The Spooky Saturday Collection: October 2014

This October saw the start of Spooky Saturday on Facebook and Twitter; a collection of some the most gruesome anatomical artworks I’ve curated through the year.

In the lead up to Halloween, we looked a one piece in all it’s grisly glory each weekend and rated it on the ‘Spooky Scale’.

So, which is the winner? Let’s put it to a vote.

Take a look at the four artworks below and cast your vote in the poll!

 

 1. 'Dissection of a pharynx affected by abscess, shown at post-mortem' from 'Principles of Surgery' by John Bell, 1801.

1. ‘Dissection of a pharynx affected by abscess, shown at post-mortem’ from ‘Principles of Surgery’ by John Bell, 1801.

 

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2. ‘Bone neoplasms on the skull’ from ‘Anatomie pathologique du corps humain’ by Jean Cruveilhier, 1829.

 

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3. Illustration by Max Brödel which was featured in a 1932 article which described “surgical procedures on the eye of a rabbit, illustrating anatomical parts”.

 

'Head and skull of malformed infants; conjoined twins, bilateral cleft lip and holoprosencephaly' from 'Surgical Anatomy' by Joseph Maclise, 1856.

4.’Head and skull of malformed infants; conjoined twins, bilateral cleft lip and holoprosencephaly’ from ‘Surgical Anatomy’ by Joseph Maclise, 1856.

 

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Hydrocephalus: Cerebrospinal Fluid and a Curious Condition

Prof. Jas. Mundie
Copyright: Prof Jas. Mundie

Although I have previously posted about hydrocephalus on the Facebook page’s ‘Fact of the Day’, I was inspired to discover more about this distinctive condition after a recent visit to Surgeon’s Hall Museum, Edinburgh. Full of fascinating pathological specimens, the congenital hydrocephalic infant skulls on display are hard to miss with their domed craniums, characteristic of bodies more alien than our own.

The term hydrocephalus comes from the Greek words ‘hydro’ meaning water  and ‘cephalus’ meaning head. Translated literally, it means ‘water on the brain’. Hydrocephalus is in fact a build up of cerebrospinal fluid within the brain.

10 Facts About Cerebrospinal Fluid

  • Cerebrospinal fluid (CSF) is a clear, colourless liquid that fills and surrounds the brain and the spinal cord, acting as a lubricator against bone and a shock absorber against trauma to our body’s most important system
  • It is formed primarily in the ventricles of the brain and circulates via a series of chambers
  • It helps to maintain a constant pressure within the cranium by decreasing in levels as the volume of blood or brain tissue increases and vice versa
  • When cerebrospinal fluid is in excess, it is moved away from the brain by absorption into the bloodstream by a specialised tissue called the arachnoid villi which act as a one way valve
  • It transports metabolic waste products, antibodies, chemicals, and products of disease away from the brain and spinal cord into the bloodstream
  • It has a slightly alkaline pH
  • It is about 99% water.
  • There are approximately 100-150ml of CSF in the average adult human body
  • It is produced continuously, and it is completely replaced every six to eight hours
  • Analysis of CSF can diagnose a number of diseases. Samples can be obtained by lumbar puncture or spinal tap by inserting a needle into the lumbar region of the lower back

Hydrocephalus
Hydrocephalus can develop where there is a blockage in one of the ventricles, preventing excess CSF from moving out of the brain, where the arachnoid villi aren’t functioning properly and CSF is unable to filter into the blood vessels or, in some rare cases,  when the brain produces too much CSF.

Joakim BlockstromCopyright: Joakim Blockstrom

Congenital hydrocephalus can occur due to the restriction of flow of CSF caused by brain defects in the developing baby which can be due to certain health conditions like the most serious type of spina bifida. It can also occur in premature babies which experience bleeding in their brain, blocking the flow of CSF and causing hydrocephalus. Other potential causes include X-linked hydrocephalus where the condition occurs as a result of a genetic mutation, rare genetic disorders such as Dandy Walker malformation and arachnoid cysts between the brain or spinal cord and the arachnoid membrane.

Acquired hydrocephalus which develops in adults or children is most often occurs by injury or illness that results in a blockage between the ventricles of the brain. Possible causes include bleeding inside the brain, blood clots inside the blood vessels of the brain, meningitis, tumours, head trauma and stroke.

