Ancient Nubians consumed tetracycline-laced beer

From eScienceCommons at Emory University:

A chemical analysis of the bones of ancient Nubians shows that they were regularly consuming tetracycline, most likely in their beer. The finding is the strongest evidence yet that the art of making antibiotics, which officially dates to the discovery of penicillin in 1928, was common practice nearly 2,000 years ago.

The research, led by Emory anthropologist George Armelagos and medicinal chemist Mark Nelson of Paratek Pharmaceuticals, Inc., is published in the American Journal of Physical Anthropology...

Armelagos is a bioarcheologist and an expert on prehistoric and ancient diets. In 1980, he discovered what appeared to be traces of tetracycline in human bones from Nubia dated between A.D. 350 and 550, populations that left no written record. The ancient Nubian kingdom was located in present-day Sudan, south of ancient Egypt...

“The bones of these ancient people were saturated with tetracycline, showing that they had been taking it for a long time,” he says. “I’m convinced that they had the science of fermentation under control and were purposely producing the drug.”..


Even the tibia and skull belonging to a 4-year-old were full of tetracycline, suggesting that they were giving high doses to the child to try and cure him of illness, Nelson says.

The first of the modern day tetracyclines was discovered in 1948. It was given the name auereomycin, after the Latin word “aerous,” which means containing gold. “Streptomyces produce a golden colony of bacteria, and if it was floating on a batch of beer, it must have look pretty impressive to ancient people who revered gold,” Nelson theorizes.

Fascinating.

Did Henry VIII carry the Kell antigen and have McLeod syndrome?

Excerpts from a report at ScienceDaily:

Research conducted by bioarchaeologist Catrina Banks Whitley while she was a graduate student at SMU (Southern Methodist University) and anthropologist Kyra Kramer shows that the numerous miscarriages suffered by Henry's wives could be explained if the king's blood carried the Kell antigen. A Kell negative woman who has multiple pregnancies with a Kell positive man can produce a healthy, Kell positive child in a first pregnancy; But the antibodies she produces during that first pregnancy will cross the placenta and attack a Kell positive fetus in subsequent pregnancies.

As published in The Historical Journal (Cambridge University Press), the pattern of Kell blood group incompatibility is consistent with the pregnancies of Henry's first two wives, Katherine of Aragon and Anne Boleyn. If Henry also suffered from McLeod syndrome, a genetic disorder specific to the Kell blood group, it would finally provide an explanation for his shift in both physical form and personality from a strong, athletic, generous individual in his first 40 years to the monstrous paranoiac he would become, virtually immobilized by massive weight gain and leg ailments...

A Kell positive father frequently is the cause behind the inability of his partner to bear a healthy infant after the first Kell negative pregnancy, which the authors note is precisely the circumstance experienced with women who had multiple pregnancies by Henry. The majority of individuals within the Kell blood group are Kell negative, so it is the rare Kell positive father that creates reproductive problems...

McLeod syndrome resembles Huntington's disease, which affects muscle coordination and causes cognitive disorder. McLeod symptoms usually begin to develop when an individual is between 30 and 40 years old, often resulting in damage to the heart muscle, muscular disease, psychiatric abnormality and motor nerve damage. Henry VIII experienced most, if not all, of these symptoms, the authors found...

The precise number of miscarriages endured by Henry's reproductive partners is difficult to determine, especially when various mistresses are factored in, but the king's partners had a total of at least 11 and possibly 13 or more pregnancies. Only four of the eleven known pregnancies survived infancy. Whitley and Kramer call the high rate of spontaneous late-term abortion, stillbirth, or rapid neonatal death suffered by Henry's first two queens "an atypical reproductive pattern" because, even in an age of high child mortality, most women carried their pregnancies to term, and their infants usually lived long enough to be christened...

The survival of Mary, the fifth pregnancy for Katherine of Aragon, fits the Kell scenario if Mary inherited the recessive Kell gene from Henry, resulting in a healthy infant.

Very interesting. Here's a link to Whitley and Kramer's publication.

Health care spending adjusted for GDP

It should be intuitively apparent that in "richer" countries, health care will tend to be more expensive, but this graph from The Incidental Economist shows the huge degree to which the United States is an outlier:

The 30 non-US OECD countries line up in a pretty good line, with increasing spending per person as their GDP gets higher. In fact, as I show in the chart, you can make a pretty good line that fits the relationship between GDP and health care spending...

