Our Enduring Preoccupation with Premature Burial 

 

ed943eb562e8e7671f2dcc7765b2ab74--premature-burial-edgar-allan-poeHours before he died, George Washington told his secretary: “Have me decently buried; and do not let my body be put into the Vault in less than three days after I am dead.” This kind of request was not uncommon. In an era when putrefaction was the only sure sign of death, many people in the past feared being buried alive.

Indeed, Washington’s nephew was even more paranoid than the former president. He ordered: “my thumbs are not to be tied together—nor anything put on my face or any restraint upon my Person by Bandages, &c. My Body is to be placed in an entirely plain coffin with a flat Top and a sufficient number of holes bored through the lid and sides—particularly about the face and head to allow Respiration if Resuscitation should take place and having been kept so long as to ascertain whether decay may have occurred or not, the coffin is to be closed up.”

By the 19th century, being trapped inside a coffin was a favorite plot twist for writers of macabre fiction, such as Edgar Allan Poe, whose story The Premature Burial (1844) contributed to the public preoccupation with the subject. Anxiety about premature burial was so widespread that, in 1891, the Italian psychiatrist Enrico Morselli coined the medical term for it: taphephobia (Greek for “grave” + “fear.”)

premature_burial_title_page1This phobia led to the creation of so-called “safety coffins.” In 1790,  Duke Ferdinand of Brunswick had built the first coffin of this kind, which included a window to allow in light, and a tube to provide a fresh supply of air. The lid of the coffin was then locked and two keys were fitted into a special pocket sewn into his burial shroud: one for the coffin itself and one for the tomb.

Many of the safety coffins that came afterward were touted as “tried and tested.” In 1822, Dr Adolf Gutsmuth consigned himself to the grave in a coffin he had designed personally. For several hours, he remained underground, during which time he consumed a meal of soup, sausages, and beer—all delivered to him through a convenient feeding tube built into the coffin. The Germans were particularly ingenious when it came to safety coffins, patenting over 30 different designs in the 19th century. The best-known model was the brainchild of Dr Johann Gottfried Taberger, and it included a system of ropes that attached the corpse’s hands, feet, and head to an above-ground bell. Although many subsequent designs tried to incorporate this feature, it was by-and-large a design failure. What Dr Taberger didn’t take into account is the fact that the body begins to bloat and swell as it decomposes, causing it to shift inside the coffin. These tiny movements would have set the bells ringing, and visitors to the cemetery running.safetycoffinsThe Russian Count Michel de Karnice-Karnicki’s design was an evengreater disaster than most. In 1897, he buried one of his assistants in order to demonstrate the features of his safety coffin. If the device detected movement from within, it was rigged to open a tube which would allow air to flow while simultaneously raising a flag and ringing a bell. Unfortunately, none of the features worked and the demonstration failed miserably. While the assistant survived, Karnice-Karnicki’s reputation did not.

image_12One of the most unsettling coffin designs came from an American doctor named Timothy Clark Smith who was so terrified of being buried alive that he created a grave that even today intrigues and frightens visitors to Evergreen Cemetery in New Haven, Vermont. When Dr Smith died—aptly enough on Halloween, 1893—his body was interred in a most unusual crypt, with his face positioned at the bottom of a cement tube. This was capped with a piece of plate glass that would allow the unfortunate doctor to gaze upward in the event of his premature burial. Visitors to the cemetery used to report that they could peer down inside the grave and see Dr Smith’s decomposing head. Nowadays, all you can see is darkness and a bit of condensation.

Escape coffins were also built for those who didn’t have the patience to wait for someone to come to the rescue. One such coffin–intended for use in vaults–had a spring-loaded lid that could be opened with a slight movement of the head or hand. Another example was built by retired firefighter Thomas Pursell for himself and his family. Located at Wildwood Cemetery in Williamsport, Pennsylvania, the ventilated vault can be opened from the inside by a handwheel attached to the door. Pursell was buried there in 1937.

9c13557a026510262f13555b436b6823-origIf all of this seems a bit irrational to your modern sensibilities, consider the fact that safety coffins are still available for purchase today. In 1995, Fabrizio Caselli invented a model that includes an emergency alarm, a two-way intercom, a flashlight, an oxygen tank, a heartbeat sensor and a heart stimulator.  Taphephobia is far from dead and buried!

