TMI Friday: The Grinch Syndrome

Last week, I blogged about the "Santa Claus" Syndrome. Taking inspiration from the "Worst ever Christmas story ever" from the "Gremlins" film, I clawed through the medical case literature to see whether there was any truth behind this story.
After much googling, I tracked down a paper entitled "The Santa Claus Syndrome", which appeared to answer all of my questions, but was locked behind a pay-wall. So I posted the awesome abstract of the paper and left it at that.
But I must have been a good little boy this year, because Santa* left me a present underneath my Christmas tree. A copy of the full paper !
So gather 'round children, you are in for a gruesome tale.

Our story begins with a 17 year old burglar who saw a tempting target of opportunity. It was in the early morning hours, the sun had not risen, and the store was empty. The doors were locked, but our enterprising thief noticed that the owners had left their chimney unguarded. I imagine a Grinch like smile crossing his face, and him rubbing his palms together. For he would not be going down that chimney to give presents, like Santa Claus. The plan was sheer elegance in its simplicity.

The paramedics found him fourteen hours later, jammed in the chimney, his hand caught in a heat vent.
You might be wondering what happens to someone when they get stuck in a chimney. I am here to give you the facts in all of their gory details.
They managed to get the burglar out of the chimney and he was immediately transported to a burns unit. His nostrils and tongue were coated with soot, and he had first and second degree burns all over his chest, abdomen and lower body. But it wasn't just the burns that were the problem for this young gentleman.
He was also covered in pressure sores. These occur at points on the body where bone is close to the surface of the skin (like your elbows, or your knees).  When you put pressure on these "bony prominences", the skin, the bone squeezes and tears at the body tissue it's pressing against.
 Effectively, the burglar's skin was been worn away, with the chimney acting as the pestle, and his very bones acting as the mortar.
The tissue around the burglars knee had already been severely damaged, and had become "Necrotic", and his hand had become infected and "gangrenous". But these weren't even his biggest problems.
His biggest problems was that there really wasn't much oxygen in that cramped chimney shaft. The oxygen levels in his blood were dangerously low. They intubated him, but his condition just kept getting worse.
He was soon suffering from "Acute respiratory distress", which happens to the cells of the lung that have suffered from so much injury that the immune system kicks into overdrive. In order to get as many immune cells as possible into the lungs, the blood vessels entering the lungs become "leaky". They leak fluid into the lungs as well as inflammatory cells, essentially flooding the lung. It's not unlike drowning.
The physicians prescribed steroids in the hope that they would bring this under control, as well as giving him antibiotics for his infection and intravenous fluid to keep him hydrated.
Yet it still got worse. The burns he had sustained, combined with the severe pressure sores and the gangrene had lead to his muscles breaking down. All muscles contain a compound known as myoglobin, which is like haemoglobin in that it stores oxygen, but only to be used for the muscles. Whilst it is useful, it is also very poisonous to the kidneys if a large amount of it enters the blood stream.
The burglars muscles had been damaged to the point that they were now leaking myoglobin into his blood, and his kidneys were now shutting down. The doctors put him on dialysis to take the pressure off the kidneys.
But his gangrene had now effectively "mummified" the patients hand, leaving it shrivelled, dried out and dead. The surgeons were forced to amputate his whole arm to prevent the spread of the gangrene.
Various parts of his "lower extremities" suffered from the burglar having been stuck so long in an upright position. The blood had flowed down to his legs under the pull of gravity, raising the pressure in his lower limbs, giving him "Compartment Syndrome".  The surgeons treated this by cutting the affected areas open so that the pressure can be relieved.
But all of this was for nought, because on the twelfth day after admission, the patient suffered from cardiac arrest and died.

The physicians who had attended this unfortunate ill fated burglar recognised that actually, people get stuck in chimneys more often than you would think. There were a number of cases reported in newspapers of people getting stuck in chimneys during burglaries, or in the process of performing pranks, many of them with fatal consequences. So the researchers devised the "Santa Claus Syndrome". These are series of specific symptoms for other physicians to watch out for if they need to treat someone who had been stuck in a chimney, so that they would have enough preparation to save their patient.
This paper was published in 1994 , and should have been a warning for us all. But housebreakers are still dying from getting stuck in chimneys.
It should be clear now that only Santa Claus is able to enter a chimney with his magic. The poor grinch is probably still stuck in some abandoned chimney in Whoville, legs swollen like melons,  skin crackling and popping from the heat, and desperately inhaling lungfuls of soot and ash.

HAPPY HOLIDAYS !

Boglioli L. & Taff M. (1995). The Santa Claus Syndrome' Entrapment in Chimneys, Journal of Forensic Sciences, 40 (3) 499-500. DOI:
*or an interested reader of the blog, who I'm assuming wishes to remain nameless, but I wasn't really very clear on that.

An Unpleasant Pheasant

Winter is open season for pheasant hunting. Families and friends come together to bond over the hunt. Dogs are released into the underbrush to scare up a few of the birds into the gunsights of the shooters.

But there are occasions when the prey can turn the tables on their predators, to spit their last breath at them in defiance. 

