European surgeons' earliest efforts to repair cleft lips, one of the most common congenital abnormalities, were recorded by some of the Renaissance's greatest artists.
A study by scholars from Germany's University of Ulm, led by Wolfgang Pirsig, has found paintings and drawings by Albrecht Durer, Jacob Cornelisz, Leonardo da Vinci and others depicting people with the distinctive profile of reparative surgery.
The oldest of these images was made 130 years before the first medical illustration of the procedure was published in 1564. This shows St Cedonius with a facial contour with characteristic drooping nasal tip, a jutting lower jaw and vertically shortened upper lip.
Although there are records of cleft-lip surgery in China more than 1,500 years ago, and Saxon surgeons are recorded as suturing harelips with silk in pre-Norman Britain, Pirsig said these late Gothic images were a surprise.
The study has been published in the British Journal of Oral and Maxillofacial Surgery .