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Posts Tagged medicine

The bosom serpent Grant Jacobs Sep 05

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Last night I was reading Alison’s latest post. In response to her blog post a commenter remarked that he was not acquainted with the “bosom-dwelling vipers” that Alison referred to in her piece, and remarked that he thought the bosom must be “a marginal ecological niche.”[1]

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The bosom-dwelling vipers phrase is allegorical, from Aesop’s fable, but looking up it’s history I found in the Journal of the Royal Society of Medicine an article titled The bosom serpent. You’ll probably want to download and read the PDF copy – I found mucking around with the single pages a bit clumsy.

In it Bondeson recounts medical science’s (science?) encounters with beasts living within us.

Despite the title, the article is more about snakes—and a variety of other creatures—reported living in patients’ stomachs or intestines rather than emanating from their breasts. (Or, for that matter, sinking their fangs into them.)

The author starts with a Viking legend, moves on to snake-expelling saints (worthy men they must have been) and spends particular time on accounts of frogs living inside patients.

Frogspawn seems to have a particularly strong European history, even the renown Linnaeus—famed for his classification living things[2]—having

stated as a fact that frogspawn, left floating in the brooks and streams by the adult frogs, was a serious threat to the health of the Laplanders: if they drank this polluted water, the spawn adhered to the membranes of the stomach, which hereafter ‘formed the nest, or rather the pond, for these dreadful animals, which tear and torture the poor patient’

Medical history is full of these curiosities, of course, and they’re great reading.

A worthy example is that of the serving-girl of the parson of Dunfermline, whose doctor had given her a strong dose of calomel for stomach pain and constipation. This medicine had the desired effect, but she was greatly frightened by passing also a small lizard, which leaped out of the chamberpot and darted in under the drawers. When she pulled the animal out with a poker and flung it on the fire, it expired with a shrill squeak.

The most recent of these accounts is, at the time his piece was written, apparently from 1987[3] and seem to appear from time to time in modern-day newspapers. (No doubt of the lower standard tabloid kind.)

Enjoy it, it’s worth a read for the quirky stories. I found it helps to skim past a couple of passages that recite repeated reports of similar events; I feel for casual readers the text could be improved by dropping a few of the more common examples.

The author of article looks to be the same J. Bondeson who wrote a book I reviewed a few years back, Buried Alive. (A fun read, quirky stuff based on researching medical history.) The footnote to the ‘bosom serpent’ article indicates article is in fact is a condensed version of a book chapter, The Bosom Serpent, in Cabinet of Medical Curiosities published by Ithaca (Cornell University Press 1997:26-50) and a review at goodreads.com suggests to me that Buried Alive may have had it’s origins in another chapter from Cabinet of Medical Curiosities.

Footnotes

These stories are also perhaps a useful reminder not to cling too tightly to treasured notions and to question unlikely assumptions. There are modern-day human-dwelling serpents too, including an example from modern genetics that I might bring in an up-coming series I am working on, Not Just DNA. More on that series in a later article.

1. In an entirely unrelated matter, breast milk contains a number of bacterial species and so, in a sense, breast milk could be described as an ecological niche for these.

2. A key (if not the key) figure in founding taxonomy, he developed the genus-species name pair we still in use today. Today computational biologists (my field) compare genes, genomes and molecular structures to identify the evolutionary history of the different organisms, a field call phylogenetics. (A tree showing the evolutionary history of a collection of species is a phylogeny.)

3. I’d quote more, but the PDF is one of those where copying text drops the space characters, which you then have to manually re-insert; it’s just too much effort!


Other reading at Code for life:

Popularity does not mean effectiveness or sensibility

Map shows New Zealand with lowest death rate on earth in 1856, over 11 in 1000 dying

Scientific baking. Great for those lab meetings or kids’ parties.

Eye sci with my little eye

Book review: Buried Alive

Dear journalists and editors, (again) Grant Jacobs Nov 14

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Some time ago I wrote to you over your advocating unsound treatments in reporting fund-raising efforts.

I now find myself writing again on much the same issue, this time regards your advocating unsound services. The issues are so similar I find myself drawing on my earlier words.

Please, when you decide to ‘advocate’ for a service, check that it is sound.

Articles about services offering hope of treating illness no doubt sell copy, but with that comes responsibility.

These articles, with their details of how to contact the service provider at the bottom, effectively advocate the service to the reader.

Sure, you could argue whether the treatment is sound is for the reader to judge before giving them their money – but wouldn’t that be newspapers shirking their moral responsibilities?