 

Fitzharris_ButcheringArt_JKFYou can now pre-order my book, all about the bloody & brutal world of Victorian surgery. Pre-orders are incredibly helpful to new authors. Your support is greatly appreciated. US link HERE, UK link HERE, Canadian link HERE, Australian link HERE. Info on other foreign editions to come.

 

 

 

 

 

 

Everyday Heroes: A Story of Self-Sacrifice & Bubonic Plague

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On 1 November 1666, a young farmer named Abraham Morten took one final, agonizing breath. He was the last of 260 people to die of bubonic plague in the remote village of Eyam in Derbyshire. His fate had been sealed four months earlier when villagers decided to shut themselves off from the rest of the world: a sacrifice they made in order to save the lives of their neighbors in surrounding villages.

eyam-plague-plaque.jpgThe nightmare began on an unremarkable day in September, 1665. George Viccars—a local tailor in Eyam—received a consignment of cloth from London for his shop. Upon inspection, Viccars noticed that the cloth was damp. He hung it before his fire to dry, not realizing that it was playing host to fleas that were carrying the bubonic plague.

Viccars was dead within a week.

The pestilence spread rapidly throughout the village. Panic broke out as villagers began making preparations to flee Eyam for contagion-free surroundings. It was then that two local clergymen, William Mompesson and Thomas Stanley, decided to intervene in order to stop the plague from spreading to neighboring villages. In a joint sermon, the two men pleaded with their fellow townspeople to recognize that it was their Christian duty to remain in Eyam until the scourge had played itself out, and to prevent the disease taking hold in other villages. Moved by the clergymen’s words, the villagers decided to make the ultimate sacrifice: they sealed themselves off from the rest of the world.

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In order to do this, they created a stone boundary around Eyam. No one was allowed in, and no one was allowed out. People from surrounding communities brought food and clothing to the disease-ridden village. They would leave their goods on the stones and pick up their payment from a well filled with water and vinegar [pictured above], which would disinfect the coins.

dsc03368.jpgWithin Eyam’s self-imposed bounds, the plague was unrelenting, killing people arbitrarily over the next fourteen months. No one was untouched by tragedy, including Elizabeth Hancock, who inadvertently brought the disease back to her farm after helping to bury a fellow villager’s body. Within a week, all six of Elizabeth’s children, as well as her husband, had died. Not wanting to put anyone at further risk, Elizabeth took on the task of burying her entire family herself.

By August, two-thirds of Eyam’s population had died from the plague, including Mompesson’s own wife. The cemetery had become so full that the dead had to be buried in nearby gardens and fields. The dwindling congregation—which grew smaller daily—began holding services outside in an attempt to halt the rampant spread of the disease. There, in the open air, they prayed earnestly to be delivered from the suffering God had seen fit to thrust upon them.

Eyam_window.jpgBy November, the plague had finally subsided. Of the village’s 350 original occupants, only 90 had survived. However, it is not the statistics that are noteworthy in this story, as these are fairly typical of plague mortality rates during this period. Rather, it is the villagers who are extraordinary. They stopped the spread of plague by their courageous, selfless actions, and in doing so, ensured that they would not become just another set of nameless statistics generated by that horrific epidemic.

No one in the surrounding area contracted plague during this time.

 

Fitzharris_ButcheringArt_JKFIf you’re interested in learning more about the plague, check out Rebecca Rideal’s excellent book 1666: Plague, War and Hellfire.

And don’t forget you can now pre-order my book, The Butchering Art. All pre-orders count towards first-week sales once the book is released, and therefore give me a greater chance of securing a place on bestseller lists in October. I would be hugely grateful for your support. If you’re in the US, click HERE. If you’re in the UK, click HERE. Info on further foreign editions to come.