It’s not that we shouldn’t spend more than other countries. We should. We are richer than almost anyone, and we should spend more on health care. The problem is that we’re spending so much more than everyone else, even after taking into account our GDP. We’re literally off the chart. And we’re not getting better outcomes for that money.

Via The Daily Dish.

You'd never guess what this is

"Sperm tails tangled up in a seminiferous tubule"

Credit Clifford Barnes, posted in the Flickr photostream of the FEI Company (which, BTW, has lots of neat SEM images), via Dr. Sci-Phy.

New insights into how neurons work

I suppose one should never assume that one fully understands biological processes.  Here are some new developments in what used to be basic neurophysiology:

Neurons are complicated, but the basic functional concept is that synapses transmit electrical signals to the dendrites and cell body (input), and axons carry signals away (output). In one of many surprise findings, Northwestern University scientists have discovered that axons can operate in reverse: they can send signals to the cell body, too.

It also turns out axons can talk to each other. Before sending signals in reverse, axons can perform their own neural computations without any involvement from the cell body or dendrites. This is contrary to typical neuronal communication where an axon of one neuron is in contact with another neuron's dendrite or cell body, not its axon. And, unlike the computations performed in dendrites, the computations occurring in axons are thousands of times slower, potentially creating a means for neurons to compute fast things in dendrites and slow things in axons...

"We have discovered a number of things fundamental to how neurons work that are contrary to the information you find in neuroscience textbooks," said Nelson Spruston, senior author of the paper and professor of neurobiology and physiology in the Weinberg College of Arts and Sciences. "Signals can travel from the end of the axon toward the cell body, when it typically is the other way around. We were amazed to see this."..

Similar to our working memory when we memorize a telephone number for later use, the nerve cell can store and integrate stimuli over a long period of time, from tens of seconds to minutes. (That's a very long time for neurons.) Then, when the neuron reaches a threshold, it fires off a long series of signals, or action potentials, even in the absence of stimuli. The researchers call this persistent firing, and it all seems to be happening in the axon...

"This cellular memory is a novelty," Spruston said. "The neuron is responding to the history of what happened to it in the minute or so before."

...led to experiments with multiple neurons, which resulted in perhaps the biggest surprise of all. The researchers found that one axon can talk to another. They stimulated one neuron, and detected the persistent firing in the other unstimulated neuron. No dendrites or cell bodies were involved in this communication.

"The axons are talking to each other, but it's a complete mystery as to how it works..."

For additional information see Science Daily. The data are published in the February issue of Nature Neuroscience.

"Wet houses" (hospices for alcoholics)

I thought I was pretty well informed, but I've never heard of this before.  Excerpts from a story at TwinCities.com:

Hagerman has been drinking for 39 years. He drinks despite decades of lectures, prayers and punishment. He drinks despite two years of homelessness, six DWI convictions, six treatments for alcoholism and 13 months in jail. What's ahead for Hagerman? The 54-year-old can see only one thing in his future — more drinking.

That's why he feels lucky to live in a hospice for alcoholics — St. Anthony Residence in St. Paul. There, 60 men can — and often do — drink until they die. There are no counselors, no scolding, no 12-step programs, no group hugs. Just the love of Hagerman's life, waiting for him every day — alcohol. On his weeklong binges, he chugs vodka, beer or mouthwash. They are interchangeable to him, he said, gazing around his 12-by-12-foot concrete apartment.

"I drink," he said quietly, "until I kill the damn day off."

For three years, St. Anthony has been operated by Ramsey County, St. Paul, the state of Minnesota and Catholic Charities, at a cost of $18,000 per person per year. It's one of four so-called "wet houses" in the state. Like a growing number of wet houses across the country, it allows alcoholics to drink, even when it's killing them...

Once alcoholics become residents, the police know their names. If one is found passed out in a park, the police simply return him to St. Anthony — no ambulances, hospitals or trips to detox. If needed, residents get medical care from an in-house nurse. If they get sick, they go to a hospital.

And when they get extremely sick? There's an in-house hospice service. Three to five residents die every year....

Please read the entire article at the link before leaving any comments here.

A boy with cerebellar hypoplasia

Of everything I saw today, this was the item that most impressed me.  As noted at the NeuroLOGICA blog, the video above errs toward hyperbole and is misleading when it indicates that the boy "does not have" a cerebellum or a pons; he almost certainly has hypoplastic ones.  Still, it is a remarkable story of the adaptive plasticity of the human brain.

