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More Stories Skin Deep

November 28th 2011

Social Topics - Singapore Tattoo Con 2009

This is part two of Stories On The Skin: The Life and Times of Tattoos, Piercings, and Modifications.

Tattoos had been used in ancient Greece and Rome to mark ownership of slaves and as punishment for criminals. Rather than being ornamental, the tattooing practices signified degradation, punishment, and permanent ownership. In Greek literature, the first reference to tattooing is as stigmatias or “a marked slave.” The word stigma in English is derived from the Greek and indicates discredit or shame.

Apparently the Greeks adapted their tattooing practices from the Persians, and later, the Romans continued the practice of tattooing slaves and the term stigmata. Within the medical text Medicae artis principes, by the sixth-century Roman physician Aetius, is the oldest known description of stigmata.

Spiritual and Religious

Body modification can certainly have spiritual meaning; many people are on nature-based spiritual paths seeking to reclaim or regenerate magical rites of passage.

Ritualising the act of tattooing may be the closest we humans have to transform the body in an ancient, Shamanic way to mark the passage of the seasons and the growth of the Self, and decorating it in a way that is pleasing to the spirit.

In the Pujab, India, there exists a widespread belief that a tattoo is inscribed on the soul as well as the body. When a person dies, the soul “will go to heaven blazoned with the same tattoo patterns which adorned the body in life.”

In the Bible, slaves who were free but chose to work for their masters had their ear pierced to signify their loyalty and steadfast devotion to their master. (Exodus 21.5, Deuteronomy15.16)

Orthodox Jews have a prohibition against chavalah (wounding), but Israel is turning more and more to aesthetic surgery. The negative overtones of tattooing include refusing the burial of tattooed Jews in consecrated grounds. The changes in society have forced even the most conservative to reconsider expansion of aesthetic permission, especially in cases of social isolation and psychic pain brought on by physical deformities.

Is it a matter of original skin vs. original sin?

The treatment of our earthly bodies as ordained by the religious mandate of cleanliness has been weighed against the tribal superstition or modern self-aggrandizement through modification and adornment.


From Egypt to South Africa, from the Native American peoples to the Inuit, tattooing has traditional uses as preventative medicine against illness in much the same way as the West uses vaccination. In the Sudan and other African states, the welt tattoos are not purely decorative but act as a way of strengthening the immune system or reducing the risk of infection. Similarly, a particular mark or symbol can used to enhance fertility or to boost courage. The tattoo here is not only a means of giving quick information about its owner, but as a way of using the body’s natural energy centres and sensitive points to work magically. The significance of the design, however cryptic, and the act of will in the application, create the medicine.

Protective tattoos are rarely used in the West during pregnancy (for fear of infecting the infant) but can be observed in other cultures as a way of ensuring the baby is healthy or guarded from spiritual attack.

As the noted medical historian Roy Porter wrote, “The body is pregnant with symbolic meanings, deep, intensely charged and often contradictory … Medical beliefs are always underpinned by cultural attitudes and values about the flesh.” The use of tattoos, modifications, and adornment often reflect attempts to ward off the perceived evil of sickness and death. Porter adds, “The dread of disease, potential and actual, the pains of acute complaints and long-term ailments, and the terror of mortality number among our most universal and formidable experiences.”

Literary References

One of the great literary characters is Queequeg, the Polynesian harpooner in Moby Dick. He opens Ishmael’s mind and eventually saves his life. Not only is Queequeg is important to the theme of friendship, but he is important for the value of diversity and tolerance. Although Queequeg is a heathen, by Christian definition, Ishmael increasingly notices the man’s independent dignity, good heart, extraordinary courage, and generous spirit. Queequeg’s body is covered with tattoos, and Ishmael initially assumes that the aborigine must be a cannibal. He soon learns that his new friend is one of the most civilized men that he has ever met. As Ishmael concludes, “You cannot hide the soul.” Born a prince, Queequeg gave up a life of ease on his native island, Kokovoko, when he stole aboard a visiting whaling ship and insisted on joining the crew. His purpose was to experience the world of which he had only heard stories. Ishmael, too, wants to see the world. What they discover is that a man’s soul is more important than his appearance or even his religion.

Ishmael has sensed his friend’s noble spirit. In fact, almost immediately Ishmael recognizes Queequeg’s noble character, noting that he “treated me with so much civility and consideration, while I was guilty of great rudeness.” Queequeg is a synthesis of all racial and ethnic characteristics; that is, he is a symbol of all mankind. His signature is the symbol for infinity.

Cosmetics and Aesthetics

Cosmetic medical procedures and permanent make-up applications utilize piercing, tattoo and modifications. Sander Gilman, in his book Making The Body Beautiful: A Cultural History of Aesthetic Surgery, writes, “The desire for rejuvenation in the West is as old as myth. Did Ponce de Leon really find the fountain of youth? One doubts it.”

