It is a dreary November night. In the solitary chamber at the top of the house, Victor Frankenstein stands, ready to animate the work his hands have produced. We, the readers, have been present for this labor: the collection of body parts, their disassembly, their reassembly, the tentative dream of an entity “eight feet tall.” The completed body lies limp and vulnerable — the physical manifestation of bodies of thought, the ideologization of the physical body. A patchwork of production, a fragile little thing. Yet, one step in the meticulous record of Frankenstein’s great work is missing: not once in the novel do we see Dr. Frankenstein pick up a needle, and begin to sew.
This is not to criticize Mary Shelley’s own masterpiece, but to identify a gap within the historical concern with the production of art and text. Suture — as labor, as craft, as writing, as the simultaneous overcoming and monumentalization of bodily division — stands as a sort of loose thread in this historical interest, something to be generally ignored, or perhaps idly picked at in moments of leisure. I propose we begin to pull on it.
The early history of suture itself exists as a sort of patchwork, composed of fragments of writing and image, interspersed with periods of development in textiles and in medicine. One record exists in the Scottish Society on the History of Medicine’s History of Sutures, which traces the practice from ancient Babylon to 20th century Scotland. According to this text, the first record of suture is found in the Edwin Smith Papyrus, the oldest known surgical text dating back to the 1600 B.C.E New Egypt Empire, which states of the activity that “thou shouldst draw together for him his gash with stitching.” Roughly 1600 years later, in 30 A.D., Roman physician Aurelius Cornelius Celsus tells us in his treatise De Medicina that sutures should be “soft, and not over twisted, so that they may be more easy on the part.” Nine centuries later, Roger of Solerno of the Schola Medica Salernita — the first known Medieval medical school — recommends in his Practica Chirurgiae the use of silk in suture, to “hold the wounded edges together,” and the technique of “interrupted sutures about a finger-breadth apart.”
These texts are crucial in understanding historical conceptions of suture-as-techne in their textuality. They serve as guidelines, as histories, and as ideologies of the body. Something done — stitching — is transformed into something written, with the intention that these writings be translated back into action through their instructive function. Yet as much as suture (and the body) has a textual history, it also has a visual history.
The man considered the ‘father of anatomy,’ Andreas Vesalius, born 1514, was as much artist as he was physician, and founded the anatomical sciences entirely through groundbreaking illustrations of the body reliant upon recently developed Renaissance art techniques. This means that the origin of anatomy as a science is a gallery of anatomic images, and this gallery has been significantly added to since its inception. The corpus of Ambroise Paré, a 16th century surgeon hugely influential in the development of ‘dry suturing,’ includes decorated, looping illustrations of different ligatures. The 18th century saw alongside its regularization of the sciences a surge in detailed, realistic depictions of various surgeries — tongues cut open and stitched together again, neatly exposed arteries with a suture hook hovering over them, step-by-step caesarian sections. An article from the American Journal of Nursing in 1933 describes the use of a “course of drawings” in which students are required to draw illustrations of surgical operations and stitch patterns for sutures, with “the objective being that the image be indelibly impressed upon the student’s mind.” The history of anatomic research and surgical practice is in this way not only implicated in the history of text, but in the history of art — underlying medical knowledge and teaching is an anatomic imaginary.
The history of the development of suture must then be read alongside the history of the translation of the body into word and image – into an object of investigation and recording. Yet suture, as this impetus for surgical writing and drawing, can itself be seen as a kind of writing — a physical inscription of a medical history onto the body itself, a literal complication of its medium (flesh) in the sense of the Latin cum plicare, “to weave together.” If Nietzsche conceives of forgetting as a process of “incorporation,” suture seems to be the opposite: an excorporation, the externalization of a trauma in permanently stitching it into the skin, the founding of a mnemonic (and therefore historic) body.