Our story regards a man, who was trying to impress his wife with his shooting. She was sat behind him, watching him as he shot at panicked pheasants. Her husband managed to hit one low flying pheasant as it was headed towards them. 

Although the pheasant had died, the laws of momentum allowed it to maintain it's trajectory. Had it been alive, it may have been able to manoeuvre out the obstacle that intersected with the aforementioned trajectory. Thus, it hit that object square on at full speed. That object was the man's wife with enough force to burst her spleen.

Enjoy your Christmas meal everybody !

Wilkinson M.C., Klein G., Cornell M. & Rainsbury R.M. (1987). The pheasant's revenge: an unusual zoonotic injury., BMJ, 295 (6613) 1659-1659. DOI: 10.1136/bmj.295.6613.1659

TMI Friday: The Santa Claus Syndrome

The Journal of Forensic Sciences has one article that I've been attempting to dig out with whatever resources I can muster, but all I could find was the abstract. Thus, I present it to you in it's full form now, until such time as I can find the full journal article and furnish you with the details.

In recent years, there have been sporadic reports in the lay press of individuals stuck in chimneys primarily during burglary attempts. Most of these individuals suffered from suffocation or soot inhalation. Because of the similarities between this form of breaking and entering and Santa Claus' traditional entrance into homes on Christmas Eve, we define the “Santa Claus Syndrome” as postural (positional) asphyxia, inhalational injuries and body burns, and/or complications related to compartment syndrome due to entrapment in chimneys. We report a case of a man who became trapped in a chimney during a burglary attempt and died a delayed death due to postural asphyxia associated with inhalational and burn injuries and anterior compartment syndrome. An analysis of this unusual case is presented. Exhaustional and postural asphyxia, compartment syndromes, and confined space-hypoxia syndrome are also discussed.

 Basically, if Santa Claus isn't dead already, he is probably some kind of horribly injured zombie.
 G'night kids !

Boglioli L. & Taff M. (1995). The Santa Claus Syndrome' Entrapment in Chimneys, Journal of Forensic Sciences, 40 (3) 499-500. DOI:

TMI Friday: Rectal Repositories !

On today's TMI Friday, we are once again contemplating colon contents, this time looking at the stories of four people who've used their rectums as repositories for interesting objects. I shall recount those takes to you now.

Case 1. For want of a Wine cabinet

We kick off this series of cases with a 52 year old man who stumbled into the emergency room with a real pain in the ass. He owned up to the emergency room staff that he had a habit of placing objects in his own rectum for sexual gratification. His latest attempt involved a wine glass. Unfortunately the wind glass got turned around in his rectum, making it impossible for him to remove it. After two days, he finally took himself to hospital. All of the doctor attempts at pulling the glass out failed, and eventually he had to go into surgery.

They opened up his abdomen and squeezed out of the colon via a surgical incision.

Case 2. Ball in the buttocks

Our next victim had managed to insert a ball into their anus. At first, the doctors tried giving him a hefty dose of laxatives. When this didn't work they tried to pull the ball out with an endoscope, but the tiny pincers on it couldn't get any purchase on the ball. In the end, they had to put the patient under general anaesthesia and scoop out the ball with two sets of forceps. This was successful, and the patient could go home the next day.

Case 3. Bottling it

 The victim (and I guess perpetrator) in this case had a history of inserting objects up his arse for sexual pleasure. The staff couldn't get any purchase on the object just by going through the anus. They had to perform surgery, which revealed that the offending object was an eight centimetre wide bottle.

Case 4. Design Flaw

One must assume that the people who design vibrators try to ensure that the don't get lost in whatever orifice they are inserted in. That would be a key safety feature, unless they thought that their customers first thought after vaginally or anally engorging the vibrator would be to buy another one. Repeat Sales !

In this final case, we have a gentleman who had suffered from that exact problem during sex with his partner. The vibrator was to slippery to grip with endoscopic forceps, and so the patient had to go into surgery to get it out. If only there were easy holds for endoscopic forceps designed into vibrators, it would save on surgery. Think about it vibrator manufacturers ! 

Sangar P., Henry G. & Sood S. (2013). Foreign bodies in the rectum: report of a case series and review of the literature, Sri Lanka Journal of Surgery, 31 (2) DOI: 10.4038/sljs.v31i2.5960

TMI Friday: The worst way to be caught dead

There are many things that we all do in our private time when no-one can possibly see us. Things that could potentially embarrass us. Like farting yourself a warm spot in bed. Or rearranging ones testicles to ensure that they don't undergo the dreaded "Testicle Torsion Injury". Or perhaps ordering a whole bucket of Choc-Chip Ice cream to yourself. But no-one would want to be found dead in bed with half a bucket of melted ice cream smeared on ones face whilst having one hand frozen mid scratch and the dreadful aroma of your farts presiding over the affair.

Today's TMI Friday was simply asking for this fate.

There is a sexual practice known alliteratively as "autoerotic asphyxiation". The idea behind this practice is that suffocating at the point of climax is meant to somehow improve the experience. But it can be dangerous, especially if the person engaging in autoerotic asphyxiation is doing it alone, and as a result we will no doubt encounter this practice in the future.