Emanuel Thorne of the Aspen Institute stated, “Human beings have become useful to each other in ways never before possible.” Cosmetic, corrective, and replacement surgeries are a rapidly growing part of our society, including hair transplantation, breast augmentation and reduction, penile implants, sex change operations, and corrective rhinoplasty. We live in a time when all of us can exist in the realm of possibility—depending on supply and demand, we are able to have a part, whether it is heart or knee, replaced. The demand, of course, far exceeds the supply, yet we march on at a furious pace. In 1996, more than 300,000 people received bone, tendon, ligament, and connective-tissue implants. More than 40,000 people underwent corneal transplantation. Hundreds of thousands of replacement and cosmetic procedures occur annually.

The replacement of a diseased organ by a healthy one has turned from dream to reality for tens of thousands of people of all ages. The “old” favorites are on the menu, such as hip or knee replacement. Many of the items may be either new or variations of old standards that are filled with exciting ways to put more zip in your drive or eliminate the catch in your giddy-up. Tasty! While you browse, you will move on to Nouvelle cuisine, and you can sample delicacies such as knee shaving, and new foci in gene therapy. As we head into a new millennium, more and more of us will be seeking to utilize the great technology that awaits.

Health Considerations

What about the piercing and tattoo scene and where is it headed? Both forms of adornment have their dangers. The American Dental Association opposes oral (tongue, lip, or cheek) piercing and calls it a public health hazard. The American Academy of Dermatology has taken a position against all forms of body piercing with one exception: the ear lobe.

People piercing their bodies should concern themselves with more than just sensitivity and allergic reactions. One of the biggest problems many of us see is keloid formation. Although the ear lobe is made of fatty tissue and has a good blood supply, it does not protect you from the wrath of keloids and other disfiguring growths that can sprout up in response to piercing.

A keloid is a large scar or raised portion of abnormal skin. I have removed horrendous keloids on those that have had ear piercings including one recently that had grown to the size of a small tomato on the right ear of an African-American man.

The tattooing procedure involves a variable amount of pain and a small amount of bleeding. The medical complications can be classified as either infectious or noninfectious. Noninfectious include scarring (common), skin allergies to the jewelry metals, urticarial (hive-like) reactions, and prolonged bleeding. Malignant melanoma, basal cell carcinoma, squamous cell carcinoma, psoriasis, sarcoidosis and lupus have been attributed to tattoos.

Infectious agents include Hepatitis B and C, tetanus, syphilis, leprosy, tuberculosis, warts, fungus, HIV, and pyogenic Staphylococcus and Streptococcus infections (cellulitis and gangrene necessitating amputation). One must even be cautious of the benign, pretty tattooed butterfly, for it may be a vector of mycobacteria.

Make sure that wherever you go for piercing is a reputable place. It’s important to ask what tools and devices they are using and whether they’re going to check for allergic reactions.

Both the U.S. and Canadian Red Cross will give you a year’s deferment if you’ve been pierced or tattooed except at a state-licensed shop. Why? Both procedures can transmit dangerous blood-borne diseases. Beyond the immediate pain and suffering of the procedure, other factors including the risk of chronic infection including abscesses or boils, prolonged bleeding, scarring, Hepatitis B and C, Tetanus, skin allergies to the jewelry that’s used, permanent holes, chipped or broken teeth, choking from mouth jewelry, and a speech impediment.

Tattoos require appropriate aftercare, including keeping them clean while they heal, usually 5-10 days. Once they’re healed, sunscreen is strongly recommended, both because the skin is more susceptible to the rays of the sun and to prevent fading.

The Adorning Reality

We’re seeing a resurgence in the popularity of tattoos, mutilation, modificatio, and adornment. The art of is a far cry from the rebellious Western teenager making a shock statement or a middle aged person making a spontaneous bid for an eternal youthfulness by picking a deliberately provocative pictorial statement as a tattoo.

I have observed many body adornments that do not seem to have a congruent common theme. Love and wonderful pastorals flourish next to death and spirits, thriving on the same skin surface as if emanating a potpurri of sentiments. Or a series of tiny earrings, each bearing a different color and tone, are on the left ear with a oversized nasal piercing on the right nostril, as if making sure the face stays in balance. I think there should be adornment planners in similar ways as life or financial planners, implementing new designs with time.

The bond between the tattooist and tattooed is filled with infinite possibility, limited only by the imagination of the participants. Whether a person uses her or his body as way to record life experiences or a canvas for tattoo art, it is the individual coming out on the skin.

“Of all the raw materials available to humanity for transformation into art, the body is the most readily available. The marking of the body is often a human being’s first expression of individuality, the putting of something of the inner self on the outer skin. The body art of tattooing is a personal means of immediate self-expression, a permanent visible statement of self.”

A trip to a local “tattoofest” was the key that unlocked a door that opened to a journey into the cultural, spiritual, and myriad other manifestations of the ancient and current use of tattoos, mutilation and adornment. Perhaps the human body is the ultimate canvas on which to chronicle your life. I prefer my computer. But I have gained quite a new perspective on a subject that is most definitely not just skin deep.

Rob Norman, MD practices in Florida.

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