 

Quacks & Hacks: Walter Freeman and the Lobotomobile

 

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On 12 November 1935, a Portuguese neurologist named Antonio Egas Moniz [below right] became the first individual to perform what would later be known as a lobotomy. Moniz’s work built upon that of the 19th-century Swiss psychiatrist, Gottlieb Burkhardt, who performed a series of operations in 1888 in which he removed sections of the cerebral cortex from six patients under his care at the Préfargier Asylum. Moniz’s early experiments involved drilling holes into patients’ skulls and pouring alcohol into the frontal cortex in order to sever nerves; and coring out regions of the brain with hollow needles.

egas4Moniz’s lobotomy quickly became a popular treatment for various mental conditions, putting an end to the therapeutic nihilism that dominated the psychiatric profession in the Victorian era. Suddenly, doctors believed they could “cure” patients whom they had previously deemed beyond help. Within a decade, the lobotomy became so esteemed that Moniz was awarded a Nobel Prize for his role in developing it.

During this time, Moniz’s procedure was adopted (and adapted) by the American neuropsychiatrist Walter Freeman, who performed the first lobotomy in the United States in 1936. Freeman won acclaim for his technique, and people all over the country began lining up to get their lobotomies, including Rosemary Kennedy [below]—sister to the man who would later become President of the United States. Rosemary was described by members of her family as a rebellious child who was prone to violent mood swings while she was growing up. In November 1941, Rosemary’s father took her to see Freeman, who diagnosed the 23-year-old girl with “agitated depression” and suggested she undergo a lobotomy to correct her erratic behavior. [Interestingly, 80 percent of the lobotomies performed in the US in those early years were carried out on women].

rosemary-kennedy-01-435Freeman performed the operation right then and there on Rosemary, without her mother’s knowledge. Shortly afterwards, it became clear that something had gone terribly wrong. Rosemary could no longer speak, and her mental capacity was equivalent to that of a toddler. Her father institutionalized her, telling people that his daughter was mentally retarded rather than admitting that her condition was due to a failed brain operation. It was only after his death decades later that the truth behind her condition was revealed. Rosemary never did recover her ability to speak coherently, and remained in care till her death in 2005 at the age of 86. She was the first of her siblings to die of natural causes.

The incident did little to damage Freeman’s reputation, who soon began looking for a more efficient way to perform the operation without drilling directly into the skull. As a result, he created the transorbital lobotomy in which a pick-like instrument was forced through the back of the eye sockets to pierce the thin bone that separates the eye sockets from the frontal lobes. This procedure—which later became known as the “ice-pick” lobotomy—could be performed in under ten minutes without anesthetic.

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Freeman took to the roads with his ice-pick and hammer, touring hospitals and mental institutions around the country. He performed ice-pick lobotomies for all kinds of conditions, including headaches. Eventually, he began performing the operation in his van—which later became known as “the lobotomobile.” At one point, he undertook 25 lobotomies in a single day. He even performed them on children as young as 4 years old. Years later, one of them spoke of the frightful incident: “I’ve always felt different—wondered if something’s missing from my soul. I have no memory of the operation, and never had the courage to ask my family about it.”

20131026_133743Over the course of four decades, Freeman performed nearly 3,500 lobotomies despite the fact that he had no surgical training. Many of his patients often had to relearn how to eat and use the bathroom. Some never recovered. And, of course, there were fatalities. In 1951, one of his patients died when Freeman suddenly stopped to pose for a photo during the procedure. The surgical instrument slipped and went too far into the patient’s brain. Many others fell victim to a similar fate at the good doctor’s hands.

The lobotomy eventually came under attack from the medical community. By the 1970s, several countries had banned the procedure altogether. Freeman eventually retired the lobotomobile and opened a private practice in California. Contrary to popular belief, he never lost his license to practice medicine.

Today, surgical lobotomies are no longer performed. The rise of drugs like thorazine make it easier to lobotomize patients chemically. In recent years, there have been calls for the Nobel Foundation to rescind Moniz’s prize that he received for developing the lobotomy, which has often been labeled one of the most barbaric mistakes of modern medicine.

 

Fitzharris_ButcheringArt_JKFSpecial thanks to Paul Koudounaris for bringing this fascinating subject to light for me when I was in Los Angeles this past April.

