Spare Parts: In Praise of Your Appendix and Other Unappreciated Organs
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Spare Parts: In Praise of Your Appendix and Other Unappreciated Organs
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Overview
This book sheds light on human body parts once considered extraneous but now – with modern medicine and modern medical paraphernalia – shown to play an important role in our healthful survival. With wit and research-honed wisdom, health writer Carol Ann Rinzler explains in layman's language why we need “bonus” body parts such as:
The appendix, once discarded as “the worm of the intestines,” but now believed to play an important role in our immune system
The coccyx, a.k.a. the “tailbone,” once considered the remnant of a human tail, but now considered the keystone of the boney pelvic arch when muscles meet and stabilize our seating
Wisdom teeth, that “extra” set of molars for which many “evolved” human jaws lack accommodating space but still remain in place where we higher primates still follow a basic “hard”diet that require extra chew power
On the other hand, having highlighted the still-important parts, Rinzler adds a chapter on dispensables: parts with which we can indeed happily dispense. Along the way, Rinzler weaves in Darwin’s theories of evolution and shares insights on what the human body may be like millennia from now.
Product Details
| ISBN-13: | 9781510712515 |
|---|---|
| Publisher: | Skyhorse |
| Publication date: | 03/21/2017 |
| Sold by: | SIMON & SCHUSTER |
| Format: | eBook |
| Pages: | 288 |
| File size: | 1 MB |
About the Author
Read an Excerpt
CHAPTER 1
Hide & Seek
The Appendix
"With respect to the alimentary canal, I have met with an account of only a single rudiment, namely the vermiform appendage of the caecum. ... Not only is it useless, but it is sometimes the cause of death ..."
— Charles Darwin, The Descent of Man (1871)
"Its major importance would appear to be financial support of the surgical profession."
— Alfred Sherwood Romer and Thomas S. Parsons, The Vertebrate Body (1986)
DID YOU SEE WHAT I SAW?
The centuries-long attempt to find and then explain the appendix is a tale of anatomical hide-and-seek peopled with pioneering 19th- and 20th-century doctors such as:
Sir Frederick Treves (1853–1923), the prominent Victorian surgeon perhaps best known for his friendship with and care of the "elephant man" Joseph Merrick and then as the man who relieved Queen Victoria's "corpulent heir," Edward VII, of his own troublesome appendix on the eve of his coronation (the coronation was postponed for two weeks)
Charles McBurney (1845–1913), who pinpointed the exact location of a diseased appendix now known as "McBurney's Point"
Irish physician Denis Burkett (1911–1993), who popularized the idea that eating foods rich in dietary fiber might reduce the risk of appendicitis and colon cancer
There are artists, including Leonardo da Vinci, who drew the first picture of an appendix, and a whole army of famous patients in addition to Churchill and the King, from (maybe) Hippocrates to (definitely) neurosurgeon Harvey Cushing and popstars Elton John, Lindsay Lohan, and Ted Turner. And, alas, there were the appendicitis deaths of famous folk such as Brigham Young in 1877. In 1902, there was Walter Reed, the U.S. Army physician who identified the mosquito as the source of yellow fever infection. Seven year later, appendicitis did in the artist of the American West, Frederic Remington. George Wesley Bellows, the painter and lithographer known for his expressive action portraits of American athletes, followed in 1925. Rudolph Valentino and Harry Houdini followed one year later. The lethal appendix made its way into books, onto the stage, and over the air. In Stephen King's novel The Stand (1978), one man survives the apocalypse only to die of appendicitis. Onstage, young Wally Webb fell victim in Thorton Wilder's drama Our Town (1938). In an episode of M*A*S*H* ("The Colonel's Horse," 1976), the person in pain is Hot Lips Margaret Houlihan; in 1977 on Laverne and Shirley, it's Shirley; in 1989 on Doogie Howser, it's Doogie Howser's girlfriend; and in the fourth season of Lost, it's Jack. For the kids, there are characters with appendicitis in the video games Trauma Center and Mega Man Battle Network, and for little girls who want to play doctor, there are Madeline dolls with appendicitis scars.
Back in Real Life, there are moments of medical fantasy such as the report that while on assignment in China in 1971, New York Times editor James Reston had his appendix removed with no anesthesia other than acupuncture. There is medical drama such as Russian doctor Leonid Rogozov's developing appendicitis while on the sixth Soviet expedition to Antarctica in 1960–1961 and, being the only physician on base, operating on himself. Finally, there is this simple but compelling fact: the unassuming appendix played a leading role in the emergence of modern surgery when, after the introduction of anesthesia and antisepsis, the operation to remove it became the single most popular emergency surgical procedure in the world.