Nietzsche’s own description of the memory of man is something that has “become flesh in him” — a symbol of the assimilation of an intrusion upon the body, or, more simply, scar tissue. Insofar as Nietzsche claims memory must be “burned in,” it perhaps can also be sewn in — bound to the flesh with the same patterns of stitches used to bind books. With suture, the body then is not only translated into but is practically treated as a text to be written upon, or a textile to be stitched into. It is no accident that the title of Andreas Vesalius’ magnum opus is De Humanis Corporis Fabrica – “On the Fabric of the Human Body.”
An interesting way to consider the body as text or fabric in the context of suture is through Michel de Certeau’s theory of the ‘pedestrian speech act.’ In his essay “Walking in the City,” de Certeau uses the theory of the speech act to analyze the relationship between the path of the pedestrian and the urban topography. De Certeau writes that “[Pedestrians] intertwined paths give their shape to spaces. They weave places together. … They are not localized; it is rather that they specialize.” This can be understood in relation to the concept of generativity in language, which argues that within a fixed number of sounds and letters that a single language permits, an infinite number of utterances are possible. Within de Certeau’s schema, streets act as a political language. As the negative spaces between the edifice of the city, they serve both as spatial ruptures and loci of possibility: within the limited area carved out, the pedestrian is allowed an infinite number of ways to pass through. He stops at one spot to look in a window, turns to dodge a different pedestrian at another, and at every second participates in a network of bodies that determine the actual spatialization of the city in the way speech determines the actualization of a grammar.
I want to propose that we can understand the specific engagement of suture with the body in the same way – as a “giving shape to spaces,” or a “weaving places together,” an actualization of a medical grammar. Furthermore, using de Certeau’s characterization of the map as a “surface of projection” which “exhibits the (voracious) property that the geographical system has of being able to transform action into legibility,” I argue that we can understand the canon of surgical literature and imagery as an attempt at a cartography of the body. Moving across the skin, creating individual spatial patterns while still confined within a structure of medical practice, encountering and initiating different organizations of space, the needle participates in a bodily topography.
De Certeau goes on to consider a defining characteristic of this ‘speech act’ that specifically relates to generativity, the “phatic”:
The "phatic" aspect, by which I mean the function … of terms that initiate, maintain, or interrupt contact, such as "hello." "well, well," etc. … Walking, which alternately follows a path and has followers, creates a mobile organicity in the environment, a sequence of phatic topoi.
The nonessential particularities of the suture – one stitch 0.1 mm longer than the next, the threads at the end of one knot slightly shorter than those of the next, two sutures marginally closer together than two others – can be seen as this ‘phatic’ characteristic. A product of the interplay of technique and wound, or of the particularity of the act situated within the particularity of the location of action, stitching becomes walking: navigating the bodily space and adjusting, adapting and reconfiguring within the historically designated path allotted to it. At the meeting of the theoretical body articulated by medical literature (the ‘map’) with the site of medical praxis (the particular body), the surgical ‘phatic’ emerges. The particular-historic body is stitched together.
We may return here to Nietzsche’s idea of memory. Alongside incorporation, Nietzsche defines ‘to forget’ as “to make room for new things.” Conversely, trauma seems to be a sort of crowding — with the suture-as-pedestrian, memory or scars serve as a sort of traffic, congesting spaces of movement, forcing diversions. The scar, necessarily a non-rupture, but simultaneously a symbol of rupture, both serves as a monument to the body’s historicity and interacts with any further impositions of history onto the body at the scar’s location. Trauma as the ‘deepening’ of man, as Nietzsche characterizes it, can in this way be seen not as a cutting into but a process of addition or edification — increasing the body’s dimensionality, grafting layers upon its surface, forcing complexity onto it.
De Certeau seems cognizant of this idea of addition when he writes, “the long poem of walking … creates shadows and ambiguities within [spatial organizations]. It inserts its multitudinous references and citations into them (social models, cultural mores, personal factors).” Sutures and scars become citations of a history of text and practice, and the body becomes an intertextual site. This relation between speaking, walking, and surgery as simultaneously a compilation and realization of text can even be found within de Certeau’s writings: it is not insignificant that he describes the “style of use” so crucial to speaking and walking as “a way of operating.”