If you’re interested in the history of surgery, you can now pre-order my book, The Butchering Art. All pre-orders count towards first-week sales once the book is released, and therefore give me a greater chance of securing a place on bestseller lists in October. I would be hugely grateful for your support. If you’re in the US, click HERE. If you’re in the UK, click HERE. Info on further foreign editions to come.

 

 

Painful Operations: Removing Bladder Stones before Anesthesia

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If you visit the Gordon Museum at Guy’s Hospital in London, you’ll see a small bladder stone—no bigger than 3 centimetres across. Besides the fact that it has been sliced open to reveal concentric circles within, it is entirely unremarkable in appearance. Yet, this tiny stone was the source of enormous pain for 53-year-old Stephen Pollard, who agreed to undergo surgery to remove it in 1828.

People frequently suffered from bladder stones in earlier periods due to poor diet, which often consisted of lots of meat and alcohol, and very few vegetables. The oldest bladder stone on record was discovered in Egyptian grave from 4,800 B.C. The problem was so common that itinerant healers traveled from village to village offering a vast array of services and potions that promised to cure those suffering from the condition. Depending on the size of these stones, they could block the flow of urine into the bladder from the kidneys; or, they could prevent the flow of urine out of the bladder through the urethra. Either situation was potentially lethal. In the first instance, the kidney is slowly destroyed by pressure from the urine; in the second instance, the bladder swells and eventually bursts, leading to infection and finally death.

2Like today, bladder stones were unimaginably painful for those who suffered from them in the past. The stones themselves were often enormous. Some measured as large as a tennis ball. The afflicted often acted in desperation, going to great lengths to rid themselves of the agony. In the early 18th century, one man reportedly drove a nail through his penis and then used a blacksmith’s hammer to break the stone apart until the pieces were small enough to pass through his urethra. It’s not a surprise, then, that many sufferers chose to submit to the surgeon’s knife despite a very real risk of dying during or immediately after the procedure from shock or infection. Although the operation itself lasted only a matter of minutes, lithotomic procedures were incredibly painful and dangerous—not to mention humiliating.

The patient—naked from the waist down—was bound in such a way as to ensure an unobstructed view of his genitals and anus [see illustration below]. Afterwards, the surgeon passed a curved, metal tube up the patient’s penis and into the bladder. He then slid a finger into the man’s rectum, feeling for the stone. Once he had located it, his assistant removed the metal tube and replaced it with a wooden staff. This staff acted as a guide so that the surgeon did not fatally rupture the patient’s rectum or intestines as he began cutting deeper into the bladder. Once the staff was in place, the surgeon cut diagonally through the fibrous muscle of the scrotum until he reached the wooden staff. Next, he used a probe to widen the hole, ripping open the prostate gland in the process. At this point, the wooden staff was removed and the surgeon used forceps to extract the stone from the bladder. [1]

L0015225 Lithotomy scene

Unfortunately for Stephen Pollard, what should have lasted 5 minutes ended up lasting 55 minutes under the gaze of 200 spectators at Guy’s Hospital in London. The surgeon Bransby Cooper fumbled and panicked, cursing the patient loudly for having “a very deep perineum,” while the patient, in turn, cried: “Oh! let it go; —pray, let it keep in!’” The surgeon reportedly used every tool at his disposal before he finally reached into the gaping wound with his bare fingers. During this time, several of the spectators walked out of the operating theater, unable to bear witness to the patient’s agony any longer. Eventually, Cooper located the stone with a pair of forceps. He held it up for his audience, who clapped unenthusiastically at the sight of the stone.

Sadly, Pollard survived the surgery only to die the next day. His autopsy revealed that it was indeed the skill of his surgeon, and not his alleged “abnormal anatomy,” which was the cause of his death.

1200px-Thomas_Wakley72But the story didn’t end there. Word quickly got out about the botched operation. When Thomas Wakley [left]—the editor of The Lancet—heard of this medical disaster, he accused Cooper of incompetence and implied that the surgeon had only been appointed to Guy’s Hospital because he was nephew to one of the senior surgeons on staff. Wakley used the trial to attack what he believed to be corruption within the hospitals due to rampant nepotism. Outraged by the allegation, Cooper sued Wakley for libel and sought £2000 in damages. The jury reluctantly sided with the surgeon, but only awarded him £100. Wakley had raised more than that in a defence fund campaign and gave the remaining money over to Pollard’s widow after the trial. [2]

Bransby Cooper’s reputation, like his patient, never did recover.

