Dr. Beatson’s short article prompted a rather lively correspondence. A couple of weeks later, a Birmingham physician, Robert Saundby, wrote a scholarly letter that included chemical analyses of the flammable gases belched by other patients. But his thunder was stolen by another Glaswegian, Dr. R. Scott Orr, who shared an anecdote sent to him by an “old gentleman aged about 70, who has since died of apoplexy”:
“Some five or six years ago I had great acidity and indigestion, and then found relief from Gregory’s mixture and bismuth, and, for a good time, found comfort by using these.”
Gregory’s powder was a mixture of rhubarb, ginger, and magnesium carbonate, a patent medicine commonly used to treat digestive disorders.
“But within the last year or two, indeed longer, I have been much troubled by great flatulency, general puffiness after dinner and during the night, with considerable pain at the pit of the stomach. Not troubled with heartburn or acidity so much, but with eructations of wind or gas, and this of such an offensive smell as to render me most uncomfortable, indeed unhappy, in any one’s company or proximity, and latterly the pain so severe, or rather oppressive, as to prevent my sleeping.”
As if it weren’t bad enough smelling like a tannery, the poor chap now developed an even more antisocial habit.
“About four or five months ago, while lighting my pipe of an evening, it so happened that one of these involuntary eructations took place while the match was at my pipe, and the gas then took fire, and burned my moustache and lips, and frightened me a good deal. It was just such an explosion or puff as would occur on your putting a pinch of gunpowder to a light.”
BOOM, as they say.
“My son H. was sitting by me, reading, and immediately looked up in astonishment. He has witnessed the same thing occur either two or three times, and it has occurred in all five or six times. I have tried all sorts of changes of diet, but to no purpose.”
Readers hoping for an explanation of the fire-breathing antics of the two patients were disappointed: The appearance of flammable gas was dismissed as the side effect of an unusual species of indigestion. But four years later, all became clear when Dr. James McNaught recorded another case of the phenomenon. His patient was a twenty-four-year-old factory worker:
His work requires him to rise early, and on one occasion after striking a match to see the time, and when holding it near his mouth, an eructation of gas from the stomach took place. To his consternation the gas took fire, burned his face and lips considerably, and set fire to his moustache.
Dr. McNaught noticed that his patient’s abdomen was bloated and unusually taut. Out of curiosity, he passed a tube down into the man’s stomach and removed some of the contents for inspection. These consisted of
soupy matter smelling exactly like sour yeast, and when it was allowed to stand, a layer of frothy stuff half an inch thick, like dirty yeast, formed on the top. This was full of bubbles of gas which could be seen forming and bursting as it stood in the vessel.
The gas was flammable, and Dr. McNaught realized that it was produced by fermentation, a process normally confined to the lower part of the gut. His patient had an obstruction in his digestive tract that made it difficult for stomach contents to pass into the small intestine. Confined in the stomach for far longer than usual, they were fermenting and giving off large amounts of hydrogen and methane that could be vented only through the mouth.
The association between flammable belches and gastric obstruction was confirmed by a number of similar cases in the early years of the twentieth century. They include this peach of a party trick, performed by a sufferer who tried to light a cigarette while playing a quiet game of bridge:
As he leaned forward he felt an undeniable necessity to belch but, being in the presence of company, he attempted to do this discreetly through his nose; he electrified his associates by producing two fan-shaped flames from his nostrils.
And what could be more discreet than that?
CYCLING WILL GIVE YOU HEART DISEASE
In September 1894, many of the world’s most eminent scientists descended on Budapest for the Eighth International Congress of Hygiene and Demography. It was an enormous gathering: more than seven hundred research papers were presented over the course of nine days, with 2,500 delegates taking part. The Hungarians’ hospitality was lavish, so much so that one journal described the whole affair as “a pleasant outing for which scientific work serves mainly as a pretext.”