Anatomical abnormalities
The physical symptoms of hydrocephalus are distinctive, but can vary with age, tolerance and progression of the disease. The characteristic, unusually large cranium is caused by the infant skull’s ability to expand to accommodate the build up of excess CSF. The sutures of the skull, which are not yet closed, provide the flexibility in the cranium to ‘grow’ with the expanding volume. The scalp may be thin with visible veins and the fontanelle (soft spot on the top of a baby’s head) may be tense or bulging. The eyes can also appear to be looking downwards due to nerve damage which can affect the muscles of the eye.

skull-of-a-newbornCopyright: A.D.A.M

Treatment
Without treatment, it is thought that up to 6 in 10 people with hydrocephalus would die. However, most children with hydrocephalus that survive past the age of one will have a fairly normal life span. Patients usually require prompt treatment to reduce the pressure on their brain either by neuroendoscopy or shunt surgery which involves implanting a thin tube into the brain to run the excess cerebrospinal fluid to another part of the body, usually the abdomen, where it can be absorbed into the blood stream.

hydroassoc.orgCopyright:  Hydrocephalus Association

Resources & further reading:

www.hcrn.org
www.hydroassoc.org
www.shinecharity.org.uk
www.nhs.uk/conditions/Hydrocephalus
www.hydroresearchfund.org/learn-about-hydrocephalus
www.childrenshospital.org/az/Site1116/mainpageS1116P1.html
www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
www.britannica.com/EBchecked/topic/103430/cerebrospinal-fluid-CSF

The Home Doctor: Homage to a Vintage Classic, 1931

Books (C)

Yesterday saw one of my favourite weekend adventures in the historic city of Edinburgh; a trawl through the town for vintage and antique medical texts.

One find from this yielding trip was ‘Home Doctor’ by Edinburgh physician and lecturer John D. Comrie, published by George Newnes Ltd, 1931.

Comrie held a long list of prestigious positions including Physician at the Royal Infirmary of Edinburgh, Consulting Physician at Deaconess Hospital, Edinburgh, Lecturer on Practice of Medicine at The School Of  The Royal Colleges At Edinburgh and Late Consulting Physician To The Forces in North Russia.

His best known work is perhaps Black’s Medical Dictionary, for which he was editor from the 1st edition in 1906 to the 17th in 1942. Black’s is still sold today and is currently in its 42nd edition.

Comrie opens Home Doctor with the following:

Preface
This volume is designed for those who, without having any medical knowledge, desire advice of a practical character, especially in matters affecting the preservation or restoration of health. Such a book is continually needed in every household, and this book has been prepared specially for use in the home.

J.D.C
Edinburgh, March 1931

A large 391 yellowed and dusty pages, the book boasts ‘two full-page illustrations in colour, with key to the same’:

Home Doctor John D Comrie George Newnes Ltd 1931
‘Organs of the body from before, with the soft parts removed’

Home Doctor John D Comrie George Newnes Ltd 1931 back
‘Organs of the body from behind, with the soft parts removed’

The beauty of antique and vintage books is the insight they give you into the way the world was at the time of writing. This 1930’s household staple has some gems in the ‘S’ section alone:

Page 324,  Snoring: is a form of noisy breathing due to sleeping with the mouth open.  It can be checked by tying up the jaw and breathing only through the nose, or by turning on the side.

Page 324,  Smallpox, Symptoms: The period of incubation is from about ten to fourteen (usually twelve) days. The invasion is sudden, with shivering, high fever, headache, and often vomiting. On the third day the characteristic eruption begins to make its appearance, and spreads all over the face, trunk, and extremities in the course of a few hours. On the second or third day after its appearance the eruption undergoes a change – the pimples becoming vesicles filled with a clear fluid. The clear content of these vesicles gradually become turbid, and by the eighth or ninth day of the disease they are changed into ‘pustules’ containing yellow matter, with an increase of the fever. The eyes may also be involved in the eruption, to the danger of permanent impairment of sight. On the eleventh or twelfth day the pustules show signs of drying up, and along with the fever abates. Great itching of the skin attends this stage. The scabs produced by the dried pustules gradually fall off and reddish brown spots remain, which according to the depth of skin involved in the disease, leave a permanent, white depressed scar – this ‘pitting’, so characteristic of smallpox, being specially marked on the face.

Page 338,  Suicide: See under ‘Insanity’

Happy bedtime reading.