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

by Thomas Morris

  That’s right: Reading books (and writing them) not only makes your hair fall out, it can also create the delusion that your body has turned into tasty dairy fat. In the case of Barloeus, the affliction proved terminal, after he became terrified that he would melt:

  He carefully avoided coming near the fire; till at last, wearied with continual apprehensions, he threw himself into a well.

  Tissot makes clear that he observed one similar case at first hand: a medical colleague of great brilliance who many expected to do great things. But this friend became so obsessed with his work that he spent all day and night in the library or performing experiments, with dreadful consequences.

  He first lost his sleep, then was seized with some transitory fits of lunacy, and at length became quite mad, so that even his life was preserved with difficulty. I have seen other men of learning who have begun by being maniacs, and have at length become complete idiots.

  His next example is a scholar whose name would have been familiar to many of Tissot’s original readers—a French priest well known for his strongly held views and combative manner.

  I have been told by a man of veracity that Pierre Jurieu, so famous for his theological disputations, his controversial writings, and his commentary on the Apocalypse, had so far injured his brain, that although his judgment was still preserved in many instances, yet he used to affirm that his frequent colics were caused by the fighting of seven knights shut up in his bowels.

  If you think that sounds a bit Monty Python, the next sentence might have been lifted from one of their scripts.

  Others have imagined themselves to be lanterns; and some have been known to afflict themselves upon the supposition of their having lost their thighs.

  For those just embarking on a literary career and anxious to avoid the (imaginary) loss of their own thighs, Dr. Tissot supplies some very sensible advice:

  The relaxation of the mind is the first preservative; without this, all other helps are inefficacious.

  After observing that scholarly persons are apt to be in denial about the state of their health, Tissot suggests that friends and family should challenge them to get out of their chair and do some exercise. His description sounds much like the contemporary idea of an intervention, when addicts are openly confronted about the destructive consequences of their addiction.

  The only way is to be resolute with them, to force them away from their closets, and oblige them to indulge in recreation and rest, which will remove their disorders and restore their health. Besides, the time they pass out of their closets is not thrown away; they return to their labours with fresh eagerness; and a few moments given up every day to leisure will be amply repaid by the enjoyment of health, which will prolong the course of their studies.

  Who could disagree? Exercise, writes Tissot, is

  one of the most powerful preservatives and restorers of the health of the learned.

  But it’s not just physical exertion that helps; being outdoors in the fresh air is important, too.

  From the combination of these two salutary powers, we receive refreshment, circulation is carried on with ease, perspiration encouraged, the action of the nerves reanimated, and the limbs are strengthened. Every man who has been confined to his study for some days, feels his head heavy, his eyes inflamed, his lips and mouth dry; he complains of a certain uneasiness about his breast, a slight tension at the pit of his stomach, is more disposed to melancholy than mirth, his sleep is less refreshing, and his limbs are weighty and benumbed. A walk for two or three hours in the country dispels them entirely, and brings back serenity, freshness, and strength.

  Never did a doctor write a truer word. And that’s all I have to say on the matter; for some reason, I feel an urgent need to go for a run.

  WHY CHILDREN SHOULD NEVER WEAR HATS

  Most of the articles included in this book were written by doctors, for doctors, and are couched in the professional jargon of medics. But here’s a rare example of an eighteenth-century physician writing for children, taken from an engaging but eccentric book published in Germany in 1792. Its author, Bernhard Christoph Faust, was personal physician to Countess Juliane of Hesse-Philippsthal, the aristocratic ruler of a minor principality in Lower Saxony. Faust was a tireless campaigner for public hygiene and did a great deal to promote vaccination against smallpox, but his greatest success was the Catechism of Health, a short work that uses the question-and-answer form of the Christian catechism to teach children about their bodies and how to keep them healthy. He was evangelical in his beliefs (some of them rather odd) and was clearly hoping that his book would eventually be used in every school in Germany. He begins with a preface addressed to schoolmasters:

  This book teaches how man from his infancy ought to live, in order to enjoy a perfect state of health, which, as Sirach* says, is better than gold. You will, therefore, with pleasure, I hope, instruct your dear little pupils in its principles; and as able and experienced men, convinced that the mere learning of the answers by heart can be of no advantage to children, you will have no objection to instruct them after the following method. The chapter which is chosen for instruction ought first to be read by the master, and then by two children that read perfectly well and distinct; one of them reading the questions, the other the answers regularly and in order to the end of the chapter; the master, understanding thoroughly what has been read, explains its general import.

  The master was also expected to quiz the children at regular intervals to test their understanding of what had been learned.

  An hour, at least, twice a week, ought to be devoted to such instruction, in order that the whole Catechism of Health may be gone through twice a year, and the minds of the children impressed with the true spirit of its doctrine.

  Two hours a week seems optimistic; but Dr. Faust cannot be faulted for his ambition. And it paid off: The book sold eighty thousand copies in the first two years, and was soon translated into several other languages. Faust even sent a copy to George Washington, with an obsequious cover letter recommending its use in the schools of the newly founded United States:

  I deemed these books worthy of being laid before you, and through you before the United States of America.

