American Flamingo - Phoenicopterus ruber

Flamingos aren’t naturally pink! They get their coloration from beta carotene found in the blue-green algae they consume. The flamingos that consume blue-green algae directly are much pinker than flamingos that primarily consume the blue-green algae secondhand (via zooplankton/brine shrimp). 

Flamingos are also unique in their method of eating - their bills are designed to scoop the bottom sediment and then filter out the mud and silt, leaving only the blue-green algae or the brine shrimp in their mouth. They shake their head back and forth under the water after scooping up the sediment. The big, fleshy tongue of the flamingo pushes water back and forth in the mouth and facilitates the filtering of all that mud. They also swallow their food while their head is upside-down! The meaty tongue used to be considered a delicacy among the Roman elite.

Images:
Nature Neighbors: Embracing Birds, Plants, and Minerals. Nathanial Moore Banta for the American Audubon Association, 1914.

Osteologia Avium; or, A sketch of the osteology of birds. T.C. Eyton, 1867.

Osteo-chondro-myxosarcoma before and after surgical intervention

Osteogenic tumors develop bone that displaces soft tissue. Osteo- means “bone”, and -genic means “to form”. In addition to the osteogenic behavior, this patient’s tumor has caused disordered cartilage (chondro-) and mucous membrane (myxo-) growth.

The case report states that it took “many” surgeries to completely remove the tumor and partially reconstruct the jaw, but that the patient lived a further 8 years after removal, and experienced no recurrence of the tumor in that time. While his vision suffered, as the left eye was unsalvagable, and his speech was impeded by both the incomplete jaw reconstruction and the excess skin remaining on the face, he was able to hold down a steady job and communicate. He was reported to be of “average-to-high” intelligence.

Tumors of the Jaws. Charles Locke Scudder, 1912.

One of these things is not like the other…

First row: Walrus (Odobenus rosmarus) skeleton
Second row: Hooded seal (Cystopkora cristata) skeleton
Third row: Dugong (Dugong dugon) skeleton, Brazilian sea lion (Otaria flavescens) skeleton.

*Skulls depicted are of species in the same genus as the skeleton.

Sirenia (manatees, dugongs, and sea cows) and Pinnipedia (the seals, walruses, and sea lions) are often seen as very similar, but they came from very different lineages.

While both came from land mammals (just like all sea mammals), the pinnipeds evolved from a bear-like ancestor, who returned to the sea around 28 MYA. They’re Caniformidae, or dog-like Carnivora.

The sirens evolved from the same ancestor as the hyraxes and elephants, and returned to the sea around 50 MYA. They’re only distantly related to Cetaceans and Pinnipeds.

Vergleicheende Osteologie. Edward D’alton, 1821.

Left: Pathological bone loss from gunshot wound. 2.5 inches lost. Ends of bones partially healed and injured bone reabsorbed due to significant delay in reaching surgical hospital (one fortnight on the battlefront after gunshot - external splinting and sanitation only).

Right: Inlay sliver fixation graft in same case. Held in place with kangaroo sutures. Engaging both ends of ulnar fragment.

Orthopedic and Reconstruction Surgery, Industrial and Civilian. Fred H. Albee, 1919.

Bone saws from the 17th and 18th centuries

Bone saws were some of the most commonly-used medical instruments during the Renaissance, as amputation was one of the most common surgical procedures performed.

Unfortunately for the patients, just like so much else during the 17th and 18th centuries, style and status was a huge thing for the surgeons, like so many other elites in society. Since the surgeries were often performed in surgical theaters, a great way for surgeons to show off their status was with ornately decorated surgical instruments - and the bone saws were often the most ornate of all.

Aside from being uncomfortable to hold, the gilt or carved cedar or ebony handles, and the ornately-embellished frames, were perfect places for bacteria to fester, and to transfer from patient-to-patient. The more elite the surgeon, the fancier the saw - and the deadlier the consequences.

Models located at Science Museum London, originally created ca. 1650-1780.

Corrective orthopedic apparatuses for antero-posterior curvature of the spine (Pott’s disease)

From the Charles Lentz & Sons Illustrated Catalog of Surgical Instruments. 1915.