The story begins with, of all things, Egyptian mummies.
Although we are used to thinking of the word mummy as Egyptian, in fact it comes from the Arabic mumiyah meaning "body preserved by wax or bitumen." That small detail aside, the ancient Egyptians really were far and away the best at preserving corpses, a skill arising naturally from their environment. Early on, during the Neolithic period, the dead were buried in the hot dry desert sand which naturally dried and preserved them. A cooler but equally dry extreme European climate produced equally preserved mummies such as the "Iceman" whose shriveled frozen body was discovered in 1991, high on the Austrian-Italian border of the Alps, where he had perished an estimated 5,000 years before. Celtic mummies dating back to the Iron Age (400 BCE–400 CE), first uncovered in 1821 peat bogs whose acid had turned them dry and leathery. "Bog mummies" have also surfaced in Germany, The Netherlands, Poland, Sweden, and the United Kingdom.
As civilization grew more sophisticated, the well-off and powerful began to inter their dead in tombs rather than hanging them out to dry. This meant that they needed to find a way to preserve the bodies that remained on view in the tombs. The solution: mummification by man rather than by environment. The world's oldest mummies made by man may be those created by the Chinchorro on the west coast of South America and dating back to 7000 BCE, 4,000 years before the Egyptian mummies. More than 100 Chinchorro mummies have been recovered from the Atacama Desert of northern Chile and southern Peru and reside in the collection of the University of Tarapacá's museum in Arica, Chile. (Unlike Egyptian mummies, which were laid on their backs after mummification, the Chinchorro stood theirs upright so the corpse's mouth often fell open. The most famous picture of this may be Edvard Munch's celebrated painting "The Scream," reliably reputed to be based on a Peruvian mummy the artist saw in the Musée du Louvre.)
In Egypt, the process of artificially mummifying a body might last more than two months. Each step in preparing the body was the focus of religious ritual. The priests charged with the job — many of whom became doctors — began by inserting a long instrument through the nose to pull out the soft brain matter. Then they emptied the body cavity, tossing the organs into four covered jars or packets representing the four sons of Horus, the god of sky, war, and hunting. The jars or packets were entombed with the body, unless the organs were, as Plutarch wrote, discarded "as the cause of all the sins committed by man." The embalmers then filled the empty human shell with "odoriferant, aromatic, and balsamic drugs, capable of arresting the progress of putrid decomposition" and put the corpse out to dry in the Mediterranean sun. Presto, change-o, mummies.
The Chinchorro may have been first to mummify their relatives, but the first people to notice that we had an appendix seem to have been those Egyptian priests who named one of the sinful entrails — the appendix — "the worm of the intestine." It was a lucky find because not every living body has one. Not even every mammal has one. Gorillas, chimps, and orangutans do. So do wombats, rabbits, rats, and some opossums. But cats and dogs, horses and cows and sheep and goats, fish and frogs and salamanders, lizards, snakes, and birds don't. Neither do monkeys, an important point because both Aristotle and Galen dissected monkeys to produce the anatomical studies on which westerners relied for centuries.
For reasons both religious and cultural, the ancients, East and West, did not practice dissection. In the West, some speculate that Aristotle dissected in secret, but you would not know that from his writings, such as Parts of Animals (ca. 350 BCE), which are strictly about nonhuman bodies. In the next century, two Greek physicians, Herophilus (335–280 BCE) and Erasistratus (304–250 BCE), were given permission to dissect human cadavers at the anatomy school they founded in Alexandria. Three hundred years after that, the Greek-turned-Roman physician Claudius Galen (c. 129–c.216) was rumored, like Aristotle, to have performed secret dissection; but, like Aristotle, his anatomical drawings were based on animals, which meant that virtually nobody actually understood what a human skeleton or most human tissues and innards looked like. Consider the neck. Unlike ours, a dog's shoulder bones are not connected; canines do not have the collar bone that reaches across the front of the top of the human torso. In addition, the muscles around our vertical backbone are connected differently than Fido's around his horizontal spine. Add to that the fact that neither the ancient Chinese nor early Islamic physicians practiced human dissection, either, and you can understand why, except for those Egyptian mummy workers, no one had a chance to see the appendix.