Found in the compilation of informative links at Miss C Recommends.

Questions raised about LASIK surgery

Excerpts from an article at Politics Daily:

LASIK -- which is neither a trademark name nor a franchise, but the acronym of a surgical method, "laser-assisted in situ keratomileusis" -- seemed miraculously easy, even though it involved a scary-sounding and delicate procedure. (It entails slicing a thin, hinged flap on the front surface of the cornea, a surgeon lifts the tissue up and, using ultraviolet excimer laser beams, reshapes the eye before folding the flap back over the cornea). Well-heeled professionals then turning 40ish, (an age in which human sight weakens), were drawn to what seemed like a medical miracle of rejuvenation. Laser eye surgery, when done correctly on appropriate candidates, painlessly turned terrible vision to nearly perfect.

In 1995, the FDA approved the first laser-assisted system for refracted surgery... For the ophthalmic profession, LASIK correction surgery was like a gold rush. By 2008, 12 million patients had undergone the procedure in the United States at an average cost of $1,500 to $2,100 per eye. Over 700,000 people have the surgery every year...

But in the months and years after LASIK became ubiquitous at 25-year class reunions, stories of eye damage and subsequent depression, even suicides, surfaced. The surgery can, it turns out, induce dry eyes, halos, light sensitivity, night blindness, ghost images, keratectasia (corneal thinning and bulging) and many other serious damaging effects...

Finally last month, Waxler filed a formal citizen's petition to his former government employer requesting the FDA withdraw approval for all LASIK devices and to issue a public health advisory for recalling the equipment... In his petition, Waxler says manufacturers and also "clinics, refractive surgeons, and agents withheld and distorted safety and effectiveness data" and, he alleges, "in a classic example of the fox guarding the henhouse," the "collaborators" routinely hide reports of LASIK injuries from FDA by settling lawsuits out of court. He also claims that equipment makers have "cherry-picked, withheld, and hid data from FDA" that he believes show LASIK with "excessive adverse event" rates of 22 percent.

More at Politics Daily.

Sodium thiopental shortage threatens executions

"A shortage of a drug used in executions in the United States has sent U.S. states scrambling to find supplies, or alternative drugs. Among the 35 states in which capital punishment is legal, some--including Arizona and California--had been sourcing a key execution drug, sodium thiopental, through a company in London--until UK government officials put a stop to its export. The only U.S. company making the drug, which sought to move its manufacturing base to Italy, has now given up producing sodium thiopental because it cannot assure Italian officials that it won't be used for executions. 

The situation demonstrates that although pharmaceutical supply chains are global, the morals and mores of drug use are decidedly local. Will U.S. states be forced to stop executing their death-row inmates by a drug embargo?...

A standard three-drug sequence is used in the United States to execute prisoners condemned to death...  three drugs, to be administered in sequence: sodium thiopental to render the condemned unconscious; pancuronium bromide, to paralyze the body and lungs; and potassium chloride to stop the heart.  ..

In recent years, sodium thiopental has been used less and less often for anesthesia, as newer drugs have gained favor. For some time, all the sodium thiopental in the United States has come from a drug company called Hospira, based in Lake Forest, Ill. In the summer of 2009, Hospira had to suspend production of the drug. The company that made the active ingredient--which Hospira would not name, but US Food and Drug Administration (FDA) records identify as Abbott Laboratories--stopped making it...

Meanwhile, companies and government officials in Germany have come together against supplying the United States with any sodium thiopental for executions, according to the Associated Press..."

More at Scientific American, via the New Shelton wet/dry.

The size of professional football players

Several nights ago I watched the HBO movie "Lombardi" (a surprisingly good documentary, even if you don't care for football as a sport), and couldn't help but notice the different body habitus of players from the 1960s.  This week the New York Times has a column addressing the same topic:

When B. J. Raji nimbly intercepted a pass and shimmied in the end zone last Sunday, helping to put Green Bay into the Super Bowl, the feat was remarkable given that Raji is a nose tackle and, at 337 pounds, is thought to be the largest player to score a postseason touchdown in N.F.L. history...

In 1970, only one N.F.L. player weighed as much as 300 pounds, according to a survey conducted by The Associated Press. That number has expanded like players’ waistlines from three 300-pounders in 1980 to 94 in 1990, 301 in 2000, 394 in 2009 and 532 as training camps began in 2010...