There are a number of ways to induce asphyxiation. The subject of today's topic decided to use a plastic bag to help improve his masturbatory experience. He set up a complex series of luggage rack straps to control the degree of asphyxiation he experienced, but some how it all went wrong.

But it get's worse. Here is the full description of how he was found.

A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. 

Atanasijević T., Jovanović A.A., Nikolić S., Popović V. & Jasović-Gasić M. (2009). Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report., Psychiatria Danubina, PMID: 19556957

TMI Friday: Telephone support

When things go wrong, often we turn to the humble telephone to help us out. Whether we turn to it to call for services found in the yellow pages, family, friends and the authorities when an emergency strikes. So when the subject of this weeks TMI Friday was faced with a problem he could not solve, he too turned to the telephone.

He had unfortunately "Lost his erections" after suffering a heart attack. Instead of opting for the usual impotence medications, he discovered another way of coping. He used his telephone to find his erections again.

He threaded telephone wire up his urethra to give himself a solid enough erection to allow him to masturbate. He did this for three years before running into any problems. One day, the telephone wire just got stuck. When he tried to pull it out, all he got was blood, and soon he lost control of his bladder.

When he eventually got to hospital, a X ray revealed that the telephone wire had coiled inside his bladder. The doctors managed to successfully pull it out with much difficulty and a heavy dose of local anaesthetic.

Trehan R.K., Haroon A., Memon S. & Turner D. (2007). Successful removal of a telephone cable, a foreign body through the urethra into the bladder: a case report, Journal of Medical Case Reports, 1 (1) 153. DOI: 10.1186/1752-1947-1-153

TMI Friday: A Shocking Discovery

You should always be careful with electricity, a fact that is perfectly illustrated in this weeks TMI Friday. Today we find yet another story of a poor soul who recklessly endangered their life during the course of masturbation.

He lived in a country mining town in Australia, and had last been seen drinking at a bar. No-one knew he'd be dead within three days. We don't exactly know the circumstances of his death, save from what could be deduced from the state of his corpse.

It seems that before he died, he decided to do some experimentation with electricity. 

He took the cord from one of his electrical appliances, and cut away the protective rubber around them to expose the wires. In any plug cord (In most countries) there are three wires. The live wire, the neutral wire and the earth wire. The live wire delivers the electricity, the neutral wire carries it away, and the earth wire diverts electricity to a safe place in the event of a fault.

The man had no use for the earth wire, so he tucked it back inside its sheath. He linked the neutral wire to his chest. He hooked the live wire up to a chain and wrapped it around his dick. With everything to his satisfaction, he plugged the cord in. Sparks flew.

It is thought that after he had separated from his wife, he had taken some time to travel overseas where he discovered how to use electricity for autoerotic stimulation. But when he tried to repeat the practice in his home town, he fell foul of one major difference between Australia and other countries.

The electric voltage overseas was less than half that of the mining town (110 V as compared with 240 V throughout Australia)

Cooke C.T., Cadden G.A. & Margolius K.A. (1994). Autoerotic Deaths: Four cases, Pathology, 26 (3) 276-280. DOI: 10.1080/00313029400169631

History of Bacteriology: Miasmas and Contagions

Have you ever found yourself walking down a street, and be confronted with a pungent turd blocking your path?

You don't know where it came from, but whether it be a dog or a tramp, you know to avoid it. It's a natural instinct. Toiletry behaviour can be found all over the natural world. Even tree sloths will make the effort to climb down to defecate far away from where they feed. The disgusting odours we associate with putrefying meat, faeces and death are ones we naturally try to avoid, and when that isn't possible we try to cleanse ourselves thoroughly so that we don't have to experience their stench.

If you were to ask me where the Miasma theory came from, I would point not to any one individual, but to that instinct of disgust. It was it's link to this natural response that also made it so difficult for people to dismiss miasmas even when confronted with overwhelming evidence that they didn't exist.