If you put down details of the service in the article you’re effectively putting your weight behind it.

Editors, like most people, will be aware that articles in the press carry some weight of creditability, rightly or wrongly. There will be an expectation among many that the media has checked ‘the facts’.[1]

It seems to me either that this checking should done, and done properly, or the advocacy dropped.

My brief missive here follows from an article espousing the services of an iridologist published yesterday in the New Zealand Herald that was brought to my attention by my colleagues.[2]

Even the briefest of background research would have revealed that iridology is nonsense. Quaint, well-meaning nonsense, perhaps, but nonsense nevertheless.

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One example of why all those genomes from different species are useful to biologists Grant Jacobs Oct 14

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In this video scientists give an example of how knowing the genomes and biology of many species can be put to use. It also gives some idea why biologists do a lot of work on so-called ‘model’ organisms – species that particular functions can be studied closely.

The scientists in the video wanted to locate genes that might be involved in human diseases caused by defects in the base of the little hairs (cilia) that through rhythmically beating move fluids in some parts of our bodies. The video explains how they got a starting list of genes that might be making proteins the form  the base of cilia by comparing genes in humans and two different types of plants, one with cilia and one without.*

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How vaccines work – a primer Grant Jacobs Oct 13

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A useful primer on how vaccines work can be found on-line at the CDC website (PDF file). At just two pages long it doesn’t go into depth, but it gives an outline of the immune system and how vaccines work. In particular, it lists the different types of vaccines and explains why multiple doses can be needed.

For many this may be enough depth. For those needing wanting more, but who are new to the topic, it provides a useful starting point that has more than the one-paragraph ‘sound bites’ seen on many websites.

This primer was prepared drawing on material from the Understanding Vaccines pages at the US National Institute of Allergy and Infectious Diseases. Further information can be found at the CDC’s information for parents (including a flyer [PDF file] for those the choose not to vaccinate to understand the risks and responsibilities).

For New Zealanders, further information can be found at IMAC, the New Zealand Immunisation Advisory Centre.

(H/T to Liz Ditz for tweeting the link to the flyer.)


Other articles on Code for life:

Thoughts on, and for, those trying to choose to vaccinate or not

Fact or fallacy, a survey of immunisations statements in the print media

Immunisation then and now

Sources for medical information for non-medics and non-scientists

Monday potpourri: maps, malaria in the USA, cholera in Dunedin and vaccines

Guest post: Ruth and her cancer Grant Jacobs Oct 11

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Once in a long time I feel a comment, such as this written by Terry Given at Respectful Insolence, is worth offering to a wider audience. Minor edits, including using full names, were at Terry’s request.

My wife Ruth Given (neé Skelly) died on 23SEP2012, one week after our 6th anniversary and 5 weeks before her 46th birthday, of lymphangitis carcinomatosis. New Years eve 2008/2009 we found a lump in her breast. two days later we had it checked out at our GP – yep, it was a lump. the GP booked an emergency mammogram and told us the appointment would arrive in the mail shortly. Ruth was a Nurse and I’m an engineer. we figured that unlike fine wine this wouldn’t improve with time, so on the monday I took Ruth to a private breast clinic and had a mammogram. The next day we got the bad news – DCIS, a 65mm tumour in the L breast and a small lump in the R breast. we scheduled a mastectomy immediately, and argued the surgeon into a double. Ruth had both breasts removed on the thursday, and we found that the R breast was also cancerous. Fifty grand well spent.

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Medicine or Physiology Nobel Prize to John Gurdon and Shinya Yamanaka for stem cell research Grant Jacobs Oct 08

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This year’s Nobel Prize for Medicine or Physiology has been awarded to John Gurdon (79) and Shinya  Yamanaka (50) for work that lead to the understanding that mature specialised cells could be ‘reprogrammed’ back towards a state that was not specialised to any one purpose, but open to become many kinds of cells.

Formally the citation is “for discovery that mature cells can be reprogrammed to become pluripotent”.

This work has many potential areas of use including testing how bodies grow and develop, and disease treatment. Yamanaka, for example, aims to create a ‘bank’ of stem cells from foetal blood cells.

This pair had previously been jointly awarded the 2009 Lasker Prize for this line of research. There is a good explanation of their work with some illustrations showing a quick outline of what was done on the Lasker Prize website.

Those wanting a very brief and overly simplified ‘gloss’ on this may read on:

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Vitamin D does not reduce colds Grant Jacobs Oct 03

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Just out today is research testing if vitamin D supplementation impacts on the common cold. Key authors are from my local university, the University of Otago.