On the other hand, the enormousness of many players, and the recent deaths of one active lineman and several relatively young retired linemen, have raised questions — and brought conflicting answers — about potential health risks associated with size...

“You can see by looking at the defensive linemen that they carry 30, 40, 50 pounds of fat,” said Jerry Kramer, the All-Pro guard who led the Packers’ famed sweep in the 1960s while playing at about 250 pounds. “Fat doesn’t make you strong and quick. It makes you heavy. Muscle makes you strong. We’ve gotten enamored with the 300-pounder, but give me an offensive guard who’s in great shape at 270 or 275 and understands leverage and positioning, and I’ll bet he’ll whip the fat guy every time.”

More at the link for those interested (and kudos to the author of the piece for writing "enormousness" rather than "enormity.").  I'll bet when the Packers and Steelers arrived in Dallas today that they brought several dozen CPAP machines with them.

A history of disinfected mail

As soon as humans became aware that infectious diseases could be transmitted by fomites (inanimate objects), attention was directed to developing methods of disinfection. Postal and public health authorities had to deal with a wide variety of extremely dangerous infections (cholera, yellow fever, smallpox, leprosy, anthrax), and applied a surprising variety of techniques to letters and packages sent through the mails, beginning as early as the 15th century in Venice.

A very informative philatelic exhibit presents examples of how the U.S. has dealth with potentially dangerous items.  Shown at the top, for example, are two letters from locations where yellow fever was present; they have been punctured to allow fumigating agents to reach the inside of the envelope.  The bottom envelope in this image -

- had its corners clipped off so that formaldehyde gas could be introduced to kill smallpox.  Other letters and postcards were autoclaved or steam sterilized, which could be deleterious to the letters inside.

These precautions were not limited to the preantibiotic era.  In 2001 threats of anthrax attacks were made in the United States, and a variety of special precautions, including x-irradiation, had to be undertaken, beginning at this page of the exhibit and continuing for a dozen pages thereafter.  And these letters from Hawaii in 1900 show how holes were punched in the envelopes -

- so that sulfur fumes could be insufflated before they were sent from areas quarantined for bubonic plague.  Other examples are shown of disinfection of mail from the Hawaiian leper colony.

Philatelic exhibitions are conventionally mounted on a series of glass-fronted frames, with up to 16 letter-size pages in one frame, and in this case spread onto six frames.   This award-winning exhibit was created by William A. Sandrik of Arlington, Virginia.  The entire exhibit may be viewed at Exponet (frame 1, frame 2, frame 3, frame 4, frame 5, frame 6).

And those interested in philately (stamp and postal history collecting) should browse the Exponet site beginning at this index page.  Over 600 exhibits are accessible, on a huge variety of topics, in a wide variety of languages.

Blogging may be hazardous to your health

The latest findings, published this week in The Journal of the American College of Cardiology, indicate that the amount of leisure time spent sitting in front of a screen can have such an overwhelming, seemingly irreparable impact on one’s health that physical activity doesn’t produce much benefit.

The study followed 4,512 middle-aged Scottish men for a little more than four years on average. It found that those who said they spent two or more leisure hours a day sitting in front of a screen were at double the risk of a heart attack or other cardiac event compared with those who watched less. Those who spent four or more hours of recreational time in front of a screen were 50 percent more likely to die of any cause. It didn’t matter whether the men were physically active for several hours a week — exercise didn’t mitigate the risk associated with the high amount of sedentary screen time...

The study focused on recreational screen time because it’s the easiest to curtail, Dr. Stamatakis said. But he encouraged employees who work at computers all day to get up and take breaks and short walks periodically. 

The rest of the story is in the Health section of the New York Times.

"Heavenly Intrigue" - Did Kepler murder Brahe?

Relevant background information in this post last month.  As promised, here are my comments on the book.

The authors are unequivocal in their conclusion, which is presented in the preface: "...recent forensic analysis of remnants of [Brahe's] hair reveals that he was murdered, systematically poisoned.  And all the answers as to motive, means, and opportunity point directly to one suspect: Johannes Kepler." 

The book provides a detailed presentation of Brahe's life and work, and the relevant aspects of Kepler's.  I won't reiterate the evidence here, but I will instead insert a few of the "things I learned" from the book.

