The Mystery of the Exploding Teeth and Other Curiosities From the History of Medicine

by Thomas Morris

  Ah, but what of the urine that “spirted out from the navel, as from a fountain”? Astonishingly, there may be a rational explanation for that, too. The bladder is connected to the navel by a structure called the urachus, the vestigial remnant of a channel that drains urine from the fetal bladder during the early months of pregnancy. This tube usually disappears before birth, leaving just a fibrous cord, but very occasionally it persists into later life.* When the channel is very narrow, it may not be noticed, but if pressure builds up in the bladder, urine can be forced through the opening and out through the belly button.

  Case closed? Not exactly. A patient with such severe uremia would be lucky to survive for six months, let alone two years. And that’s not the only problem. It is not just unlikely but physiologically impossible for urine to be discharged from the ear, or from the nose for that matter.* Either Maria Burton was the only person in medical history to have peed through her nose or she was very good at faking it. And I know which of the two is more likely.

  THE BOY WHO VOMITED HIS OWN TWIN

  This delightful case was originally reported in a Greek newspaper in 1834, and quickly caused a sensation in the European medical press. Pierre Ardoin, a French doctor who had settled on the Aegean island of Syros, was summoned by the worried parents of a young boy called Demetrius Stamatelli who had fallen ill. This is how one London journal reported the tale:

  On the 19th July last, when M. Ardoin was called to see this youth, he found him suffering from acute pains in the abdomen. He prescribed several remedies, none of which in the least assuaged his torments, and he so far gave up all hope of saving the patient that he recommended the administration of the sacrament.

  Either Dr. Ardoin detected some signs of improvement or the parents took violent exception to his giving up on their son, because he soon decided that there were more useful things he could do for the boy than arrange the last rites.

  The next day he gave him an emetic cathartic, which produced at first slight vomiting.

  The “emetic cathartic” was a vile-sounding concoction of castor oil, coralline* and ipecacuanha.* Its effects would not have been pretty, since it was intended to provoke both vomiting and diarrhea.

  This lasted a short time, when the vomiting returned with excessive pain, and at length he vomited a foetus by the mouth.

  OK. He vomited . . . a fetus?

  The head of the foetus was well developed, also one arm perfectly formed; it had no inferior extremities, but merely a fleshy prolongation, thin at the extremity, and attached to the placenta by a kind of umbilical cord. Three days afterwards the patient was much better, all the morbid symptoms were diminished, and he has since continued to improve.

  Dr. Ardoin took the unexpected object home and invited all the other doctors of Syros to join him in examining it, after which it was preserved in alcohol. “I made it thus public,” writes Dr. Ardoin, “so that it might not be considered a deception.”

  Sure enough, there were many who doubted the veracity of Dr. Ardoin’s account. Members of the Academy of Sciences in Paris were suspicious of the “extreme zeal” with which he had publicized the case, and asked the distinguished naturalist Étienne Geoffroy Saint-Hilaire to investigate further. Saint-Hilaire had a particular interest in teratology, the study of congenital deformities, so was ideally qualified for this task. He arranged for the preserved fetus to be sent to him in Paris and, after dissecting it, pronounced himself satisfied that it was indeed a partially formed human fetus.

  In the meantime, the young patient Demetrius Stamatelli had died, from causes unknown. The doctor who performed the autopsy found the boy’s digestive tract virtually normal in appearance, and concluded:

  The autopsy is far from confirming that he vomited a foetus; but neither does it prove that the story was made up, because of the time that had elapsed between the appearance of the foetus and the examination of the digestive organs.

  There was, however, one intriguing anomaly: A small area of the stomach lining was unusually well supplied with blood vessels. A committee of medical experts in Athens agreed that this might have been the point at which the fetus was attached by its placenta. Saint-Hilaire’s report took account of all these findings, concluding that although the case was far from proven, he could not rule it out entirely. He noted that if it was a hoax, the “simple and ignorant” parents of young Demetrius certainly had nothing to do with it.

