INFLUENCE OF CRANIOFACIAL SURGERY ON THE SOCIAL-ATTITUDES TOWARD THE MALFORMED AND THEIR HANDLING IN DIFFERENT CULTURES AND AT DIFFERENT TIMES - A CONTRIBUTION TO SOCIAL WORLD-HISTORY

A historic overview including the European, American, Asian, and Afric an continents is given on attitudes toward and the handling of humans with congenital malformations in ancient cultures and on pertinent cus toms in some prehistoric peoples. Figures of early works of art showin g malformed individuals are presented testifying to this worldwide and timeless problem of humankind. In parallel, analogous patient photogr aphs from our hospital before and after reconstructive surgery are sho wn. Philosophies of ancient Greece, Rome, and China on the subject of malformed infants essentially did not differ from the known attitudes of the less developed tribes in Europe and pre-Columbian America, alth ough the means of elimination of unwanted offspring were rather passiv e (exposure) than active (manual killing). A radical change in attitud es and practices occurred with the spread of the Christian religion an d its political installment in Europe: The care for the underprivilege d including the malformed ones was considered a Christian duty to be p erformed with compassion and love. In our century, the clocks have bee n and apparently are turned back again. Atheistic and Darwinian influe nces, political atheism, and the belief in ''higher ethics'' issued by ''superman'' have led to a relapse into barbarism, also within the me dical system. We, as craniofacial surgeons, are privileged to have the means to turn the clocks forward again by rehabilitating the physical ly most underprivileged: those with conspicuous craniofacial malformat ions. The necessary techniques exist and are applied, as the figures o f patients from our hospital demonstrate, but the will and the emotion al strength for their consequent application require more than our han ds.