The miracle transplantation of a black leg by the surgeon saints Cosmas and Damian

The miracle of the saints Cosmas and Damian refers to transplantation of a black leg onto a white man that took place in medieval Rome (Figure 1) (1). A sexton of a church in Rome was seriously affected by cancer in his right leg. Flung into a delirious fever, he dreamed that the holy surgeons, saint Cosmas and saint Damian, visited him and skilled as they were, decided to remove the affected leg and replace it with a healthy leg. They went to the grave of a recently deceased Ethiopian man and retrieved the right leg of this black man and took it to the sexton. The sick leg of the sexton was amputated and they transplanted onto him the leg of the black donor. Since their miracle operation, Cosmas and Damian have been elevated to patron saints of the surgical profession and many surgical societies have adopted their names in honor of them.

Figure 1 The miracle of the saints Cosmas and Damian in which they transplanted the leg of a black man onto a white recipient in medieval Rome [1515]. Collection Wüttembergisches Landesmuseum, Stuttgart, Germany.

While the transplant was technically a miracle, the choice of a leg graft from a black cadaveric donor for a white recipient was remarkable. It shows that even in times in which surgeons could only dream of transplantation, altruism prevailed free of racial issues. In our era of organ transplantation, altruism has been the fundamental principle in organ donation by which each available organ should go to anyone in need of the organ, irrespective of race, religion or any other conditions.

In South Africa during the early days of organ transplantation in the 1960’s, the nation was divided by the ‘apartheid’ regime, drawing a line between the white and black population. Although the hospital wards were segregated by law, there were initially no racial issues in transplant surgery. Christiaan Barnard, the South African cardiac surgeon who performed the world’s first successful heart transplant in Cape Town in 1967, was an outspoken opponent of ‘apartheid’. He previously transplanted a kidney graft in a white female with the name Mrs. Black. She received a kidney donated by an African male. The newspaper headlines the next day read: ‘Mrs. Black gets black kidney!’ (2).

Later he performed his first cardiac transplant using a heart from a white South African donor that went to a white recipient. Two weeks earlier, a suitable black donor was admitted, but Barnard and his team decided to avoid any criticism that could arise of exposing a black individual to an experimental procedure (2).

The miraculous transplantation of a black leg into a white recipient, stands out as a primeval symbol of unconditional altruism in transplantation surgery.

Acknowledgments

Image provided by Wüttembergisches Landesmuseum, Stuttgart, Germany.

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Hepatobiliary Surgery and Nutrition. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-24-26/coif). T.M.v.G. serves as an unpaid Deputy Editor-in-Chief of Hepatobiliary Surgery and Nutrition. The author has no other conflicts of interest to declare.

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References

1. Friedlaender GE, Friedlaender LK. Saints Cosmas and Damian: Patron Saints of Medicine. Clin Orthop Relat Res 2016;474:1765-9. [Crossref] [PubMed]
2. Barnard CN. The first human-to-human heart transplant. In: Terasaki P. editor. History of Transplantation: Thirty-Five Recollections. Los Angeles, USA: UCLA Tissue Typing Laboratory; 1991.