Tuberculous spondylitis - Historically known as “Pott’s Disease”

Pott (or Pott’s) disease was named after Percivall Pott, who wrote several lectures on the nature and treatment of this condition.

The name “tuberculous spondylitis” comes from the disease tuberculosis, and the Greek “spondylos”, meaning spine, and “-itis”, meaning swelling. This is actually a form of chronic osteomyelitis, generally found in the lower thoracic or upper lumbar spine of adults. It’s also one of the oldest chronic conditions for which we have archaeological evidence.

Before tuberculosis had effective treatment modalities, this was one of the most common bone afflictions in adults. There were often internal abscesses that the infection drained into, which, while generally not the primary concern, could rupture and cause peritonitis or generalized infection of the thoracic cavity.

As the condition advanced, the degeneration of the bone often caused spinal cord compression and so-called “Pott’s paralysis” - a form of paraplegia that was actually reversible if the pressure was taken off the spinal cord soon after it started. This was usually done by stiff metal or (later) plastic braces or medical corsets. Once the infection advanced to the point that paralysis was caused, it often caused a complete collapse of the affected vertebrae, and could result in thoracic kyphosis, or “hunchback”.

The images above show a mummified priest of Ammon, from the XXIst dynasty (1000 BCE) of Egypt, with the characteristic lateral protrusion of the spine (left image) that hasn’t yet advanced to a collapse of the spinal discs. There is also a large sac in the abdomen (right image) that was soft when mummification occurred, and which would have been the abscess where the infection drained. There was evidence that the priest lived for over a decade with this condition, and it was probably not what killed him in the end.

Studies in the Paleopathology of Egypt. Sir Marc Armand Ruffer, 1921.

Acute Osteomyelitis - Historically known as “Bone Fever”

Osteo-: Bone
-myelo-: Marrow
-itis: Fever

Top: Acute supperative osteomyelitis in femur - note the purulent cavities and pus-filled medullary canal at A, B, and C. In this case, the epiphysis (E) and conjunctive cartilage (D) are uninfected.
Center Left: Acute osteomyelitis of tibia, cicatrices showing common position of sinuses in bone.
Center Right: Acute epiphysial separation due to osteomyelitis following typhoid fever.
Bottom: Early stage of acute osteomyelitis in tibia. Note site “A” - where the infection passed from the periosteum to the interior of the bone. The articular cartilages (C) are sodden with pus from the infected joint.

Acute osteomyelitis is most commonly seen in children and those with diabetes. It is rarely “spontaneous” - the bacteria that infect the subperosteum and marrow have to be introduced into the bloodstream somehow, and there is usually a known source.

Systemic infection or traumatic injury are the most common ways that bacteria (today, most commonly Staphylococcus aureus) can get to the bones. Historically, scarlet fever (caused by group A Streptococcus pyogenes) and typhoid fever (Salmonella typhi) were known to cause a large number of osteomyelitis cases in their wake.

When children develop osteomyelitis, the long bones of the body (the femur, humerus, etc.) are most often affected, whereas the spine and pelvis are most commonly affected in adults. This is because there is much greater bloodflow to the growing long bones in kids, and as such there’s much more opportunity for bacteria in the blood to infect the site.

Early symptoms of what used to be called “bone fever” are fever and bone pain (as one might assume), as well as local warmth and swelling, and an overall malaise. The bone infection usually presents after a patient appears to have recovered from a disease or wound, as it takes several days to become established enough to cause symptoms. Later on, if left untreated, extreme pain and open, often purulent, wounds above the infection may occur, as the bacteria bore canals through the affected bones.

Without treatment, osteomyelitis can lead to sepsis, complete breakdown of affected bones, or gangrene. When the epiphysis is affected by the infection, growth of that bone can be significantly stunted.

Today, the condition is usually treated with long-term, high-dosage, IV antibiotic therapy. If it’s not caught at the start of the infection, debridement of the bone (removing the infected tissue) may be required, and in extreme cases, bone resection (cutting out an entire chunk of infected bone) or amputation may be required. Prior to antibiotics, resection was the most common cure.

Diseases of the Bones, their pathology, diagnosis, and treatment. Thomas Jones, 1887.