Topics dealt with at the congress ranged from the management of diphtheria outbreaks to the health benefits of cold-water bathing. On Wednesday, September 5, a brief session was devoted to the “hygiene of sport.” The Paris doctor E. P. Léon-Petit gave a talk entitled “Women and the Bicycle,” addressing himself to the vexed question of whether the newfangled contraption was safe for the poor delicate creatures. The dangers had been exaggerated, he suggested, and the potential health benefits significant, adding that in women with anemia or constipation, he had even found that a bike ride brought some improvement.*
Dr. Léon-Petit was himself an accomplished club cyclist, as was the delegate who spoke after him. But George Herschell, a specialist from London, had an altogether less sunny message to impart:
Cycling, rationally pursued, is one of the most health-giving forms of amusement; but when indulged in to excess, or under improper conditions, one of the most pernicious. I have been led to choose this subject for my paper from the fact that my position on the staff of a special hospital devoted to the treatment of diseases of the heart has given me unusual opportunities of studying the subject. Moreover it is of great interest to me, as I am myself a practical cyclist. I am sorry to say that during the last few years a considerable number of cases of heart disease, undoubtedly caused by cycling, have come under my observation.
But cycling is physical exercise, and the Victorians were all in favor of that. So what’s the problem? Dr. Herschell explains:
The chief danger of cycling, or rather the reason why it is more injurious than some other forms of exercise, is the probability when riding alone of being led into an injurious excess of exertion, and the almost certainty of the same thing happening when riding in company, especially with a club.
“Injurious excess of exertion” is a good phrase, and one that I intend to use next time I am feeling too lazy to go out for a run.
In the first place we will take the solitary rider. He is extremely likely to take much more exercise than he is aware of before he recognises the fact that he has done so.
It does not apparently cross Dr. Herschell’s mind that the “solitary rider” might be a she.
He starts off in the morning for a ride, fresh and vigorous, having previously mapped out his course. It not unfrequently happens that when the time arrives for his midday meal some unforeseen delay may have caused him to have some few miles yet to go. He has perhaps overrated his capacity; or the condition of the roads render travelling at the rate upon which he had based his calculations impossible. But he is hungry, and so he redoubles his efforts to reach the place. When he arrives there he is utterly fagged out and has lost his appetite.
“That cycle ride has left me so exhausted that I could not possibly manage a hearty lunch”—a sentence I have never uttered, nor ever expect to.
Again—the roads are good, the wind is at one’s back, and the rider is fresh. The machine runs easily. Having ridden out for half a day or so the rider starts to return. But everything is now reversed. The rider is tired, and the wind is against him. Moreover he has been led by the easiness of the outward journey to go much further than he had intended; so that by the time he reaches home he is in the vernacular of the cyclist ‘baked’.
In 1890s cycling slang, baked meant “extremely tired” rather than the modern surfer-dude sense of “intoxicated by drugs.” That said, given recent scandals in the world of cycling, perhaps the latter isn’t so far off the mark
.
The commonest way however in which the cyclist does himself harm is in climbing hills. He is nearing the top of the hill, the heart is dilated with the strain put upon it by the increased arterial tension. If the rider were now to stop to recover himself no harm would be done. But in too many cases he does not do so. Only a few more revolutions of the wheel will be required to carry him to the top. So he redoubles his exertions, and puts further strain upon a heart already taxed to the utmost limit of its capacity. But in those few moments, damage has been done to the heart from which it perhaps cannot recover.
Dr. Herschell adds that his concern is mainly for recreational cyclists rather than serious road racers. But the experts are not exempt from such danger, since they are “deliberately sacrificing their future health for the sake of winning a few prizes.”
Another very wicked thing is what is known as a “hill-climbing contest”. If people were to deliberately set themselves to devise a method of riding which should be as injurious as possible they could not hit upon a better one. Hills of the steepest gradient are deliberately selected, and the competitors ride up them against time. Nothing more suicidal, or more certain to produce heart disease, can possibly be imagined.
What on earth would he have made of the Tour de France, with its regular ascents of mountain peaks? On a single day of the 2017 Tour (Stage 9), competitors rode 180 kilometers through the Jura Mountains, during which they climbed 4,600 meters. In climbing the Grand Colombier, exactly halfway through the stage, they had to propel themselves up an eye-watering gradient of 22 percent for over 3 kilometers.
Dr. Herschell then lists a number of precautions that he suggests the leisure cyclist should take “to prevent this fascinating sport from injuring us”:
The use of a low gear.