They conclude that vitamin D does not affect how often or severe people’s colds were,

“monthly administration of 100 000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults.”

[From abstract of paper. URTI = upper respiratory tract infection.]

This work is a randomized, double-blind, placebo-controlled trial testing 322 otherwise healthy adults. This type of trial is generally regarded as the ‘gold standard’ of trials for medical treatments.

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The Panic Virus Grant Jacobs Sep 18

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…is the bold title of Seth Mnookin’s exploration of the ‘vaccination debate’.[1]

The Panic Virus® is a ruminative, thoughtful, exploration of vaccine history and, in particular, how people come to think the things that they do.

Not too many popular science books are headlined with the support of Nobel laureate – if you look closely you’ll see Peter Doherty’s praise for the book at the top of the cover to the left.

It surveys key events – without minutiae that you might get from an historian. It draws on the reader to do their own thinking slightly more than Offit’s Deadly Choices but is lighter than Allen’s Vaccine, which at 500+ pages is a much more lengthy affair.

I especially appreciated that the material seemed well-balanced with negative points in public health, for example, presented plainly without excuses and criticism given where it seemed deserved.[2] Vaccination is a topic that’s easy to polarise or to stick to one side of the fence. Mnookin does pretty well to see it both ways.

He touches on some of cognitive dissonances involved, where some of the poor thinking arises from and these emerge as a key underlying themes.

This from the blurb,

“Wakefield eventually lost his medical licence, yet the myth that vaccines cause developmental disorders lives on. In The Panic Virus Seth Mnookin examines how the anti-immunisation panic spread and looks at a controversial Australian case that exposed the claims and tactics of the movement to new scrutiny. Sorting fact from rumour, he confronts fundamental questions: with more facts at our fingertips than ever, why is our trust in science so fragile? Has the internet made us better informed, or simply enabled panic to spread more quickly? And how might we balance fact and intuition when it comes to decisions about children’s health?”

The book, in part, tracks the author‘s personal exploration into parents and their relationship with vaccination information starting from his own new parenthood and dinner parties,

“The more I pushed my friend, the more defensive he grew. Sure, I said, there had to be something tangible, some experiment of epidemiological survey, that informed his decisions. There wasn’t I was even more taken aback when he said he likely would have done the same thing even if he’d been present with conclusive evidence that the MMR vaccine was safe.” (From the Introduction, p11.)

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Shaun Holt on iridologist Ruth Nelson’s treatment of cancer patient Yvonne Maine Grant Jacobs Sep 06

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Wellington professor of medicine, Shaun Holt, recently spoke to Radio Live about the Health and Disability’s Commissioner’s report into iridologist Ruth Nelson’s treatment of cancer patient Yvonne Maine:

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One of the topic he raises is what might be done to avoid these cases from arising. Dr. Swee Tan, the surgeon who treated Mrs Main, suggested a registration scheme. I had mixed feelings at that:

My own thoughts, as a non-medical person-on-the-street, are that in one sense registration might legitimise the more moderate use of ’remedies’ like iridology, which grates given that many, if not most, of these remedies are nonsense under any use, but on the other hand registration offers some control over the worst extremes of misuse by obligating practitioners to adhere to guidelines.

Shaun felt there was no sense in registering practices that don’t work, comparing it to registering psychics. Instead he felt that the law should be used where practitioners make fraudulent claims or harm someone, including contributing to someone’s death.

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Communication and trust in medicine Grant Jacobs Aug 14

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For Dunedin locals: talks on this evening (free entry; refreshments before).

We talk a lot about science communication here. Quite a few of the topics we cover relate to health or medical issues. One element that may underlie some people’s taking unsound positions on their  health and medicine choices is a weakening of communication lines and trust with their medical practitioners. Two talks on this evening in Dunedin explore this.

  • When Doctors Become Patients: Exploring ways of improving doctor-patient relationships and communication – to be presented by Professor Robert Klitzman; Professor of Clinical Psychiatry, College of Physicians & Surgeons and the Joseph Mailman School of Public Health; Director of Masters of Bioethics Programme Columbia University; Director of Ethics & Policy Core, HIV Centre, NYSPI.
  •  Trust and Health Professionals: The importance of trust in health care relationships - presented by Professor Mark Henaghan; Dean and Professor of Law at the University of Otago; Barrister and Solicitor of the High Court of New Zealand; Principal Investigator, Human Genome Project.

Details for attending:

Tuesday 14th August

6pm to 8pm (complimentary refreshments served from 5.30pm)

Dunedin Public Art Gallery


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