Surgical patient with a skin flap from the arm transplanted to the nose. From Gaspare Tagliacozzi (1597), De curtorum chirurgia per insitionem, p. 18. Woodcut.
This 16th century volume is the first book on plastic surgery in Europe since antiquity. Tagliacozzi details amputations, skin transplants, and prosthetics for the nose, lips, and ears. The bandages depicted here were designed to hold the arm to the nose for several weeks for the skin graft to take hold.
Apparently, damage to the nose was not uncommon in the 16th century, thanks to outbreaks of syphilis, and duel-related nasal injuries.
Oooh! I’m glad they replayed that segment! Well, one of them, at least. I’m not sure which one you heard, but there are a couple good ones - here’s the Science Friday segment on it. This Fresh Air interview of Carl Zimmer has some additional information on it.
As for “if it works”, that’s still being determined in many respects, but so far, it’s looking like one of the most effective treatments for infections caused by the destruction of gut bacteria - when our normal gut flora is destroyed by antibiotics, bacteria that are normally kept in check by the “good bacteria” can take hold and take over, like Clostridium difficile. C. difficile is in your gut already, most likely, but the good flora in there makes it so that it can’t get a solid footing in your intestines and cause problems.
Really, that’s the primary use for fecal transplants right now, but they’re being investigated in other intestinal diseases and conditions. For now, though, we’re pretty sure that the extremely high success rate for eliminating C. difficile infections(80%+ with non-“matched” transplants, 95%+ with transplants from a household member) is directly due to the infusion of good bacteria back into the gut - nothing is for certain until every possibility is investigated, but it’s looking like a really solid solution, possibly even a new standard solution to be used BEFORE giving a patient more antibiotics. We’ll see how studies on other diseases turn out eventually, but C. difficile is a horrible infection, and affects a lot of people, and this is actually a really promising treatment modality.
Among the things to be grateful for this holiday season, you’re most likely not dying from any of these conditions…
I’ll be elaborating on all of these conditions soon, but here’s the 30,000 ft overview of some significant nutritional disorders (aside from allergies and deliberate poisoning/ordeal poisons - the latter I may cover in the future, as culturally they’re fascinating) that have plagued mankind since we took our first bite of food.
While many nutritional disorders are due to a lack of food, some are due to an excess of a toxin from some food that the body can’t process. The staple foods that end up harming people when over-consumed or not properly processed often are eaten or poorly prepared as a result of famine, and just like nutritional deficiencies, many still plague the world today.
Nutritional Disorders - Deficiencies:
- Beriberi: Thiamine (Vitamin B1) - Extreme fatigue, difficulty walking, and confusion/difficulty speaking are the primary symptoms. Also can cause heart failure, vasodilation, peripheral edema, nystagmus (involuntary eye twitching), and tingling sensation in limbs.
- Goiter: Iodine - Swelling of thyroid gland. Rarely fatal, but can cause severe deformity and hypothyroidism.
- Rickets: Vitamin D, magnesium, phosphorus - Dental problems, skeletal deformity and stunting, muscle weakness, swollen wrists, bone pain, soft skull.
- Marasmus: All nutrients, especially protein - Tissue and muscle wasting, dry folds of skin hanging from buttocks and armpits, extreme adipose loss, voracious appetite
- Pellagra:Niacin (Vitamin B3) or tryptophan - “The four D’s”: Diarrhea, dermatitis, dementia, and death. Causes extreme sunlight sensitivity, pale skin that breaks out in blisters/keratinitis upon sun exposure, insomnia, aggression, as weakness. (Basically, they’re crazy pissed-off vampires.)
- Tetany: Calcium deficiency or phosphate excess - Involuntary contraction of muscles due to increased action potential of neuronal membranes, due to low plasma calcium, which increases membrane permeability to sodium, causing progressive depolarization. It’s complicated. It’s basically involuntary and painful stiffened muscles.
- Kwashiorkor: Protein calories - Pedal edema, distended abdomen, lack of adipose tissue, anorexia (as opposed to marasmus, where the child wants to eat everything), loss of hair and teeth. More common in wetter climates, marasmus more common in dry climates.
- Scurvy: Vitamin C - Lethargy, spots on skin, paleness, spongy gums, fever, bleeding of mucous membranes. Eventually causes open and pus-oozing wounds, tooth loss, jaundice, neuropathy, and death.
- Keshan Disease: Selenium - Fosters a mutated strain of coxsackie B virus which causes pulmonary edema and heart failure, mostly in women of child-bearing age and in children. Can be cured with selenium supplementation
Nutritional Disorders - Toxicity:
- Lathyrism: Untreated grass pea - Causes an inability to move the lower limbs. Not usually fatal on its own, but when it occurs in concert with famine (as in the Spanish War of Independence), death from starvation sometimes occurs.
- Ackee Poisoning/Jamaican Vomiting Sickness: Unripe ackee fruit - Intense thirst, nausea and vomiting, tachycardia, headache, general weakness, and confusion/stupor. Death can follow in just 12 hours. Caused by hypoglycin A and B in unripe fruit and mantle of fruit (even when ripe). General symptoms of hypoglycemia, similar to diabetes.
- Konzo: Cyanide intoxication from poorly treated cassava (manioc) - “Bound legs” - extreme hypertonia in leg muscles. Causes pain and very disturbed gait, but is not progressive, so does not cause death. Does generally disable the afflicted persons, and this can be debilitating (socio-economically and physiologically) to patients.
- Lytico-Bodig: Cycad nuts and seeds - Unique to Guam, far western Papua New Guinea, and Honshu, Japan. Parkinson-dementia complex, difficulty speaking, tremor, stiffness, loss of sense of smell, lethargy, memory loss. Caused by accumulation of BMAA from cyanobacteria that grows on cycads. Incurable. Has not been seen in those born past 1961, due to elimination of both cycad products and fruit bats (which feed on cycad flowers and accumulate BMAA in their own bodies).
Vesalius the person:
Andreas Vesalius was born in Brussels in 1514, on the morning of December 31. His given name was André Wesele (Witing) Crabbe, and Andreas Vesalius was a name taken on after deciding to pursue medicine, at age 17. He came from a line of physicians and apothecaries, and his great-great-grandfather was a physician who had amassed a large collection of medical texts, in which Vesalius sated his early interest in medicine. After studying medicine at the University of Paris for his Bachelor’s, he received his title of doctor in medicine cum ultima diminutione from the University of Padua, where only days later he was appointed Professor of Surgery and Anatomy.