  An American edition duly appeared, complete with a foreword by the founding father Benjamin Rush, one of the country’s leading physicians. The Catechism in fact contains a good deal of sensible advice, and you can see why the architects of the USA might have been attracted to it: It encourages self-reliance, virtue and abstinence—just the sort of values a young nation might want to inculcate in its children. Some of Faust’s views are decidedly progressive: He is emphatically in favor of equal education for both sexes, and condemns corsets and other forms of female dress that constrict the internal organs.

  That said, Faust obviously had a few hobbyhorses, and sections of the book make amusing reading today. Perhaps the clearest example of his idiosyncratic views is the chapter on clothing:

  Q. By what means does man preserve, particularly in his infancy, the genial warmth of his body?

  A. By good wholesome food and bodily exercise.

  Q. Is it necessary to keep children warm, and protect them against the inclemency of the weather, by many garments?

  A. No.

  Q. Why so?

  A. That the body may grow healthy and strong, and be less liable to disease.

  Q. How ought the heads of children to be kept?

  A. Clean and cool.

  Q. Is it good to cover children’s heads with caps and hats to keep them warm?

  A. No; it is very bad; the hair is a sufficient protection against cold.

  Q. Are those artificial coverings dangerous and hurtful?

  A. Yes; children are thereby rendered simple and stupid, breed vermin, become scurfy, full of humours, and troubled with aches in their heads, ears, and teeth.

  Q. What kind of
caps are, therefore, the most dangerous?

  A. The woollen, cotton, and fur caps.

  Q. How, then, ought the heads of children to be kept?

  A. Boys, as well as girls, ought to remain uncovered, winter or summer, by day and by night.

  Lower Saxony has a mild climate and the temperature rarely drops much below freezing in winter; one wonders how the children of colder parts of Europe and the US felt about this advice.

  Q. How ought children, male as well as female, to be dressed from the beginning of the third to the end of the seventh or eighth year?

  A. Their heads and necks must be free and bare, the body clothed with a wide shirt and frock, with short sleeves; the feet covered only with a pair of socks to be worn in the shoes; the shoes ought to be made without heels, and to fit well.

  Q. What benefit will be derived from this kind of dress?

  A. The body will become healthier, stronger, taller, and more beautiful; children will learn the best and most graceful attitudes; and will feel themselves very well and happy in this simple and free garment.

  It was Dr. Faust’s passionate belief that a smock was the best form of dress for both boys and girls; but his subsequent campaign to outlaw trousers was sadly unsuccessful. While his views on clothing were often peculiar, there was one aspect of the subject on which he was unambiguously correct:

  Stays and stiff jackets are inventions of the most pernicious nature; they disfigure the beautiful and upright shape of a woman, and, instead of rendering her straight, as was formerly supposed, they make her crook-backed; they injure the breasts and bowels; obstruct the breathing and digestion; hurt the breasts and nipples so much that many mothers are prevented by their use from suckling their children; many hence get cancers, and, at last, lose both health and life; they in general destroy health, and render the delivery of women very difficult and dangerous, both to mother and child. It is, therefore, the duty of parents, and especially of mothers, to banish from their houses and families both stays and jackets.

  Wise advice; if only those corset-loving Victorian parents had taken note!

  KILLED BY HIS FALSE TEETH

  William Guest Carpenter was not a famous surgeon, nor a particularly successful one. He spent many years as surgeon to Pentonville, Clerkenwell and Millbank prisons before suffering the humiliation of himself becoming an inmate. He was locked up in 1861 after being unable to pay his debts—bad timing, since legal reforms a few years later would vastly reduce the number of people incarcerated for the offense.

  It would be sad if Mr. Carpenter were remembered only for his time as a guest of Her Majesty. Fortunately, an otherwise unremarkable career was distinguished by one case of a truly exceptional nature. Though not attached to any hospital, he was a member of the oldest medical society in London, Guy’s Hospital Physical Society, and at one of its meetings in 1842, he told a strange tale about a missing set of dentures:

  Mr H., aged 35, the subject of the present case, was an assistant to Mr Watts, an extensive chemist in the Edgware Road, with whom he had resided for upwards of eight years. Mr H. was afflicted from childhood with asthmatic bronchitis; and it appears that several branches of his family have fallen victims to pleuritic, pulmonic, or tracheal affections.

  Broadly speaking, Mr. H. and his relatives suffered from respiratory disorders: those affecting the windpipe, the lungs or the membrane surrounding them.

  With the exception of an occasional attack of increased difficulty of breathing, nothing which attracted particular notice seems to have occurred during the early part of his residence with his last employer; although, from the curious facts that were brought to light in the post-mortem examination, I think he must have suffered more or less for some years past; but his high flow of spirits, and his devoted attachment to business, were perhaps the means of diverting his attention from his own state of health. I first became acquainted with him in the early part of last winter. I never found him free from fever: his pulse was always above 100, skin hot, with other symptoms of inflammatory action.