If you’re interested in the history of pre-anesthetic and pre-antiseptic surgery, you can pre-order my book The Butchering Art in the US (click here) and in the UK (click here). Information of foreign editions to come!

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1. Druin Burch, Digging up the Dead: Uncovering the Life and Times of an Extraordinary Surgeon (2007), p. 26. I am greatly indebted to his work for bringing this story to my attention.
2. Thomas Wakley, A Report of the Trial of Cooper v. Wakley (1829), pp. 4-5.

The Wandering Womb: Female Hysteria through the Ages

Hysteriaa

The word “hysteria” conjures up an array of images, none of which probably include a nomadic uterus wandering aimlessly around the female body. Yet that is precisely what medical practitioners in the past believed was the cause behind this mysterious disorder. The very word “hysteria” comes from the Greek word hystera, meaning “womb,” and arises from medical misunderstandings of basic female anatomy.

Today, hysteria is regarded as a physical expression of a mental conflict and can affect anyone regardless of age or gender. [1] Centuries ago, however, it was attributed only to women, and believed to be physiological (not psychological) in nature.

enhanced-1129-1458094853-1For instance, Plato believed that the womb—especially one which was barren—could become vexed and begin wandering throughout the body, blocking respiratory channels causing bizarre behavior. [2] This belief was ubiquitous in ancient Greece. The physician Aretaeus of Cappadocia went so far as to consider the womb “an animal within an animal,” an organ that “moved of itself hither and thither in the flanks.” [3] The uterus could move upwards, downwards, left or right. It could even collide with the liver or spleen. Depending on its direction, a wandering womb could cause all kinds of hell. One that traveled upwards might cause sluggishness, lack of strength, and vertigo in a patient; while a womb that moved downwards could cause a person to feel as if she were choking. So worrisome was the prospect of a wandering womb during this period, that some women wore amulets to protect themselves against it. [4]

The womb continued to hold a mystical place in medical text for centuries, and was often used to explain away an array of female complaints. The 17th-century physician William Harvey, famed for his theories on the circulation of the blood around the heart, perpetuated the belief that women were slaves to their own biology. He described the uterus as “insatiable, ferocious, animal-like,” and drew parallels between “bitches in heat and hysterical women.” [5] When a woman named Mary Glover accused her neighbor Elizabeth Jackson of cursing her in 1602, the physician Edward Jorden argued that the erratic behavior that drove Mary to make such an accusation was actually caused by noxious vapors in her womb, which he believed were slowly suffocating her. (The courts disagreed and Elizabeth Jackson was executed for witchcraft shortly thereafter.)

So what could be done for hysteria in the past?

e789fb4fb909b2a53918eb9a18b08db3Physicians prescribed all kinds of treatments for a wayward womb. These included sweet-smelling vaginal suppositories and fumigations used to tempt the uterus back to its rightful place. The Greek physician Atreaus wrote that the womb “delights…in fragrant smells and advances towards them; and it has an aversion to foetid smells, and flees from them.” Women were also advised to ingest disgusting substances—sometimes containing repulsive ingredients such as human or animal excrement—in order to coax the womb away from the lungs and heart. In some cases, physical force was used to correct the position of a wandering womb (see image, right). For the single woman suffering from hysteria, the cure was simple: marriage, followed by children. Lots and lots of children.

Today, wombs are no longer thought to wander; however, medicine still tends to pathologize the vagaries of the female reproductive system. [6] Over the course of several thousand years, the womb has become less of a way to explain physician ailments, and more of a way to explain psychological disfunction—often being cited as the reason behind irrationality and mood swings in women. Has the ever-elusive hysteria brought on by roving uteri simply been replaced by the equally intangible yet mysterious PMS? I’ll let you decide.

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You can now pre-order my book THE BUTCHERING ART by clicking here. THE BUTCHERING ART follows the story of Joseph Lister as he attempts to revolutionize the brutal world of Victorian surgery through antisepsis. Pre-orders are incredibly helpful to new authors. Info on how to order foreign editions coming soon. Your support is greatly appreciated. 