Since we accept a heliocentric solar system, it's sometimes hard to understand how pre-Copernican scholars could have been so accepting of a geocentric model, but this analogy from the book is quite informative in that regard:

"It's important to understand in all of this that, visually and mathematically speaking, there is no differnce between a moving earth revolving around a stationary sun and a moving sun revolving around a stationary earth... a demonstration is provided by those battery-powered models of the solar system sold at planetariums and most toy stores.  Pick it up by the sun and hold that stationary, and all the planets will revolve as they are supposed to.  But if you hold the mechanism up by the earth and hold that stationary, all the planets and now the sun, too will continue to revolve, in exactly the same relation to one another as before." (pp. 83-4)

This sentence startled me: 

"Apparently, Rudolf [Holy Roman Emperor Rudolf II] had been peeking through his window as Brahe approached in his carriage, and -- fascinated as he was by all things mechanical -- was especially interested in an odometer he saw affixed by the wheel.  Brahe had it brought to him, and after examining it carefully, Rudolf said he would have one made by his artisans according to the same pattern." (p. 137)

Odometers in the 16th century??  Who knew?  Topic bookmarked for a future separate post.  Here's more about Rudolf:

"More a collector than a connoisseur, with tastes that were less eclectic than simply promiscuous, Rudolf sent his agents across Europe to purchase items that might excite his fancy.  Some brought back Durers and Breugels, while others transported back objects by the thousands whose major organizing theme seems to have been their oddity.  All were placed in his famous Kunstkammer - the private rooms in which he would increasingly shut himself off - which contained what was perhaps the largest private collection up until that time.

There, housed in myriad cabinets and displayed along tabletopes, lay thousands of disparate artifacts: beautiful porcelain cameos along with the shells of tortoises, crabs, and other sea creatures; the horn of a unicorn (which probably came from a narwhal) and rhinoceros horns mounted in gold; priceless gems; drawersful of gold, silver, and copper antique medals; as well as the dagger with which Caesar's wife was said to have been murdered and a knife swallowed by a Prague peasant.  Mechanical objects were a special fascination: among the many clocks, globes, and astrolabes, records mention a mechanical peacock that walked, turned around, and fanned its featuers and a windup spider that could scurry across a table..." (p. 143)

There is a painting of Rudolf and a diagram of his family tree in the post below this one. 

Chapter 15 of the book is particularly good in explaining the strained relations between the two scientists and the consequent motivation for murder.  Chapter 22 details the use of mercury as a medication and the formulations of it that the (al)chemists of the time created, which were of quite varying potency and toxicity.  In explaining why Brahe's acute renal failure was probably not due to a bladder stone, the authors point to the absence of any attempts at catheterization, which would have been attempted had anuria been accompanied by a distended bladder:

Jessenius, one of the leading medical authorities of his time, wrote in some detail about urinary problems and their cures.  He clearly had considerable experience in the area and recommended in one of his numerous publications "the small tubes, conceived by Venetian wound doctors, which are made of horn and made flexible by soaking them in warm water," rather than the "slim wax light used by Fabricius Aquapente (which he warms up and then inserts  coated with almond oil)," as the latter were "not strong enough to overcome the resistance of the bladder opening or a bladder stone." (p. 213)

A surprising sophistication in knowledge of urinary catheters - before the invention of plastic or the discovery of rubber.  Since Brahe had access not only to physicians but to the physicians of the royal family, the fact that catheterization was not considered is prima facie evidence that the physicians attending him considered the acute renal failure to be nonobstructive in nature (or at least above the bladder).  That, along with the mercury in the forensic analysis of his hair, constitutes the principal evidence of murder by poisoning.

Rhinoplasty - 1597

I am recurrently startled by flashes of medical brilliance in ancient times. That was the case this week when I read about De Curtorum Chirurgia Per Insitionem  (The Surgery of Defects by Implantations), written in 1597 by Gaspare Tagliacozzi, professor or surgery and anatomy at the University of Bologna.

The tome, which is written in Latin, is illustrated with diagrams, including the rhinoplasty, in which the patient's nose was attached to a flap of skin from his upper arm. In one plate, the patient is seen in bed with his forearm attached to his head and a flap of skin from his bicep region stuck onto his nose.

The book tells how he stayed like that for about three weeks until the skin from his arm had attached itself properly. After a further two weeks the flap of skin was shaped so it resembled a nose and the process was complete.