  The patient asked for medicine, but Dr. Carpenter refused. This was a matter of professional courtesy, as it transpired that another physician had already been consulted. Whatever the other medic prescribed was no use, since the symptoms persisted throughout the winter. A few months later, the patient took a turn for the worse:

  On Friday the 13th of April I received a note from him requesting me to call, as he had been attacked with pain in the side and chest, which had that evening become so acute as to render coughing, speaking and breathing almost impossible. I immediately visited him. He complained of an acute pain in the right side of the chest shooting up to the clavicle, increased upon deep inspiration: respiration short, and hurried; pulse 140, rather wiry; skin hot and dry; tongue furred at the base and margin, red in the centre; bowels confined; cough troublesome.

  After listening to his chest, the doctor concluded that there was an infection of the right lung: Breathing sounds on that side were inaudible.

  Considering the case one of active inflammation, I bled him from the arm to eight ounces, without inducing syncope:* this relieved him of pain: he could then breathe with more freedom, and said that bloodletting was always of service to him. I ordered him some calomel, antimony, and compound extract of colocynth, to be taken at bedtime.

  The trio of drugs prescribed for the unfortunate patient made up a cocktail of highly unpleasant laxatives. Colocynth, also known as the bitter cucumber or bitter apple, was particularly nasty, described by one contemporary writer as a “drastic cathartic, exciting inflammation of the mucous membranes of the intestines, causing severe griping, vomiting and bloody discharges.”

  After three days, and despite a variety of treatments and medicines, there was no improvement in the patient’s condition. Dr. Carpenter sought a second opinion from a colleague. The upshot was a new therapeutic regime—the complete opposite of what had preceded it. Instead of violently emptying his gut, they were filling it up again:

  An enema of gruel and olive oil to be administered immediately. Diet to be more generous: some port wine to be given occasionally throughout the day, with good beef-tea.

  A few days later, matters came to a head.

  I had prepared the requisites for administering an enema, to relieve the abdomen and allow its muscles more freedom of action; and had left him for a few seconds, to get some wine which he might take as a support through the operation, when I was summoned up to his room, as he had become very restless. I went immediately, but only to see him breathe his last.

  The following day, Dr. Carpenter and another colleague performed a postmortem. They opened the man’s chest to look at the lungs.

  As soon as I passed the scalpel into the right pleura, a gush of very offensive gas escaped. The pleural cavity on this side contained five pints of sero-purulent fluid.

  Thin yellow pus, in other words. Just try to imagine what five pints of the stuff would look (and smell) like. Both lungs showed clear signs of disease, but there was one other obvious anomaly, a hole on the surface of the right lung “large enough to admit the tip of my little finger.” A little later, Dr. Carpenter discovered what had made it:

  After I had completed the examination, I was removing the remaining fluid and coagula of blood that had escaped from the pulmonary vessels to replace the lung, when I came to an irregular substance, which when examined turned out to be, to our great astonishment, a piece of ivory worked into four artificial front teeth, covered with a brownish crust, with a pointed piece of silver riveted into the upper part of the teeth, which had evidently assisted in fixing them to the upper jaw.

  These false teeth were not in the stomach or intestines, but in the chest cavity! How on earth had they got there? The surgeon asked the dead man’s father if he knew:

  He immediately exclaimed that his son swallowed them thirteen years ago, in a fit of coughing, du
ring his apprenticeship. I again examined the oesophagus; and we were satisfied that there was neither a recent wound nor a cicatrix to be found; and the only opening through which it could have escaped into the pleura of the right thoracic cavity, where I found it, must have been the fistulous* one in the corresponding lung.

  The doctor realized that a set of false teeth lodged in the lung was likely to be intensely painful, so asked whether the patient had been in serious distress at the time, but apparently not.

  The morning after it happened, he mentioned the circumstance to Mr Champley, his master, who advised him to take an aperient,* supposing the teeth had passed into the stomach: it was thought that the teeth had passed away by the bowels, unnoticed; and then the circumstance gradually became forgotten.

  Dr. Carpenter surmised that the patient had somehow managed to inhale the denture, that it had entered the lung and then worked its way through the wall of the organ before lodging inside the pleura, the sac around it. He noted that one of the false teeth was still quite sharp: enough, he thought, to have created the opening he observed. It all seems rather unlikely (you’d expect such a major injury to have caused serious bleeding and altogether more dramatic symptoms), but it’s difficult to explain the case any other way. What is particularly remarkable about it is that the teeth remained in situ for thirteen years before the patient’s death.

  The report ends with a postscript for the morbidly curious:

  The teeth are now in the possession of Mr Carpenter, West Street, Finsbury Circus.

  Where I’m sure he received a steady stream of visitors eager to see them.

  PEGGED OUT

  In 1864, a surgeon from Gloucester, Robert Brudenell Carter, sent a series of case reports for publication in The Ophthalmic Review. By his own admission the thirty-six-year-old Carter was “a conspicuously unsuccessful general practitioner in the country,” but within a few years, his career had blossomed, providing some justification for the old chestnut that for some, at least, life begins at forty. Carter was an unusually accomplished individual whose achievements went far beyond surgery. He performed with distinction as an army surgeon in the Crimea, and his dispatches from the front were published in The Times.