Many peoples across the world developed their own culture of hygiene and cleanliness, which usually involved some form of cleaning ritual and disposal of waste.
Often, these traditions would propose a specific association between bad smells and disgusting objects with disease. Across the world, incense and pungent smelling products tended to be used for treatments. Getting rid of the smell equated to getting rid of the disease.
Hippocrates advised people to stay away from places with "bad air" in many of his writings, and expounded the earliest iteration of the Miasma theory. His work was translated into multiple languages and passed through the ancient world, forming the basis of medical practice for centuries after his death. The concept of "Bad air" being the cause of diseases became well established. But it was not the only theory of disease people used.
In 1546, Girolamo Fracastoro published "De Contagione et Contagiosis Morbis", where he wrote about the "Contagion" theory of disease. He drew together various observations on disease that he had accumulated over his forty year long career as a physician. He proposed that diseases could be caused by the transfer of some imperceptible, yet corrupt matter between the sick and the well.  He called this corrupt matter "the seeds of contagion". He proposed that these seeds could spread in three distinct ways. Through direct contact with infected people, through contact with inanimate objects that had been in contact with sick people (he named these "Fomites") and at a distance. He connected these seeds to "putrefaction", in that they could cause it in their hosts, explaining diseases such as gangrene. His explanations generally attempted to reconcile contagion with Hippocratic theories that all diseases were caused by imbalances between four mysterious "humours" found within the body. The types of disease would be determined by which particular humour interacted with specific seeds.
His work sparked off as debate throughout Europe. Whilst the idea of contagion became more widely known, there was much debate over its theoretical causes and his interpretation of the work of Galen and Aristotle and objection over creating a whole new form of life, these seeds, out of thin air.  Fracastoro's most fierce critic was one of the first converts to contagion, Giambattista da Monte. The two would continually clash over the differences in their ideas, a hostile relationship that would eventually develop into one of mutual respect. The students who were privy to these lectures came from all over Europe, and when they returned to their home countries, they would bring the theory of contagion with them.
When proponents of "Bad Air" theory heard of the contagion theory, sparks most conspicuously did not fly. There were arguments, but they were no less vicious than the ones going on between the people who accepted contagion as a theory. Contagion theory still accepted that diseases could be caused by "Bad Air", but that the reason for this was that the air was filled with the "seeds of disease". "Bad Air" Theory held that sufferers of disease were primary sources of "Bad air", and people could catch disease from close contact with the sick.
However, the "Bad Air" theory got a boost in the 17th century when the Hippocratic corpus began to be re-evaluated by a number physicians. I've already talked about a gentleman named Thomas Sydenham who was key for bringing the Hippocratic corpus into the English language and kick starting a new era in evidence based medicine. He lived in an era where doctors applied many treatments based on theoretical ideas, such as bloodletting, sweating and forcing patients to vomit in order to "balance the humors". Sydenham however recognised that many of these treatments did more harm than good, and that the only way to truly divine a theory of medicine would be by a patients bedside.
Unfortunately, he did not have access to the fabulous microscopes of Anton Leeuwenhoek (No-one did, Leeuwenhoek was incredibly protective of his work) so he had no way of determining an evidence basis for contagion. In the end, he tended to favour Hippocratic theories of "Bad air" being the cause of disease, as he had no evidence available to prove otherwise.
In a treatise about malaria* written by Giovanni Maria Lancisi called "On the Noxious Effluvium of Marshes"he connected the disease with the noxious smells emanating from marshes and the mosquitoes that live within them. He gave a name to these noxious smells, he was the first to call them "Miasmas".
The Contagion theory and the Miasma theory were no longer seen as compatible by a growing number of physicians.
His writings went global, and were of particular influence in the United States on medical professionals such as Noah Webster and Benjamin Rush. During an outbreak of Yellow Fever in Philadelphia, many suspected that it had arrived from a contaminated consignment of Coffee from a ship with a crew riddled with the disease. However, Benjamin Rush disagreed with this vehemently, suspecting it had come from the marshy miasma's he believed surrounded the city. Even though Rush believed that contagion played a role in these early cases, that belief eventually waned. By 1799 he actively protested against quarantine procedures for sailors entering the city. By 1805 he began writing treatises to dismiss the idea of contagionism.
Maritime Quarantine procedures were a problem the world over, and cut into the business of many growing companies. It was in the interests of these companies to fuel the backlash against Contagionism.
When quarantine procedures** failed to prevent the Liverpool Cholera epidemic, a major blow was struck to the theory. The Cholera Riots demonstrated the true chaos which could follow a disease epidemic, and spurred people to enact new precautions against these outbreaks. These precautions would be based on the theory of Miasma.
Edwin Chadwick was a major supporter of the Miasma theory, and a vehement anti-contagionist. . He was aware that often, Cholera was associated with unsanitary conditions, and he realised that if the Miasma theory was true, then the greatest threat to peoples health was the presence of open sewers within cities. Through his efforts, open sewers were eliminated, and the cleaning of the streets began to be seen as an issue of public health. These massive clean-up efforts were incredibly effective, and would fuel further support for Miasma theory.
As we now know, Miasma's do not exist, at least not in the form that most people believed in at the time. There are solid reason why humans developed an aversion to particular bad smells. Often the sources of these smells would contain harmful diseases. Clearing out sewage from cities helped people because it meant that flies that fed on faeces could not then transfer microbes from those faeces onto food. It removed opportunities for bacteria such as typhoid from spreading through the streets in shit.
Whilst Chadwick's reforms produced results, they still had problems that are a lot more obvious to modern readers. Whilst the sewers were covered, they still discharged into the water supply, which caused regular outbreaks of cholera and typhus within the city.
Nevertheless, the Miasma Theory had risen to prominence by the 1830's, and its supporters would often define themselves as "anti-contagionist".
But the picture, as always, is more complex. Contagionism, whilst under attack, was far from dead.

*The very name "Malaria" refers to the bad air theory, with "Mal" meaning bad and "Aria" referring to the air. Although it didn't necessarily just refer to our modern interpretation of the disease. Many sweating sicknesses similar to what we understand as malaria would be referred to by its name as well.
** No-one knew of the waterborne nature of the disease, and nor was it thought that fomites could have played a role.

