistemi per aprire la bocca del paziente. Molto spesso, dopo un trauma facciale, i muscoli della mascella rimanevano tirati e in tensione e aprire la bocca risultava impossibile. A seconda del grado di gravità, venivano utilizzati diversi sistemi. L’apri-bocca più comune era questo:

Si trattava di una sorta di morsa “al contrario” che veniva aperta gradualmente per allentare la tensione dei muscoli. Aveva effetti poco rilevanti nel tempo. Altri metodi, però, erano ancora più drastici e dolorosi.

Il “procedimento del sacco”, esposto dal dottor Pitsch nel 1916, è un esempio di terapia davvero brutale. Una volta trovato un interstizio tra i denti, due assicelle venivano inserite nella mascella del paziente.

Appena dischiuse le due pareti dentarie, un uncino veniva attaccato alla mascella inferiore e a questo veniva attaccato un sacco pieno di sassi o carbone il cui peso veniva velocemente aumentato per consentire l’apertura della bocca.

Il procedimento era dolorosissimo e non aveva effetti notevoli a lungo termine, perché i muscoli, troppo bruscamente e violentemente stirati, si ricontraevano poco dopo. Anche se la trazione veniva bilanciata da una banda che tratteneva il capo del paziente, le vertebre della nuca risentivano comunque dello stress.

Più complesso ancora era il caso dei volti sottoposti a un vero e proprio trauma che li aveva lasciati a brandelli e con ferite aperte. La protesi immediata veniva effettuata mediante maschere di contenimento che riportassero assieme i vari frammenti di volto, in modo che non si allontanassero ma anzi si fondessero assieme. L’idea era quella di cicatrizzare l’area più grande possibile, favorendo il consolidamento in buona posizione delle fratture, per permettere in seguito la riparazione delle parti lese. Il casco di Darcissac teneva insieme i diversi “pezzi” di faccia finché non si fossero riattaccati e cicatrizzati. L’intera procedura durava due o tre settimane, di immobilizzazione assoluta.

Passarono alcuni anni, prima che nel 1918 si arrivasse alla rivoluzionaria tecnica di Dufourmentel. Egli scoprì infatti che la pelle del cuoio capelluto reagiva meglio ed era più solida rispetto a quella del braccio. Tagliando quindi ampi lembi di pelle dal cranio dei pazienti, Dufourmentel riuscì a ricostruire elementi fino ad allora inapprocciabili della ricostruizione facciale. Ecco una mandibola “rimodellata” a partire dal cuio capelluto.

Anche gli italiani ebbero una parte in questa “corsa” alla ricostruzione dei volti dei reduci. I medici, infatti, provarono anche a ricorrere a una metodologia già inventata e spiegata addirittura nel XVI secolo dal chirurgo italiano Tagliacozzi, modificando qua e là il procedimento e le indicazioni di questo storico precursore. Questa tecnica si applicava soprattutto alle perdite moderate di tessuto nell’area nasale e del mento.

L’idea era quella di “rialzare” un lembo di pelle dal braccio, connetterlo al tessuto mancante del volto e lasciare che la pelle facesse il suo lavoro, “ricucendosi” con le parti mancanti. Ovviamente bisognava assicurarsi che il braccio fosse immobilizzato, per due o tre settimane, al fine di permettere la vascolarizzazione dei nuovi tessuti. Questa tecnica era stata, nei secoli precedenti, violentemente ostracizzata dalla Chiesa, a motivo della presunta interferenza con i piani del Creatore, e la Santa Sede dispose addirittura la riesumazione del Tagliacozzi e la sua sepoltura in terra non consacrata.

Infine la tecnica di ricostruzione prevedeva degli esperti dentisti che, a partire dai calchi del volto dei pazienti, progettavano e scolpivano protesi che potessero ridare loro la fisionomia perduta.

Le protesi alle volte includevano occhiali per dissimulare l’artificio.

Infine, ecco un raro filmato della Croce Rossa, datato 1918, in cui alcuni dottori e infermiere posizionano e controllano l’efficacia delle protesi facciali su alcuni reduci.

[youtube=http://www.youtube.com/watch?v=8epVBKiMmns]

Le tecnologie di ricostruzione del maxillo-facciale hanno da allora fatto un passo in avanti decisivo, e ad oggi costituiscono la fortuna di chirurghi plastici proprietari di atolli e isolotti, così come di onesti medici che cercano di ridare il sorriso e un’integrazione maggiore alle vittime di incidenti terribili.

Per ironia della sorte, la chirurgia estetica è nata proprio da uno dei più grandi e sanguinosi confilitti che il mondo abbia mai conosciuto.

Pugni in slow motion

Il nostro corpo è più elastico di quanto non sembri a prima vista. Ecco cosa succede nella frazione di secondo in cui riceviamo uno schiaffo… o un pugno. (Scoperto via Laccahrossa)

[youtube=http://www.youtube.com/watch?v=LRHK0K2ii6Q]

[youtube=http://www.youtube.com/watch?v=kgdyBvHdNKY]