 

 

1. Mark J Adair, “Plato’s View of the ‘Wandering Uterus,’” The Classical Journal 91:2 (1996), p. 153.
2. G. S. Rousseau, “‘A Strange Pathology:’ Hysteria in the Early Modern World, 1500-1800” in Hysteria Beyond Freud (1993), p.104. Originally qtd in Heather Meek, “Of Wandering Wombs and Wrongs of Women: Evolving Concepts of Hysteria in the Age of Reason,” English Studies in Canada 35:2-3 (June/September 2009), p.109.
3. Quoted in Matt Simon, “Fantastically Wrong: The Theory of the Wandering Wombs that Drove Women to Madness,” Wired (7 May 2014).
4. Robert K. Ritner, “A Uterine Amulet in the Oriental Institute Collection,” Journal of Near Eastern Studies 45:3 (Jul. 1984), pp.209-221. For more on the fascinating subject of magical amulets, see Tom Blaen, Medical Jewels, Magical Gems: Precious Stones in Early Modern Britain (2012).
5. Rousseau, “A Strange Pathology,” p. 132.
6. Mary Lefkowitz, “Medical Notes: The Wandering Womb,” The New Yorker (26 February 1996).

Syphilis: A Little Valentine’s Day Love Story

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Photo Credit: The Royal College of Surgeons of England 

We don’t know much about her. We don’t even know her name. What we do know is that the woman who wore the above prosthetic in the mid-19th century was suffering from a severe case of syphilis.

Before the discovery of penicillin in 1928, syphilis was an incurable disease. Its symptoms were as terrifying as they were unrelenting. Those who suffered from it long enough could expect to develop unsightly skin ulcers, paralysis, gradual blindness, dementia and “saddle nose,” a grotesque deformity which occurs when the bridge of the nose caves into the face.

stlcfo00239This deformity was so common amongst those suffering from the pox (as it was sometimes called) that “no nose clubs” sprung up in London. On 18 February 1874, the Star reported: “Miss Sanborn tells us that an eccentric gentleman, having taken a fancy to see a large party of noseless persons, invited every one thus afflicted, whom he met in the streets, to dine on a certain day at a tavern, where he formed them into a brotherhood.”[1] The man, who assumed the name Mr. Crampton for these clandestine parties, entertained his “noseless’” friends every month until he died a year later, at which time the group “unhappily dissolved.”[2]

The 19th century was particularly rife with syphilis. Because of its prevalence, both physicians and surgeons treated victims of the disease. Many treatments involved the use of mercury, hence giving rise to the saying: “One night with Venus, a lifetime with Mercury.” Mercury could be administered in the form of calomel (mercury chloride), an ointment, a steam bath or pill. Unfortunately, the side effects could be as painful and terrifying as the disease itself. Many patients who underwent mercury treatments suffered from extensive tooth loss, ulcerations and neurological damage. In many cases, people died from significant mercury poisoning.

For those determined to avoid the pox altogether, condoms made from animal membrane and secured with a silk ribbon were available [below], but these were outlandishly expensive. Moreover, many men shunned them for being uncomfortable and cumbersome. In 1717, the surgeon, Daniel Turner, wrote:

The Condum being the best, if not only Preservative our Libertines have found out at present; and yet by reason of its blunting the Sensation, I have heard some of them acknowledge, that they had often chose to risk a Clap, rather than engage cum Hastis sic clypeatis [with spears thus sheathed].[3]

13Everyone blamed each other for the burdensome condom. The French called it “la capote anglaise” (the English cape), while the English called it the “French letter.” Even more unpleasant was the fact that once one procured a condom, he was expected to use it repeatedly. Unsurprisingly, syphilis continued to rage despite the growing availability of condoms during the Victorian period.

Which brings me back to the owner of the prosthetic nose. Eventually, she lost her teeth and palate after prolonged exposure to mercury treatments. Her husband—who may have been the source of her suffering—finally died from the disease, leaving her a widow. But it wasn’t all doom and gloom for the poor, unfortunate Mrs X.