References

Curtis V.A. (2007). Dirt, disgust and disease: a natural history of hygiene, Journal of Epidemiology & Community Health, 61 (8) 660-664. DOI: 10.1136/jech.2007.062380

Nutton V. (1990). The Reception of Fracastoro's Theory of Contagion: The Seed That Fell among Thorns?, Osiris, 6 (1) 196. DOI: 10.1086/368701

Ayliffe G.A.J, English M.P. (2003) Hospital Infection: From Miasmas to MRSA, Cambridge University Press. Link

TMI Friday: Friction Burns

When engaging in  Slicking the Willie, Molesting the monkey and Throttling the turkey, a thought may occur to the male masturbator. "If I do this too much, will it fall off ?"
So we come to the subject of today's topic. This gentleman showed up to the emergency room with a heavy fever, vomiting and muscle pain.
The patient had developed "Fournier's Gangrene" on his member. To those of you who don't know what Fournier's Gangrene is, it is a flesh eating disease which afflicts male genitalia. I probably don't have to tell you how awful it is, but you can always google image it.
How did this individual get Founrier's Gangrene ?
The doctors asked the patient.

Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant. He reported that past episodes of masturbation often resulted in recurrent penile erythema and abrasions

I am not exactly sure what the authors mean when they say that the patient "Endorsed" severe scrotal pain, but the frequent masturbation whilst using soap may have dried out his skin, and caused friction burns. These burns then got infected , and caused gangrene.
Unfortunately, the paper does not relate exactly how frequently the man masturbated before he gave himself a flesh eating disease.
But it turns out that if you do masturbate enough to give yourself friction burns, it could drop off. So ease up on the joystick jacking.

Heiner J.D., Eng K.D., Bialowas T.A. & Devita D. (2012). Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male, Case Reports in Emergency Medicine, 2012 1-3. DOI: 10.1155/2012/154025

#MicroTwJC: Dicing Up Virus Genomes Part 3: The Controversy

In this weeks Microbiology Twitter Journal Club we are going to be discussing two papers published a month ago in Science. These papers purport to provide evidence for RNA Silencing as an antiviral mechanism in mammals.

For those of you who don't know what RNA silencing is, or have no idea about these papers, feel free to check out my first two posts for this weeks MicroTwJC.

MicroTwJC: Dicing up Viral Genomes Part 2

Good news everybody ! I managed to source a copy of the second paper for this weeks' Microbiology Twitter Journal club, after not an insignificant expenditure of time and energy.

In the last blog post, I went through the basics of how siRNA mediated silencing works, and how it could potentially be used to attack the RNA genomes of viruses. The paper I reviewed for that post focused on what happened when viruses infected embryonic stem cells, and looked at how these cells chopped up the viral genome into siRNA's.

The paper we will be discussing today will extend that work, focussing on a virus we had just been introduced to in the last #microtwjc post. The authors use Nodamura virus in their studies. Nodamura virus has a positive stranded RNA genome. It produces a protein called B2, which protects viral DNA from DICER and the RNA induced silencing complex.

B2 is a viral suppressor of RNA interference.

The researchers used a variant of the Nodamura virus with a mutation in B2, so that they could see what happens to the virus without B2 there to protect it.

So without further ado, let us get to the first experiment.

#MicroTwJC: Dicing up Viral Genomes

In this week's Microbiology Twitter Journal Club, we have been challenged to dissect not one, but two papers.

Fortunately, the  University of California San Francisco have made one of the papers widely available, so you can access it here, and the ever important supplemental material can be found here. 

The title of the paper we'll be going through is "Antiviral RNA Interference in Mammalian Cells".

So let's quickly refresh ourselves on how viruses cause infections. They attach to the surface to a host cell, inject their genetic material into said cell (which can be in the form of either DNA or RNA). The Viruses genetic material does all of the hard work, finding ways to trick the host into replicating it and create new viruses, and possibly killing the host cell in the process.

TMI Friday: Eat your Vegetables

There are a number of odd things that people do in pursuit of a sexual high, but today's story may just be the most bizarre event I've written about for TMI Friday.

It was a peaceful afternoon, when a middle aged couple heard a frantic tapping, a frantic rapping at their door. It was their neighbour, and he was in quite a lot of trouble. He was a 29 year old man, of normal build, dressed only in trousers with the waist button unfastened and desperately attempting to talk before dropping dead in front of them.
What happened to him, and why did he die ?
Perhaps an autopsy could answer these questions.

Removal of the trousers showed the penis to be semi-erect; around the base of the penis was a rubber band. On the lower abdomen and in the groin was dried, white coloured material, subsequently identified as semen.

 Okay, so now we can draw a few conclusions as to what the young man was doing before he showed up at his neighbours door. It rhymes with "Rasta-Dating". But that still doesn't explain what killed him.

However, when they opened up his throat cavity, the revealed it. The man had inhaled a whole zucchini, and suffocated as a result. His cries for help were stymied because the zucchini had blocked his airways.