  As Saint-Hilaire knew, it is sometimes possible for one fetus to develop inside another, a phenomenon known as fetus in fetu (FIF). Demetrius may have shared his mother’s womb with another fetus—his twin—which was subsequently absorbed into his own body. This is an incredibly rare occurrence, with fewer than two hundred cases recorded in the medical literature. In one extreme example, reported in 2017, a fifteen-year-old Malaysian boy was admitted to the hospital with abdominal swelling and severe pain; surgeons found a malformed fetus weighing 1.6 kilograms inside his body. What makes Demetrius’s case unusual is the location of his “twin”: Although FIF cases have been found inside the abdomen, skull, scrotum and even the mouth, it is difficult to believe that such an object could remain intact in the highly acidic environment of the human stomach for more than a few days.

  THE CASE OF THE LUMINOUS PATIENTS

  The Irish medic Sir Henry Marsh began his career hoping to become a surgeon, but at the age of twenty-eight he cut his forefinger while dissecting a cadaver and it became necessary to amputate the digit to prevent gangrene. His surgical ambitions thwarted, he instead became a physician, a profession in which he achieved great eminence. In 1821, he helped to found a children’s hospital in Dublin—the first such institution in Great Britain and Ireland—and was later appointed a physician to Queen Victoria.

  In an age when doctors were often imperious and forbidding, Marsh was known for his kindly and cheerful bedside manner. He was also renowned for the quality of his medical research on conditions including diabetes, fevers and jaundice. In June 1842, the Provincial Medical Journal devoted no less than ten pages to one of his essays. But what subject could be so important that a leading publication would make it the main feature of that week’s issue? Sir Henry explains:

  Having obtained from an unquestionable and authentic source an account of a phenomenon of a very curious and interesting nature, not hitherto recorded or brought into public notice, I am induced to bring forward some facts I have been able to collect, illustrative of the spontaneous evolution of light from the living human subject.

  That’s right: Sir Henry’s chosen subject is people who glow in the dark. It was his sincere belief that it is possible for the human body to produce its own light. Before unveiling his evidence for this startling assertion, however, he first points out that the phenomenon—known as bioluminescence—is quite common in marine organisms including plankton and deep-sea fish as well as a few insects such as fireflies.

  Sir Henry reports a story told to him by a colleague who had attended the bedside of a young woman, identified only as L.A., who was dying from tuberculosis:

  “It was ten days previous to L.A.’s death that I first observed a very extraordinary light, which seemed darting about the face, and illuminating all around her head, flashing very much like an Aurora Borealis.”

  An indoor northern lights is not quite what a doctor expects to see when tending a patient on their deathbed.

  “After she settled for the night I lay down beside her, and it was then this luminous appearance suddenly commenced. Her maid was sitting up beside the bed, and I whispered to her to shade the light, as it would awaken Louisa. She told me the light was perfectly shaded. I then said, ‘What can this light be which is flashing on Miss Louisa’s face?’ The maid looked very mysterious, and informed me she had seen that light before, and it was from no candle.”

  A line that would not be out of place in a ghost story by M. R. James.

  “I then inquir
ed when she had perceived it; she said that morning, and it had dazzled her eyes, but she had said nothing about it, as ladies always considered servants superstitious. However, after watching it myself half an hour, I got up and saw that the candle was in a position from which this peculiar light could not have come, nor, indeed, was it like that sort of light; it was more silvery, like the reflection of moonlight on water.”