According to records at the Royal College of Surgeons in London, the woman found another suitor despite her deformities. After the wedding, she sought out the physician, James Merryweather, and sold the contraption to him for £3. The reason? Her new husband liked her just the way she was – no nose and all!

And that, kind readers, is a true Valentine’s Day love story…Ignore the part where she most certainly transmitted the disease to her new lover.

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1. Origin of the No Nose Club. Star, Issue 1861 (18 February 1874), p. 3.
2. Ibid.
3. Daniel Turner, Syphilis: A Practical Treatise on the Venereal Disease (1717), p. 74.

The Surgeon who Operated on Himself

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Leonid Ivanovich Rogozov (pictured above and below right) knew he was in trouble when he began experiencing intense pain in lower right quadrant of his abdomen. He had been feeling unwell for several days, but suddenly, his temperature skyrocketed and he was overcome by waves of nausea. The 27-year-old surgeon knew it could only be one thing: appendicitis.

blog3The year was 1961, and under normal circumstances, appendicitis was not life-threatening. But Rogozov was stuck in the middle of the Antartica, surrounded by nothing but thousands of square miles of snow and ice, far from civilization. He was one of thirteen researchers who had just embarked on the sixth Soviet Antarctic Expedition.

And he was the only doctor.

At first, Rogozov resigned himself to his fate. He wrote in his diary:

It seems that I have appendicitis. I am keeping quiet about it, even smiling. Why frighten my friends? Who could be of help? A polar explorer’s only encounter with medicine is likely to have been in a dentist’s chair.

He was right that there was no one who could help. Even if there had been another research station within a reasonable distance, the blizzard raging outside Rogozov’s own encampment would have prevented anyone from reaching him. An evacuation by air was out of the question in those treacherous conditions. As the situation grew worse, the young Soviet surgeon did the only thing he could think of: he prepared to operate on himself.

Rogozov was not the first to attempt a self-appendectomy. In 1921, the American surgeon Evan O’Neill Kane undertook an impromptu experiment after he too was diagnosed with a severe case of appendicitis. He wanted to know whether invasive surgery performed under local anesthetic could be painless. Kane had several patients who had medical conditions which prevented them from undergoing general anesthetic. If he could remove his own appendix using just a local anesthetic, Kane reasoned that he could operate on others without having to administer ether, which he believed was dangerous and overused in surgery.

Lying in the operating theater at the Kane Summit Hospital, the 60-year-old surgeon announced his intentions to his staff. As he was Chief of Surgery, no one dared disagree with him. Kane proceeded by administering novocaine—a local anesthetic that had only recently replaced the far more dangerous drug, cocaine—as well as adrenalin into his abdominal wall. Propping himself up on pillows and using mirrors, he began cutting into his abdomen. At one point, Kane leaned too far forward and part of his intestines popped out. The seasoned surgeon calmly shoved his guts back into their rightful place before continuing with the operation. Within thirty minutes, he had located and removed the swollen appendix. Kane later said that he could have completed the operation more rapidly had it not been for the staff flitting around him nervously, unsure of what they were supposed to do.

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Emboldened by his success, Kane decided to repair his own inguinal hernia under local anesthetic eleven years later. The operation was carried out with the the press in attendance. This operation was more dangerous than the appendectomy because of the risk of puncturing the femoral artery. Unfortunately, this second surgery was tricky, and ended up taking well over an hour. Kane never fully regained his strength. He eventually came down with pneumonia, and died three months later.

Back in Antartica, Rogozov enlisted the help of his colleagues, who assisted with mirrors and retractors as the surgeon cut deep into his own abdomen. After forty-five minutes, Rogozov began experiencing weakness and vertigo, and had to take short breaks. Eventually he was able to remove the offending organ and sew up the incision (pictured below, recovering). Miraculously, Rogozov was able to return to work within two weeks.

blog4The incident captured the imagination of the Soviet public at the time. After he returned from the expedition, Rogozov was awarded the Order of the Red Banner of Labour. The incident also brought about a change in policy. Thereafter, extensive health checks became mandatory for personnel before their departure for Antartica was sanctioned.

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