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A Calculus cut from a urinary bladder
The brief notes for this object detail that the calculus measures 69mm diameter at the widest point and is made of uric acid. A build up in uric acid can be caused by a diet high in purines, which are found in high amounts in animal protein, especially red meat. The appearance of the calculus shows it to be smooth, oval and mounted in a leather case. This is one of several calculi from the collections, which include a bladder calculus weighing 6.25kg, alleged to have come from an elephant.
Osteomyelitis is the medical term for a bone infection, which is usually caused by bacteria. This week’s specimen is of a tibia from a male aged 31 years. In summer 1814, aged 17 years, whilst sailing in the Baltic, he fell on deck with his leg doubled under him. After seeing a surgeon who recommended rubbing a liniment on it, he fell again when in Riga and was conveyed to the hospital for six weeks where he was told the bones below the knee were splintered.
By 1817 swelling on the tibia had increased and an incision was made by a surgeon in Dundee to relieve pressure. A little pus was discharged, but soon healed up. The following year, an opening had formed where the incision had been made, however the sore continued to open discharging a bloody serum.
As the swelling increased in size he fitted a wood and tow plug to assist washing out the cavity and preventing the discharge. Draining of the cavity was carried out daily until the limb was eventually amputated in 1831, 14 years after the initial injury.
The fibreglass recasting of ‘From Nature’ has been a fixture of the Jules Thorn Museum at Surgeons’ Hall Museums since late 1980’s. The cast was funded by the National Fund for Acquisitions and the National Museums of Scotland in 1986. The original cast was made by Sir John Goodsir, a former Conservator of Surgeons’ Hall Museum in 1841, and Professor of Anatomy at Edinburgh University in 1846 & 1867. Goodsir was a dissector of exceptional skill who produced many excellent teaching specimens. He published widely on subjects such as human teeth and studies of diseased tissues. Through his teaching, educational innovation, writing and anatomical dissections, Goodsir made notable contributions to medical science and his brilliance was recognised by both James Syme and Rudolf Virchow.
The Case of Robert Penman
When Robert Penman was 16, he was presented to a local surgeon with an egg sized tumour in his lower jaw. The teeth that were connected to the lower were removed and the over time the growth grew rapidly. The tumour was then cut off from the bone at the Royal Infirmary of Edinburgh, however it continued to grow, and as such would not heal. 5 years later when Penman was 24 years old, James Syme was approached to assess and operate on the tumour.
In 1828, Syme removed a 72oz tumour from the lower jaw of Penman. The procedure was carried out without anaesthesia in 24 minutes, while Penman sat upright in a chair. The Penman operation is a significant example of Syme’s extraordinary skill as a surgical pioneer. The case was well documented by Syme, and a preoperative portrait, postoperative photo and an addiitonal preoperative cast are also held in the Museum collections.
This month we will be looking at foreign objects in our collection.
The first to feature is a small bead that was covered in tetanus bacteria. This bead was inserted through the left nostril of a small boy who was then taken to his local doctor’s surgery where a rhinoscopy (a method that involves using a tube like instrument to examine the inside of the nose) found that there was no bead in sight.
The boy was sent on his way and remained in good health until seven days later. On the morning of the seventh day, he was admitted to hospital being unable to open his jaw. The doctors found the boy to have spasms that were seen as tetanic as well as a temperature of 39°C. The normal human temperature is 37°C. It was later discovered that the bead had never been found after the initial consultation, seven days previously. The boy was taken in for an operation to remove the bead which was successful. Unfortunately, the boy became unconscious and died two days later. A post-mortem revealed that the bead had tetanus germs on it that had spread throughout the boy’s body causing his death.
This week's object is a Sole, but in keeping with this month's theme is also a foreign object from inside the human body.
Whilst a fisherman was drawing his net with both hands, he seized the sole with his teeth as it was trying to escape from a hole in the net. It managed to force its way into the fisherman’s throat, and before it could be removed it suffocated him. Upon post-mortem examination the sole was found with its teeth fastened to the wall of the man’s oesophagus, near his stomach.
This week we look at a phytobezoar from the inside of a young child. A phytobezoar is a trapped mass that is made up of indigestible items such as fibres, skin or seeds, as opposed to a trichobezoar, which is more commonly known as a hairball. The girl from who the phytobezoar came from was described as being well-grown but gaunt and being unable to eat due to the pain. The girl was also described as being very nervous and easily frightened from an early age chewing on whatever she had in hands.
This particular specimen was donated to the by Gertrude Herzfeld, the first female fellow to “take her seat” at the Royal College of Surgeons of Edinburgh.
This week we take a look at a slightly different type of bezoar. This specimen would be commonly known as a hairball, or trichobezoar. These hairballs are formed when hair is ingested by a human eating it, in what is known as trichophagia.
With this particular specimen the patient had ingested hair over a period of seven years resulting in a very large hairball forming in their stomach. To remove the hairball a longitudinal incision was made in the wall of the stomach.
We have placed a one pence piece next to the stomach to give you an idea about how large this trichobezoar actually was.
Foreign Metal Objects
Our final “Object of the Week” in our Foreign Bodies series is a selection of ingested metal articles. These metal objects all come from one man who had swallowed them for a series of bets for money or alcoholic drinks. Whilst the man was in prison, he was treated for epigastric pains and acute indigestion. A scan of his stomach showed a large mass that had formed within it. This mass turned out to be the entire contents of this jar of nails, screws and other metal bits and pieces. There are 84 in total, weighing a combined weight of nearly 250g! Fortunately for the man, the objects were all removed without incident and without causing any further pain. You may notice that some of the objects are wrapped up in metal wire. This was to allow for easier ingestion.
In August, we are looking at different skulls in the museum collections as part of our on-going Object of the Week series.
Our first object of the week is a Neanderthaloid skull.
This skull was given to the College by David M. Greig, a former conservator of Surgeons’ Hall Museum, who obtained it from a “medical friend, who had inherited it without knowledge of its origin”. The skull was described as having Neanderthal characteristics, with features such as the low forehead and heavy brow ridge. The back of the skull was also described as protruding at the base.
In 2008 part of the mystery of this skull was solved when it was sent away for radiocarbon dating; the results show that the skull is that of a much more modern human, dating from the mid-17th century, as opposed to being from a Neanderthal. Neanderthals are our closest extinct relatives, having died out around 28,000 years ago.