With this understanding of suture as spatialization and complication, a literal engraving of a body of history into the particular body, inextricably linked to trauma and scar; we can consider another instance of the prominence of the suture in cultural history: in its caricaturization, prosthetic makeup.
One of the earliest instantiations of what could be considered ‘modern’ prosthetics was seen at the early 20th century Théâtre du Grand Guignol in Paris, known for its graphic horror productions. Accredited to Grand Guignol is significant innovation in the manufacturing of different shades of fake blood. The theatre’s stage manager was rumored to receive a daily delivery of bodily horror from a nearby butcher, including sheep eyes and cow tongues to be used as props. Onstage, eyes were carved out, stomachs were torn open, arms were ripped off: violence was treated as festival. What is significant about Grand Guignol’s iteration of prosthesis is that it relied upon the unrealizability of the bodies it created. Its horror was celebrated in its fictionality — violence had to be unnatural or supernatural in order to be spectacle. Following the realization of indescribably horrifying violence in WWII, the theatre, finding it had lost its audience, was forced to close.
The necessary fictionality of prosthetic makeup is perhaps most interesting in relation to the idea of suture as addition. Literally meaning “to place in addition to” (pros tithenai), prosthesis is a practice of accumulation, a placing of exterior materialities in a specific relation to the organic body. Crucially, with prosthetic makeup, this constitutes an impermanent addition. One of the pioneers of prosthesis in film, Lon Chaney, was made famous precisely for his transformation of wax, cotton, wool, tissue paper, latex, and greasepaint into a technology of removable addition. With Richard Smith’s invention of the 3-piece prosthetic face mask in the 1950’s, allowing the actor a wider range of facial expressions, prosthesis became easier to assimilate with the ‘real’ face, but also, more crucially, easier to take off. Prosthetic makeup in its essence allows for the production of a disposable trauma.
In this way, the body in prosthetics can be seen as a sort of false topography: it represents space that does not exist, a surface without depth (complication), speech without content. Insofar as the theoretical body built by the history of medical literature cannot itself physically exist (an existent body must be a particular body), the prosthetic body is particularity without mnemonics and without history. Or, if it does display a history, it is an artificial one — artificial because it is one that the body is not actually, painfully bound to.
We can perhaps return here to Vesalius and the “fabric of the human body.” If we accept suture as a textile practice of sewing history into the flesh, prosthesis seems to bring to the forefront the idea of the body as a space of fabrication — fabrication of depth, of spatiality, of story (the inauguration of the Award for Best Makeup at the Academy Awards in 1981 stands as a testament to the legitimization of prosthesis as a form of storytelling and the body as a tool of narrative). One thinks of Freud’s famous description of the modern, prosthetic man: “When he puts on all his auxiliary organs he is truly magnificent; but those organs have not grown on to him and they still give him much trouble at times.” In what way can additions to the body ‘grow on to’ it? Only when they are forcibly stitched in.
Ironically, then, it is only in the fabrication of surgery and suture that it is given weight as an artistic practice, or as a ‘work.’ Considering this, one further moment in prosthesis perhaps deserves consideration as the final point of this investigation. In 1931, Jack Pierce (incredibly, born with the name Janus) created through prosthetics the now virtually canonical image of Frankenstein’s monster. The cultural adoption of Pierce’s monster as the monster indicates one further capacity of prosthesis: that of hermeneutics. Pierce, who heavily studied surgical texts before beginning his design, was able to visually account for the lacunae in Shelley’s text in regards to the physiology of the monster and fundamentally impact future engagements with the original text (try rereading Frankenstein without visualizing at least one aspect of Pierce’s design in the monster — you can’t). In the iconic picture of Boris Karloff, the monster looks down upon the viewer with sunken eyes and a suggestion of a grin. The famous electrodes jut out of either side of his neck. A gaping wound extends down his face. It is to this prosthetic outfit designed by Pierce, and to this specific wound, that we can attribute one of the most recognizable features of the cartoon monster that infiltrates grocery store windows and candy bar wrappers around Halloween: running down the right side of his forehead, a perfectly neat set of stitches.