The book was sold for £11,000 to a modern-day plastic surgeon.

The technique used then is not widely dissimiliar from how some reconstructions are facilitated today.  Facsimiles of the book can be purchased at Amazon ($250), or browsed at Google libri.

Tycho Brahe's artificial nose

I've written three posts this year re Tycho Brahe (here, here, and here). In view of the post above this one, I just wanted to insert a note here re Brahe's nose - something I learned from the book Heavenly Intrigue (re which more later...):

[After the swordfight sliced away the bridge of his nose]... Brahe escaped serious infection and, after his recovery, had a resplendent prosthesis made of gold and silver alloy, which he wore for important occasions, employing a lighter, copper-based nosepiece for general use.  Had he desired to hide his deformity more effectively, he could have had a more convincingly flesh-colored piece fashioned from wax.  It was characteristic of his larger-than-life personality, however, that he did not."

Image source.

Neuron

A colorized scanning EM of a nerve broken open to reveal the vesicles containing the neurotransmitters.

Image credit to NIH, via Curiosity/Discovery, via Sloth Unleashed.

80% of U.S. antibiotics are used in animals

From a report at Wired, citing the Center for a Livable Future, which used data from the FDA:

Most important to note: Most of the drugs used in animal agriculture and in human medicine are functionally identical. That’s one reason why the overuse of antibiotics in animals is such a concern: When organisms become resistant on the farm to drugs used on livestock, they are becoming resistant to the exact same drugs used in humans. (One major drug category used in animals, ionophores, do not have a direct human analog...)

The next battle, which industry has already begun, is defining what non-therapeutic use will constitute. Producers are already claiming that the use of antibiotics for growth promotion has decreased, maintaining current low-dose usage is aimed at disease prevention. Regardless, all low-dose usage of antibiotics can lead to a significant increase in antibiotic resistance.

Additional data and discussion at the links.

No amygdalae = no fear

SM is a woman without fear. She doesn’t feel it. She has been held at knifepoint without a tinge of panic. She’ll happily handle live snakes and spiders, even though she claims not to like them. She can sit through reels of upsetting footage without a single start. And all because a pair of almond-shaped structures in her brain – amygdalae – have been destroyed.

Ralph Adolphs, Antonio Damasio and Daniel Tranel at the University of Iowa have been working with SM for over a decade. She is a 44-year old mother-of-three, who suffers from a rare genetic condition called Urbach-Wiethe disease, which has caused parts of her brain to harden and waste away. This creeping damage has completely destroyed her amygdala, a part of the brain involved in processing emotion (white arrows in the diagram below). She’s one of the few people who shows such a striking pattern of damage...

She lives in a poor area “replete with crime, drugs and danger”. As Feinstein writes, “she has been held up at knife point and at gun point, she was once physically accosted by a woman twice her size, she was nearly killed in an act of domestic violence, and on more than one occasion she has been explicitly threatened with death.” But in most of these situations, she didn’t act with urgency or desperation, something that police reports have corroborated.

It’s not that she doesn’t understand the concept of fear; after all, she knew that other people might be scared by the films she saw. However, she has a lot of problems with detecting danger. In a previous study, the team showed that she has no personal bubble. She’ll happily stand a foot away from complete strangers, far closer than most people would be comfortable with (even though, again, she understands the concept of personal space). It’s no surprise that she gets herself into a lot of difficult situations...

Even SM’s case doesn’t imply that the amygdala is the brain’s fear centre. Feinstein thinks that it’s more of a “broker”, going between parts of the brain that sense things in the environment, and those in the brainstem that initiate fearful actions. Damage to the amygdala breaks the chain between seeing something scary and acting on it...

“[SM]’s behaviour, time and time again, leads her back to the very situations she should be avoiding, highlighting the indispensable role that the amygdala plays in promoting survival by compelling the organism away from danger. Indeed, it appears that without the amygdala, the evolutionary value of fear is lost.”

More at Not Exactly Rocket Science.

Mozart's 140 causes of death

Every year the BMJ (British Medical Journal) publishes a "Christmas issue," with many nontraditional and lighthearted articles.  You can search and read some of the issue here.  I've selected three items to highlight at TYWKIWDBI.  The first one is a literature review by Lucien R Karhausen of the numerous medical and mental illnesses that have been attributed to the composer Wolfgang Amadeus Mozart.