The upright position in riding. The stooping posture so affected by the modern cyclist, by contracting the chest, prevents the proper expansion of the lungs, and by interfering with the aeration of the blood, causes the condition of breathlessness to come on quicker.
Adequate food when riding, and the avoidance of muscle poisons such as beef-tea.
The cyclist must avoid the advertised preparations of kola and coca. These by numbing the sense of weariness, enable injuriously excessive work to be done, almost without the knowledge of the rider.
Kola nut contains caffeine and is relatively innocuous, but coca leaves are used to make cocaine, the consumption of which is generally frowned upon in competitive sport.*
On no account should the cyclist continue riding after he has commenced to feel short of breath, or when there is the slightest sensation of uneasiness in the chest.
Duly noted. Any club cyclists who followed Dr. Herschell’s advice to the letter would have been denying themselves much of the benefit they could otherwise expect from their hobby. Raising the heart rate, and getting out of breath, is the whole point of aerobic exercise: It helps to strengthen the heart muscle and improve the circulation and (within reason) is unambiguously a Good Thing. These days, cycling is even recommended to some patients in chronic heart failure to improve their cardiac function.
Despite his position at a specialist heart hospital, Dr. Herschell published very little on cardiac disease. He was highly regarded as an expert on disorders of the digestive tract, and his textbook on the subject ran to several editions. He thoughtfully included a short chapter of recipes for those with delicate stomachs, and a few years after his death, these were excerpted and published as a slim volume called Cookery for Dyspeptics. I don’t know if any recipe book has ever had a better title, but somehow I doubt it.
SOURCES
INTRODUCTION
“Sudden protrusion of the whole of the intestines into the scrotum,” London Medical Gazette 3, no. 72 (1829), 654.
James Young Simpson, “General observations on the Roman medicine-stamps found in Great Britain,” Monthly Journal of Medical Science 12, no. 16 (1851), 338–354.
1. UNFORTUNATE PREDICAMENTS
A FORK UP THE ANUS
Robert Payne, “An account of a fork put up the anus, that was afterwards drawn out through the buttock; communicated in a letter to the publisher, by Mr. Robert Payne, Surgeon at Lowestofft,” Philosophical Transactions 33, no. 391 (1724), 408–409.
SWALLOWING KNIVES IS BAD FOR YOU
Alexander Marcet, “Account of a man who lived ten years after having swallowed a number of clasp-knives; with a description of the appearances of the body after death,” Medico-Chirurgical Transactions 12, pt. 1 (1823), 52–63.
THE GOLDEN PADLOCK
“Case of infibulation, followed by a schirrous affection of the prepuce,” London Medical and Physical Journal 58, no. 345 (1827), 558–559.
THE BOY WHO GOT HIS WICK STUCK IN A CANDLESTICK
M. Marx, “Chirurgie clinique de l’Hôtel-Dieu,” Répertoire Général d’Anatomie et de Physiologie Pathologiques, et de Clinique Chirurgicale 3 (1827), 108–109.
SHOT BY A TOASTING FORK
Thomas Davis, “Singular case of a foreign body found in the heart of a boy,” Transactions of the Provincial Medical and Surgical Association 2 (1834), 357–360.
MR. DENDY’S EGGCUP CASE
Walter Dendy, “Discovery of a large egg-cup in the ileum of a man,” Lancet 21, no. 543 (1834), 675–677.
BROKEN GLASS AND BOILED CABBAGE
Thomas Mitchell, Materia Medica and Therapeutics (Philadelphia: J. B. Lippincott, 1857), 343.
Antoine Portal, Observations sur les Effets des Vapeurs Méphitiques dans L’Homme, sur les Noyés, sur les Enfans qui Paroissent Morts en Naissant et sur la Rage (Paris: Imprimerie Royale, 1787), 410–411; translated in “Swallowing pins and needles,” London Medical Gazette 23, no. 586 (1839), 799–800.
HONKING LIKE A GOOSE
K. Burow, “On the removal of the larynx of a goose from that of a child by tracheotomy,” British and Foreign Medico-Chirurgical Review 9 (1850), 260–261.