Eventually, of course, science crept into the picture. Christians formalized their opposition to dissection at the Council of Tours in 1163, but in 1492, just as Columbus sailed off to his New World, Leonardo da Vinci began to defy the Church ban on human dissection. He made anatomical drawings that, had they been published, would have introduced the appendix to the Old World. But it was one thing to do dissection quietly, and quite another to make the results public, so Leonardo's drawings did not appear until after his death. Thus the prize for being first to describe the appendix in public is usually awarded to Italian anatomist Jacopo Berengario da Carpi of the University of Bologna, where, in January 1513, the Vatican approved the Italian physician Mondino de Luzzi's bringing public dissection of human cadavers into his classes on anatomy. Twenty years later, while performing an autopsy, Carpi discovered an empty, small cavity at the end of the cecum and included it in his groundbreaking text, Anatomia Carpi (1535). After that, Andreas Vesalius, the founder of modern anatomy and the Belgian Imperial physician at the court of Charles V, included drawings of the appendix in De Humani Corporis Fabrica (1543). His book was a classic, but his anatomy acumen was not. He grouped the appendix together with the ileum and the colon as one of the three openings of the cecum, a pouch at the junction of the small and large intestines.
The Egyptians had called the appendix "the worm of the intestines." Leonardo thought it looked like a little ear, so he called it orecchio. Carpi, ignoring both, chose the name addentramentum, from the Latin ad meaning near, intra meaning inside something, and mentum meaning medium or result of. The switch back to "worm-shape" (vermiformis) has many supposed fathers including Philip Verheyen, a Flemish physician so intrigued by anatomy that when his own leg was amputated in 1675, he injected it with a mixture of waxes and fragrant oil and preserved it either in balsamic vinegar or brandy and black pepper. Then he dissected the leg bit by bit in search of the source of his discomfort; instead, he discovered a tissue at the back of the heel that he christened chorda Achillis (Achilles tendon). In 1710, having moved back up and into the body, he is reputed to have rechristened the appendix "the appendix."
FALSE DIAGNOSES & FAVORED FOLK REMEDIES
Simply put, the appendix is, as its name implies, an appendage, a small, closed tube attached to the cecum. An adult human appendix is about the size of a finger, 6 to 8 centimeters (2.4 to 3.1 inches) long and slightly less than one-half inch around. Like other body parts, its size may vary from person to person. In 2004, The Guinness Book of Records listed as the world's champion the 8.26-inch appendix extricated from a twenty-six-year-old man at Lister Hospital in Herefordshire, England. Two years later, the new champion was a 10.24 inch appendix removed during autopsy on a Croatian man at the Ljudevit Jurak University Department of Pathology in Zagreb, a record broken in 2011, when a team of Egyptian and Qatari surgeons reported removing a 21.6-inch appendix from a thirteen-year-old boy.
Like the rest of the intestines, the appendix has several layers of tissue: a mucosa (thin lining with overlying mucus), a sub-mucosa (connective tissue and immune cells) covering a muscular layer, and an external membrane (serosa) such as the one that covers the entire contents of the abdomen. The appendix is filled with glands that secrete mucus and fluids. Its blood supply arrives via a branch off the aorta called the superior mesenteric artery and flows away into the superior mesenteric vein. The same nerves that reach the rest of the gut come here, and the appendix is full of lymph tissue, which means that, like the equally underappreciated tonsils, it appears to be part of your immune system.
In 1859, when Charles Darwin labeled the appendix rudimentary, and his contemporaries translated that into useless, nobody even knew we had an immune system, which wasn't identified until around 1908. They also didn't know about or have:
• A detailed anatomy of "the worm" and what (if anything) it might do
• A list of the creatures that had an appendix and those that didn't
• Knowledge of the link between a high white cell count and an infection (c.1840s–1850)
• Anesthesia (1846), antisepsis (1867), and antibiotics (1936)
• Diagnostic imaging such as X-rays (1895), ultrasound (1957) and MRIs (1977)
• A laparoscope (1916) or a computer chip television camera laparoscope (1986)
Which didn't really matter until something went wrong.
FROM NEEDLE TO KNIFE
They had not yet discovered the appendix, but early physicians were familiar with the distinctive pain in the lower right quadrant whose name evolved over time from the ancient passio iliaca to colic passion, then to typhlitis and perityphilitis (from the Greek tuphlon enteron, "blind intestine," i.e., the cecum), and finally, in 1886, to appendicitis, when Boston surgeon Reginald Heber Fitz published "Perforating inflammation of the vermiform appendix with special reference to its early diagnosis and treatment" in The American Journal of Medical Science.
