IMFW: Don't Be So Prosthetic

After last week's Interesting Medical Fact of the week focused on glass eyes, I decided to stick with a winning theme and move on to a post about prostheses of all shapes and sizes.

BBC News have this jolly picture book of prosthetic limbs throughout the ages, which is well worth a look; my favourite is probably the Ancient Egyptian prosthetic toe; found on a mummy and dating back to at least 750 BC, it's the oldest functioning prosthetic ever discovered. Earlier prosthesis exist which appear to have been crafted to replace missing body parts after death - so that the person could enter the afterlife whole. But the bottom of this wooden toe shows wear and tear, indicating that it was used during the Egyptian woman's lifetime. Big toes support about 40% of the weight on each foot, meaning that losing one can upset your balance and slow you down. Plus, although it's quite possible to walk and move around without a toe, a prosthesis can protect the foot where the amputation occured and may be more aesthetically pleasing. Apparently Egyptologists have been seeking volunteers who've had their big toe amputated to try on replicas of the ancient prosthesis to see if it's effective at aiding balance and walking.

And this wooden toe was so well crafted that it's still attached to its owner's foot, 2750 years later.


Warning: prosthetic toe may not be detachable



IMFW: Turned Into Bone

This week's IMFW is about an extremely rare and extremely curious genetic illness: fibrodysplasia ossificans progressiva. In this disease, fibrous tissue such as muscle, tendons and ligaments are ossified - literally turned into bone - when damaged.

As you can imagine, the illness causes severe disability, with sufferers becoming slowly trapped inside immovable sheets of bone; new growths of bone often join up with the main skeleton. Bone growths may leave patients unable to eat, speak, sit down or even breathe as the growing bones compress the lungs. Attempts to remove the excess bone usually only results in further growth, because any injury (such as surgery) to fibrous tissue is liable to result in ossification of that tissue. The notable early symptom of this illness is that babies with the genetic mutation which causes fibrodysplasia ossificans progressiva are usually born with deformed big toes; however, the illness is so rare that sufferers are often misdiagnosed, and the bone growths taken to be cancerous tumours.

One notable sufferer was Harry Eastlack, who died before his fortieth birthday and bequeathed his skeleton to medical science. You can see a photograph of it here.

Although the genetic mutation which causes this condition has been identified, there is no cure and no real treatment.

IMFW: Moral Dilemma

The first Interesting Medical Fact of the Week for 2012 - the first interesting fact for a whole new year - concerns something (or rather, someone) that I've written about before. Highly relevant to the pituitary adenoma theme of this blog, in fact.

In my last post, I mentioned Charles Byrne, the Irish Giant, as he was known in his lifetime, a man who suffered from acromegaly in the 1780s. He was briefly a popular attraction in London before succumbing to alcoholism and dying very young at the age of 22. Although he is probably the most well known, as his skeleton is part of the collection in the Hunterian Museum, there were several well-known Irish giants, all of whom likely suffered from acromegaly, who exhibited themself across Europe at the time.

Byrne's skeleton was preserved against his will; the story goes that he was so keen to avoid his body falling into the clutches of John Hunter, a noted surgeon of the time, that his will requested his friends bury his body at sea in a lead coffin. Hunter managed to get his hands on the body, however, allegedly through bribery.

It's curious how many websites I've found when googling the name "Charles Byrne" which not only fail to mention acromegaly, but fail to mention that Byrne had an illness at all - as though growing to 7'7" is a kind of character flaw which could happen to anybody. His skeleton is still on display to the public at the Hunterian Museum, and around a year ago there was some publicity around some genetic research that has been taking place, looking at a genetic cause for  pituitary tumours which recur in families, which identified some modern-day acromegaly patients who may be related to Byrne.

More on that research another day.

Today, the news is that there have been calls for Charles Byrne's skeleton to be removed from display, and buried in accordance with his original wishes. It seems fairly unlikely that this will happen, he's a significant feature of the museum; but it's an interesting debate, and on the whole, I have to say that I would broadly be in favour of allowing him to be buried. It's interesting that the moral debate is still going on, more than two hundred years after his death.