Further enquiry revealed that the deceased had been married for 2 yrs at the time of his death. He was casually employed but, unlike his wife, was not working on that day. The couple grew zucchinis in their backyard garden.

Cooke C.T., Cadden G.A. & Margolius K.A. (1994). Autoerotic Deaths: Four cases, Pathology, 26 (3) 276-280. DOI: 10.1080/00313029400169631

History of Bacteriology: The Cholera Riots

Murmurs of murder rippled through the crowd as it accumulated outside the entrance of the building, cursing the people who entered and exited it. They had watched helpless woman stretchered into the building, knowing she would soon join of the hundreds of people who had died within its walls. Whole city of Liverpool was in uproar, and had endured enough.

History does not record who threw the first stone, but soon the air was thick with them. They thudded against the buildings wall's, breaking the windows and scattering the people within. The men and women escaping the building were chased and beaten. 

The building was Toxteth Park Hospital, the people being chased were Doctors and nurses, and this was the beginning of the Liverpool Cholera Riots.

It was the age of the Industrial Revolution, Empire and Mass migration. Irish immigrants formed a major part of this migration, travelling to America to avoid the depredations back home. The primary intersection between the British Isles and America was a Liverpool. Immigrants awaiting passage to the new world would often find themselves stuck in the overcrowded city of Liverpool.

Like many cities of this era, Liverpool was transforming into a haven of squalor and disease. Urine and faeces were flung freely into the streets where they flowed into the rivers from which people drank. Tuberculosis and Typhoid ravaged the poor.  

The industrialization of Europe had meant that transport links had become much quicker, and trade had improved, but brought with it diseases. Rags from continental hospitals sold to farmers in Yorkshire to help manure hops also carried with them a disease that had not been seen in England before. It was known as "Asiatic Cholera" * at the time, and it frightened the rich and poor alike. Before its appearence, "Cholera" had only referred to seasonal stomach bugs and diarrhoea, and didn't relate to the deadly bacterium which we now refer to as Vibrio cholerae.

The month after the infected rags had been imported into Hull, the first cases of Cholera began to be recorded. Patients suffered from diarrhoea, severe cramps, followed by severe dehydration and then death, with the final symptom being the patients turning blue. It could turn a healthy person into a corpse within twenty four hours.

In 1831, an epidemic devastated Sunderland, killing over 20,000 people. The doctors could not contain the outbreak, their treatments consisting of brandy, bleeding and opium. Fear of this disease was high when it reached Liverpool in 1832.

A veteran medic who had experienced Cholera first hand whilst stationed in India tried his best to calm the situation. After the first two cases reported in Liverpool, he publicly stated that this "was not the case of an epidemic" like people may have heard about in Europe or Dublin. Not long after this, Cholera broke out on a vessel named the Brutus, claiming eighty-one deaths. Liverpool's Board of Health were slow to act, at first apparently denying the news of the outbreak within their city. At the boards very outset it was criticised as being filled with "a few fat-bellied magistrates" who had obtained their position through patronage rather than any medical expertise. Their sluggish reaction to this epidemic did not help that public perception.

The hysteria surrounding this disease was only rivalled by the scandal surrounding the whole medical profession. In the early half of this century, medical schools suffered from a dearth of human cadavers for students to practice on, and had begun to pay quite handsomely for them. In Edinburgh, two enterprising gentleman by the names of Burke and Hare decided to capitalise on this need by making a few corpses of their own, killing 16 people and making approximately £8K in today's money. The complicity of the medical establishment in this case combined with widespread reports of grave-robbing and the publics general distaste for dissection stained the medical establishment. People were now well aware of the high prices doctors would pay for a good corpse. A patient walking into a doctors surgery may have worried that they could be worth more dead than alive.

When Cholera began to spread through Liverpool people began to refer to doctors as "Burkers", invoking the more notorious of the murderers and implying that doctors were profiting from the deaths of their patients. 

The medical board in the meantime were doing their best to contain the disease, setting up new hospitals for patients to go to, and arranging carts to carry sufferers to these hospitals. The doctors and nurses worked hard to help their patients, but were severely hampered by the fact that none of their treatments appeared to work. In fact, it is likely that treatments like bloodletting made the disease a lot more dangerous.

Things however came to a head when Mr Clarke and his wife fell ill from Cholera. The doctors were jeered at by the mob when they brought the woman into the building. At this point the Liverpool Chronicle picks up the story.

“Stones and brickbats were thrown at the premises, several windows were broken, even in the room where the woman, now in a dying state, was lying, and the medical gentleman who was attending her was obliged to seek safety in flight. Several individuals were pursued and attacked by the mob and some hurt."

 The next few days saw the protests escalate. Mobs prevented doctors from carrying away their patients by any means necessary. They would halt the palanquins that were used to carry patients away, and when that didn't work they started to smash them to pieces. In one incident, people opted to hide a patient away from a surgeon tasked with treating her, and upon confronting them is chased across town to take refuge in a shop. Nightly gatherings surrounded the hospital in Toxteth Park. The police were often called in to hold back the worst excesses of the violence, but were simply overwhelmed.