As a medical malefactor, the appendix is small potatoes. True, when angered and ignored, it can turn lethal. But appendicitis is not contagious like the plague; when it kills, it does so one body at a time. The infection does not linger hidden for years like syphilis, slowly rotting your body and brain, nor does it leave its victims alive but paralyzed, as polio may. An acute infection may spread, but appendicitis is not secretive like cancer, quietly savaging its way through the body. Yet, as one researcher wrote as late as 2010, "Though appendicitis is fairly common, it still remains a frustrating medical mystery ... we know surgical removal is an effective treatment, [but] we still don't know the purpose of the appendix, nor what causes it to become obstructed."
Nothing new here; their predecessors didn't know, either. Early on, an irritated appendix was blamed on a variety of causes, most commonly something the victim had swallowed, which then became stuck in the appendix, a proposal resting on what seemed an uncommonly common Victorian appetite for pins and other unusual objects such as fruit pits. Whatever the cause, the problem was treated with useless and often gruesome remedies. As late as the 17 century, Thomas Sydenham, the English physician commonly regarded as the father of modern medicine, favored applying the sliced-open body of a freshly killed puppy to the painful abdomen. If that didn't work, he advised horseback riding to bounce problematic matter out of the cecum. Other therapies for "deplorable iliac passions" included bloodletting, laxatives, crouching in a hot oil and herb sitzbath, and even swallowing lead pellets to stimulate intestinal movement. As one medical historian reported: "An autopsy on a man who had died of the iliac passion and who had been made to swallow three large balls [in the hope of overcoming the obstruction], showed these same balls in the appendix, which was dilated by fecal matter nearly, to the size of the rest of the gut."
(Continues…)
Excerpted from "Spare Parts"
by .
Copyright © 2017 Carol Ann Rinzler.
Excerpted by permission of Skyhorse Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Introduction
Where in the World Was Charles Robert Darwin? 8
The Darwin Dictionary 9
1 Hide & Seek: The Appendix
Did You See What I Saw? 13
Mummy Meds 18
False Diagnoses & Favored Folk Remedies 21
From Needle to Knife 23
Sir Winston's Triple Complaint 30
Form Follows Function 31
After Words 40
The Appendix 42
2 Feathers & Fur: Body Hair
The Natural Nature of Our Hair 48
The Tree of Human Life 48
Hair & Fur & Feathers 52
How We Lost Our Hair 55
Hair on Top 58
The Price of Male Facial Hair 62
Hair in the Middle 62
Hair Down There 66
Less Hair but Not Hair-less 71
3 The Tale of the Tailbone: The Coccyx
The Incredible Versatile Tail 74
Fascinating Far End Factoid 75
Getting By with No Tail at All 81
The Man Who Invented the Human Tail 83
Defects Associated with "Human Tail" 89
At the Tail End 90
Flowers & Funnies & Men with Tails 92
4 Ear Rings: The Auricular Muscles
Breathing Through Your Ears 96
How We Hear 98
Smelly Ears = Smelly Armpits 99
Picturing the Pinna 102
Muscle Mechanics 108
5 Blink!: The Third Eyelid
What Richard Owen Wrote 114
Looking through the Lid 117
What You See Is What We've Got 119
The Human Eye Unmasked 120
The Very Human Version of a Third Eyelid 128
Two Eyes. Four Lids. What Could Possibly Go Wrong? 131
Eyelids of the World 133
6 Pearly Whites: Wisdom Teeth
Fish Teeth & Darwin's Finch 136
How Old Is Your Eon? 143
Missing Bone & Surplus Molars 147
Building & Keeping Human Teeth 149
The Last Bite 157
Name That Tooth 159
7 Dispensables
The One and Only Brain 162
Replaceable/Remediable 165
Transplantation Waiting List, United States, 12:14 PM, April 26, 2016 167
(Almost) Reliably Redundant 167
Useful but Dispensable 168
Four (Really Pretty Much) Useless Human Body Parts 173
One Indisputably Vestigial Organ 177
8 Future Man
Yes. No. Maybe 181
The End of Evolution 182
The Next Evolution 184
Man Improving Man 186
Infant Mortality in the United States, 2010 189
Life Expectancy at Birth in the United States, 1900-2010 190
Fictional Futures 191
Future Films 193
The Rise of Mr. Robot 198
9 Postscript
The Darwin Family Business 201
Development in Dress by George Herbert Darwin 205
About the Author 221
Endnotes 223
Index 263