  Sir Henry did not witness the phenomenon himself but had it on good authority that one of his own patients was also affected. A few months earlier, he explains, he had been treating another young woman in the final stages of tuberculosis. Shortly after her death, he had received this intriguing communication from the girl’s sister:

  “About an hour and a half before my dear sister’s death, we were struck by a luminous appearance proceeding from her head in a diagonal direction. The light was pale as the moon; but quite evident to mamma, myself, and sister, who were watching over her at the time. One of us at first thought it was lightning, till shortly after we fancied we perceived a sort of tremulous glimmer playing round the head of the bed; and then recollecting we had read something of a similar nature having been observed previous to dissolution, we had candles brought into the room, fearing our dear sister would perceive it, and that it might disturb the tranquillity of her last moments.”

  Sir Henry cites several other anecdotes of a similar nature, observing that in rural Ireland such occurrences were generally attributed to supernatural causes. As a man of science, he dismisses this as mere superstition, suggesting instead that as death approaches, some unidentified organic process may create phosphorescence around the human body. By way of illustration, he gives a final “luminous patient” story—this one supplied by Dr. William Stokes, an illustrious Dublin physician and one of the greatest heart specialists of the nineteenth century:

  “When I was residing in the Old Meath Hospital, a poor woman labouring under an enormous cancer of the breast was admitted. The breast was much enlarged, and presented a vast ulcer with irregular and everted edges, from all parts of which a quantity of luminous fluid was constantly poured out.”

  Skeptical? For reasons that will be explained in due course, I believe Dr. Stokes may have been telling the truth.

  “Upon being asked whether she suffered much pain, she answered, ‘Not now, Sir, but I cannot sleep watching this sore which is on fire every night.’ I directed that she should send for me whenever she perceived the luminous appearance, and on that night I was summoned between ten and eleven o’clock. The lights in the ward having been then extinguished, she was sitting leaning forward, the left hand supporting the tumour, while with the right she every now and then lifted up the covering of the ulcer to gaze on this, to her, supernatural appearance. The whole of the base and edges of the cavity phosphoresced in the strongest manner.

  Dr. Stokes walked to the end of the ward and found to his amazement that he could still see the luminous tumor from a distance of twenty feet.

  “The light within a few inches of the ulcer was sufficient to enable me to distinguish the figures on a watch dial. I have no very distinct recollection of the colour of the light, but I remember that its intensity was variable, it being on some nights much stronger than on others.”

  Sir Henry now attacks the most important question: What is the process responsible for this mysterious light? He speculates that when tissues begin to putrefy, they emit some luminous gas or fluid that is highly flammable. This would, he adds, explain the mystery of spontaneous human combustion: If the fluid were to ignite for some reason, perhaps the body itself could burst into flames. Sir Henry concluded that the luminescence observed in dying patients might have been caused by the presence of phosphorus, which burns spontaneously in the presence of oxygen. This theory is not tenable, because elemental phosphorus is far too reactive to be produced naturally by the human body. But there is one intriguing alternative.

  In 1672, the natural philosopher Robert Boyle was thrilled to discover that a joint of veal hanging in his larder had started to glow in the dark. The luminous meat produced enough light to read by, of the same “fine greenish-blue as I have often observed in the tails of glow-worms.” Boyle’s joint had almost certainly been colonized by one of the many photobacteria, light-producing microorganisms found in seawater (and therefore in fish) all over the world. It has been known for years that poor food hygiene can result in cross-contamination if fish and meat are stored together; in a darkened room the surface of affected meat appears to be studded with points of light, like stars in the night sky. Most luminous bacteria are not human pathogens (agents of disease), but some are capable of colonizing the human body. If this is the case, it would offer one possible, albeit unlikely, explanation of the ghostly phenomena of Sir Henry’s patients who glowed in the dark.

  THE MISSING PEN

  You know those stories about old soldiers who suddenly develop mysterious back pain in their eighties, and discover that it’s caused by a bullet from their army days, long forgotten but still deeply embedded in tissue? They’re usually true. Foreign objects made from all sorts of surprising materials are often well tolerated by the body and can lie dormant for decades before causing any problems.

  Even in that context, this tale published in The Medical Press and Circular in 1888 is something of an outlier—not least because it concerns a foreign body that remained in the brain for as long as twenty years before symptoms became apparent.