I have identified 140 (sometimes overlapping) possible causes of death, in addition to 85 other conditions. But Mozart died only once. Some causes are plausible, only few—maybe one, or maybe none of them—can be true, so most if not all of them are false...

Many authors have favoured the hypothesis of an acute condition such as influenza; staphylococcal, streptococcal, or meningococcal infection; various septicaemias; scarlatina or measles; typhoid or paratyphoid fevers; typhus; tuberculosis; trichinosis; and so on. Postinfectious glomerulonephritis was first proposed by Barraud in 1905. Schoental, an expert in microfungi, thought that Mozart died from mycotoxin poisoning. Drake, a neurosurgeon, proposed a diagnosis of subdural haematoma after a skull fracture identified on a cranium that is not Mozart’s. Ehrlich, a rheumatologist, believed he died from Behçet’s syndrome. Langegger, a psychiatrist, contended that he died from a psychosomatic condition [!!]. Little, a transplant surgeon, thought he could have saved Mozart by a liver transplant. Brown, a cardiologist, claimed he succumbed to endocarditis. On the basis of a translation error of Jahn’s biography of Mozart, Rappoport, a pathologist, thought Mozart died of cerebral haemorrhage. Ludewig, a pharmacologist, suggested poisoning or self poisoning by drinking wine adulterated with lead compounds. For some, Mozart manifested cachexia or hyperthyroidism, but for others it was obesity or hypothyroidism. Ludendorff, a psychiatrist, and her apostles, claimed in 1936 that Mozart had been murdered by the Jews, the Freemasons, or the Jesuits, and assassination is not excluded by musicologists like Autexier, Carr, and Taboga...

Lange-Eichbaum complained early in 1930 that too often pathography becomes a “historical game, a literary feuilleton, or a medical entertainment.” The motto of Mozart’s biography written by Nissen (Constanze Mozart’s second husband) was: de mortuis nil, nisi vere...

Most of the 27 psychiatric disorders attributed to Mozart result from disregarding or misquoting the criteria that demarcate normal from abnormal behaviour.  Some authors upgrade daily worries into paranoid ideas or anxiety neuroses; blues or genuine worries into depression; elation into hypomania; linguistic games into jargonophasia; wit into immature or manic behaviour or into a childish, psychotic other self; the dissonant harmonies of the Haydn quartets into Tourette’s syndrome; and, at the end of his life, a small shuddering into a convulsion... This has resulted in psychiatric narratives that blend an uninterrupted long tradition of defamation—the film Amadeus was one of the last public expressions of this tradition.

The image is of Mozart's unfinished Requiem.

I posted one "cause of death" (with a video clip from Amadeus) last fall.  Since I don't know when I'll be able to post a Mozart topic again, I can't resist asking "Why could noone ever find Mozart's teacher?"  (answer in the Comments...)

Crocodile forceps? or alligator forceps?

A difference in terminology between U.K. and American medical personnel prompted the authors to research the proper terminology for this instrument:

We sought the earliest post-1758 uses of the terms “crocodile forceps” and “alligator forceps” using a web based literature search concentrating on medical textbooks and catalogues. We obtained representative specimens of the forceps in question (Microfrance Incorporated, Medtronic Xomed, Jacksonville, FL; n=13 models), and we compared measurements with those obtained from adult and juvenile skulls of C acutus (n=8) and A mississippiensis (n=12), from the collections of the University Museum of Zoology, Cambridge and the Natural History Museum, London. Snout width was measured between the positions of the most caudal teeth, while snout length was measured from the midpoint of the line connecting these teeth to the most rostral point on the snout. For the forceps, these measurements were made from the point of articulation at the most posterior tooth. Snout ratio was defined as snout length divided by snout width. We also counted the numbers of teeth in the upper jaws. 

The full report is in the Christmas issue of the BMJ, along with photographs of the appropriate skulls. TL:DR...

Our literature search suggests that the terms “alligator forceps” and “crocodile forceps” appeared at around the same time, but “alligator” has become the preferred term worldwide. However, our morphological comparison shows that the snout ratio and the modal tooth number of the forceps are actually closer to that of the crocodile than to the alligator... Some important differences remain, however; notably the fact that in the forceps it is the upper jaw that moves, whereas in crocodilians—despite Aristotle’s assertions to the contrary in his History of Animals—it is the lower.