But it wasn't just the fear of the doctors that motivated people. Cholera hospitals were rapidly being set up, bringing sick people to places of business. Some of those in the crowd wanted the doctors to take their grisly business elsewhere. Conspiracy theories abounded about how doctors were perpetuating the epidemic for a £10 "cholera fee" paid out by local bureaucrats. In some cities, Grocers believed doctors were advising people from staying away from certain food, leading them to be pelted with fruit.

The riots in Liverpool were solved when a threatening letter was sent to the mayor of the city. In the content of the letter, the author promised to do "wicked things" to any doctors who attempted to treat their patients. The author signed the letter off simply as "An Irishman". It was this last part of the message that suggested an alternative solution to the violence. Most of the cholera victims were the Irish Catholics crammed together within cramped underbelly of the city, and they were the loudest voices speaking out against doctors.

The Board of Health invited the Catholic clergy into a meeting to discuss solutions to the violence, and the clergy were given a message to deliver to their congregations. The speech addressed people fears about the cholera outbreak, and more importantly announced in no uncertain terms that the people who were dying were not being dissected. Furthermore, they declared that people had the right to go into the hospitals to see this for themselves, and to see the untouched bodies of their deceased before burial.

This was supported by an article published in the Liverpool journal by Dr James Collins , who also made a point of talking to people during church meetings. 

Soon, the streets of Liverpool were once again relatively quiet.

These riots occurred before anybody had a real handle on how infectious diseases spread. It was an era where the doctors had little idea of how to control a cholera outbreak, nor even what truly caused it. But the massive death toll and the incredible civil unrest spurred the government into action nonetheless. At this point, people had started to make the connection between overcrowding and poor sewerage to the spread of disease. The government would soon take steps to solving these problems, but in the process promote a troublesome theory that nearly strangled the nascent science of microbiology in its crib.

References

Burrell S. & Gill G. The Liverpool cholera epidemic of 1832 and anatomical dissection--medical mistrust and civil unrest., Journal of the history of medicine and allied sciences, PMID: 16144959

Puntis J. 1832 cholera riots., Lancet, PMID: 11597715

Gill G., Burrell S. & Brown J. Fear and frustration--the Liverpool cholera riots of 1832., Lancet, PMID: 11476860
Howie W.B. (1981). Stephen T. Anning, The history of medicine in Leeds, Leeds, W. S. Maney, 1980, 8vo, pp. ix, 218, illus., [no price stated], (paperback)., Medical History, 25 (04) 442-443. DOI: 10.1017/S002572730003502X

Further Reading

The First Spasmodic Cholera Epidemic in York, 1832, Issues 37-46 By Michael Durey

* The only doctors who had observed it were those who had been serving in the armed forces in the Empire when this disease swept through India during the Kumbh Mela, hence why it is known as Asiatic Cholera. A second pandemic had been working its way across Europe.

History of Bacteriology :The Rebirth of Microscopy

It was Robert Hooke who first popularised microscopy when he published his seminal work in "Micrographia". He had produced exquisite images of the eye of a fly, of tiny fleas, and of the tiny structures within a cork plant, naming them "cells". However, within five years of its publication, many of its findings were overshadowed by the work of a  mysterious Dutchman.

 The Dutchman in question was a successful garment seller who had developed a keen interest in Microscopy. In his workshop he had quietly begun to develop some of the most advanced microscopes of his era. This man was Anton Leeuwenhoek, and is often credited as the "Father of Microbiology". 

He created the first microscope powerful enough to see the Microbes. He could see organisms too small to be visible to the naked eye, and stunned the world with his intricate drawings of these tiny creatures. He was the first person to discover the existence of single celled organisms, and his regard spread throughout Europe.
 Robert Hooke became a massive fan of Leeuwenhoek, and a supporter of his work. He had but one problem. The entire field of microscopy was "Reduced to a single Votary, which is Mr Leeuwenhoek". Whilst the world was filling with astronomers, mathematicians and naturalists, there was only one person who was looking into the tiny world of single celled organisms.

Why was Anton van Leeuwenhoek the only microscopist left in the world ?   

Hooke believed that it was the lack "of the inquisitive genius of the present age". i.e. no-one was interested in the subject.  But there were somewhat justifiable reasons why people weren't interested in microscopy.

 Leeuwenhoek was intensely defensive of his discoveries, fearing that some other may come along to take the credit. It was an understandable fear. Quite notably Robert Hooke had a long standing dispute with Newton over who discovered gravity first, and believed that Newton had purloined his ideas on the inverse square law and gravitational attraction*.

This is why Leeuwenhoek kept his methods secret, apprenticed no students, and refused to show anyone the microscopes he had used to make his discoveries. Leeuwenhoek's place in history was secured, but his legacy was not. 

When Leeuwenhoek died, he took microbiology with him. Whilst microscopes could be found in some places, they were merely curiosities with no practical function for those wanting to push the boundaries of science. They were incredibly difficult to use, and often produced distorted images, due in part to chromatic aberration. No-one knew how Leeuwenhoek got around these problems, and it would be a long time before anyone would create microscopes of comparable power.