  The infliction of fatal injury to the brain by the thrusting of pointed objects beneath or through the upper eyelid, through the orbital plate into the brain, has occurred a number of times. Baby-farmers have been known to procure the death of their charges by pushing needles in.

  “Baby farmers” were those who looked after another person’s child for money. Since they were often paid in one (small) lump sum, many of them stood to profit if the child died. This led to many cases of infanticide: After a campaign led by The British Medical Journal in 1867, the law was reformed to introduce more rigorous regulation of fostering and adoption.

  And not long since an irascible ‘fare’ thrust his stick some four inches into the brain of a cab driver in the same way.

  I’ve sometimes been irritated by a cab driver, but I can’t think of circumstances in which this would be a proportionate response.

  The effect of such an injury is generally very prompt, and within an hour or two—even if not at once—serious symptoms manifest themselves. A curious exception to this rule was the subject of an inquiry last week at the London Hospital, the victim being a commercial traveller 32 years of age. Until the last few weeks the deceased is stated to have been in good health, and to have kept a set of books most accurately.

  The patient is identified in contemporary newspaper reports as Moses Raphael from Bromley-by-Bow in London’s East End. Because of his facility with numbers, this peripatetic young gentleman was described as a “wonderful brain worker”—a somewhat ironic description, as it turns out. Moses suddenly developed a splitting headache and complained of drowsiness. He was admitted to the hospital and, a few days later, died after developing symptoms of “apoplexy.” This word was generally used to describe a cerebrovascular accident or stroke, but his doctors were in for a shock:

  On making a post-mortem examination of the brain, an abscess the size of a turkey’s egg was discovered at the base, evidently not of recent formation, inside which was a penholder and nib, measuring altogether some three inches in length. This foreign body must have been in its position for some considerable time, it being embedded in bone. No trace of injury to the corresponding eye or nostril could be detected.

  His widow was amazed: She had never heard him allude to anything of the kind, and nobody could recall his having been injured at any stage of his life.

  The pen and nib were of the ordinary school pattern, and there is nothing to show that the injury was not inflicted years ago when the deceased
was at school. Altogether, it is a very remarkable case and demonstrates the extreme tolerance of the brain to a very serious injury, and to the presence of a foreign body under certain circumstances. It is fortunate, in one sense, that the deceased died in a hospital; in private practice his death would have been certified as due to apoplexy, or, in case of an inquest, to ‘visitation of God’.

  “Visitation of God” was a verdict often returned in cases of sudden or unexplained death. In the case of this patient’s demise, it seems unnecessary to invoke a deity—even one wielding a pen.

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  DUBIOUS REMEDIES

  ONE THING MOST people know about the history of medicine is that doctors used to prescribe some pretty strange courses of treatment. For millennia, they were famously reliant on bleeding—a therapy invented (at least according to the Renaissance scholar Polydore Vergil) by the hippopotamus:

  Of the water horse in Nylus, men learned to let blood: for when he is weak and distempered, he seeketh by the riverside the sharpest reed-stalks, and striketh a vein in his leg against it, with great violence, and so easeth his body by such means; and when he hath done, he covereth the wound with the mud.

  Some forms of bleeding were comparatively mild. Leeches, widely used across Europe for hundreds of years, removed only a teaspoonful of blood per application. More drastic was venesection, when the doctor opened a vein to evacuate larger volumes. The technique was most often used on an arm, although it could be applied all over the body. In a treatise published in 1718, the German surgeon Lorenz Heister gives instructions for taking blood from the eyes, the tongue and even the penis. One particularly enthusiastic exponent of bloodletting, the eighteenth-century American Benjamin Rush, encouraged his pupils “to bleed not only by ounces or in basins, but by pounds and by pailfuls.” The practice finally died out in the nineteenth century, although a few older practitioners were still espousing it as late as the 1890s.