PENIS IN A BOTTLE
A. B. Shipman, “Novel effects of potassium—foreign bodies in the urethra—catalepsy,” Boston Medical and Surgical Journal 41, no. 2 (1849), 33–37.
THE COLONIC CARPENTRY KIT
Andrew Valentine Kirwan, The Ports, Arsenals, and Dockyards of France (London: James Fraser, 1841), 138.
“Foreign body in the colon transversum,” Medical Times and Gazette 2, no. 596 (1861), 564.
SUFFOCATED BY A FISH
Kajari Roy, Pankaj Kundra and M. Ravishankar, “Unusual foreign body airway obstruction after laryngeal mask airway insertion,” Anesthesia and Analgesia 101, no. 1 (2005), 294–295.
“Extraordinary death,” British Medical Journal 1, no. 119 (1863), 369.
Norman Chevers, A Manual of Medical Jurisprudence for India (Calcutta: Thacker, Vining & Co., 1870), 619.
Syed Rizwan Ali and Atul C. Mehta, “Alive in the airways: live endobronchial foreign bodies,” Chest 151, no. 2 (2017), 481–491.
2. MYSTERIOUS ILLNESSES
A HIDEOUS THING HAPPENED IN HIGH HOLBORN
Benjamin Ward Richardson, “Vacation lectures on fibrinous deposition in the heart,” British Medical Journal 1, no. 161 (1860), 65–68.
Edward May, A most certaine and true Relation of a strange Monster or Serpent, found in the left Ventricle of the Heart of John Pennant, Gentleman, of the Age of 21 Yeares (London: Printed by George Miller, 1639).
THE INCREDIBLE SLEEPING WOMAN
Terence Brady, “An account of an extraordinary sleepy woman, near Mons, in Hainault,” Medical Observations and Inquiries 1 (1757), 280–285.
THE DREADFUL MORTIFICATION
Charlton Wollaston, “Extract of a letter from Charlton Wollaston, M.D. F.R.S. to William Heberden, M.D. F.R.S. dated Bury St Edmund’s April 13, 1762, relating to the case of mortification of limbs in a family at Wattisham in Suffolk,” Ph
ilosophical Transactions 52 (1761), 523–526.
THE HUMAN PINCUSHION
“The Copenhagen needle patient,” Medico-Chirurgical Review 7, no 22 (1825), 559–562.
THE MAN WHO FOUGHT A DUEL IN HIS SLEEP
“A singular case of somnambulism,” London Medical Repository 6 (1816), 475–478.
THE MYSTERY OF THE EXPLODING TEETH
W. H. Atkinson, “Explosion of teeth with audible report,” Dental Cosmos 2, no. 6 (1861), 318–319.
J. Phelps Hibler, Pathology and Therapeutics of Dentistry (St. Louis: James Hogan, 1874), 28.
THE WOMAN WHO PEED THROUGH HER NOSE
S. A. Arnold, “Case of paruria erratica, or uroplania,” New England Journal of Medicine and Surgery 14, no. 4 (1825), 337–358.
THE BOY WHO VOMITED HIS OWN TWIN
“A foetus vomited by a boy,” London Medical and Surgical Journal 6, no. 151 (1835), 663.
“Foetus monstrueux de Syra,” Comptes Rendus Hebdomadaires des Séances de l’Académie des Sciences 3 (1836), 52–53.
R. Yaacob et al., “The entrapped twin: a case of fetus-in-fetu,” BMJ Case Reports (2017), doi:10.1136/bcr-2017-220801.
THE CASE OF THE LUMINOUS PATIENTS
Sir Henry Marsh, “On the evolution of light from the living human subject,” Provincial Medical Journal 2, no. 9 (1842), 163–172.
Robert Boyle, Peter Shaw (ed.), The Philosophical Works of the Honourable Robert Boyle Esq (3 vols; London: Innys & Manby & Longman, 1738), 3: 168–169.
THE MISSING PEN
“An extraordinary injury,” Chicago Medical Journal and Examiner 56, no. 3 (1888), 182–183.
3. DUBIOUS REMEDIES
The Mystery of the Exploding Teeth and Other Curiosities From the History of Medicine Page 26