Solving Chromatic Aberration
Lenses work by re-directing light into a focal point by taking advantage of light slowing down when it enters glass. Using shaped glass allows you to bend light, and focus it to magnify an image.

Each part of the wavefront entering the lens is slowed down, but because of the shape of the lens, they are all slowed down for different lengths of time, causing them to be distorted. This means that wavefronts coming out of the convex glass end up focused on one point.

This effect is the basis for telescopes, spectacles and your eye's ability to read the words I've just typed.

Here is the problem. Any optical material can split different wavelengths of light. This is what happens when we pass light through a prism, or when it goes through the raindrops to form a rainbow. The different wavelengths of light are slowed down to different speeds, which is what causes them to separate.
This effect is what causes chromatic aberration. 

Chromatic aberration causes multiple images of different colours to have different focal points. This results in blurry and miscoloured images. Leeuwenhoek's microscopes had sidestepped these problems by being incredibly small, and didn't suffer from chromatic aberrations due to the incredibly small distances involved.

It was an amateur optician named Chester Moores Hall who eventually solved the problem. The answer came to him as a result of his studies of the human eye. He noticed that the human eye itself had a spherical lens, so why wasn't human sight blighted with chromatic aberrations ?

He hypothesised that the jelly like vitreous humour in the eye held the answer. Somehow, the vitreous humour cancelled out the aberrations caused by the lens. He decided to use a similar method to compensate for the chromatic aberrations. He knew that some glasses would separate light in the opposite way to others. So if he used a type of glass that would naturally bend light the opposite way to the lens, he could use it to cancel out the splitting of light caused by chromatic aberration. He decided to use flint glass to form a cover over the lens, and theoretically correct for any aberration.

He had one big problem. He didn't know how to grind his own lenses. He needed to get someone to make his special lenses, but he didn't want any of them to figure out that he had solved chromatic aberration.
To keep his discovery secret, he used different lens-makers to make each part of his new invention separately. One would make the objective lens, and the other would make the corrective cover for it.
But Chester Moores Hall fell victim to an unfortunate coincidence. Neither of these lens makers could make the parts he requested, and both of them decided to subcontract the work onto a man named George Bass. When he constructed both of the primary parts for the lenses, he literally put the pieces together, and figured out what Chester Moores Hall had done.

George Bass mentioned this discovery to another optician, John Dollond, who had also been struggling with the same problem. Dollond immediately patented this discovery, and started selling corrective lenses that accounted for chromatic aberration.

It was his son, Peter Dollond,  who decided to fully enforce those patents. By this time, many other opticians around London were using chromatically corrected lens. Peter Dollond managed to use his fathers patent to try to run them out of business. In the subsequent legal proceedings, Dollond's competitors believed they had an ace in the hole. They called Chester Moores Hall to the stand, who confirmed that he was indeed the true inventor of the achromatic lens, giving them the right to dispute the patent.

The problem was that Chester Moores Hall kept it to himself, which became a major sticking point for the judge. The Judge ruled in favour of Dollond, because Dollond had tried to make a profit from his invention.

 It was a Dutch instrument maker named  Jan van Deijl who had managed apply achromatic lenses to microscopes. But he wanted to get them absolutely right, and spent such a long time perfecting them that the work had to be passed down to his son Harmanus, who would eventually publish that work and set up a company to start selling microscopes.  They suddenly became popular again, and scientists like Giovanni Amici and Joseph Jackson Lister* made further improvements to this design. Microscopy had been successfully rescuscitated.

Soon these instruments were in high demand, with microscope manufacturers popping up across Europe, and then across America.  They became the essential tools for naturalists and physicians, and microscopy became the forefront of important research during this era.

During the next month I will be writing a series of posts on the history of microbiology, focussing mostly on the massive leaps that happened during the 19th century. If I was to point at one reason why microbiology would finally came into its own during this era, I would point you to the microscope. Many of the greatest discoveries of this era simply would not have happened if these instruments had not become fixtures on the desks of reputable scientists around the world, waiting to be used.

References and Further Reading

Cassedy J.H. (1976). The Microscope in American Medical Science, 1840-1860, Isis, 67 (1) 76. DOI: 10.1086/351546

Dobell, Clifford (1932). Antony van Leeuwenhoek and His "Little Animals": being some account of the father of protozoology and bacteriology and his multifarious discoveries in these d

isciplines. New York: Harcourt, Brace and Company. 

Department of the History of Science (Harvard)  Description of Harmanus Van Deijl's compound microscope

Nineteenth-century Scientific Instruments by Gerard L'Estrange Turner

Peter Dollonds answers Jesse Ramsden -http://www.mhs.ox.ac.uk/sphaera/index.htm?issue8/articl5

* The impression I get from what I've read is that Robert Hooke, like many scientists of his era had come up with the rough idea that celestial bodies attract eachother, and that attraction dissipates with distance, but it was Newton who actually went ahead and created a mathematical model with a series of quantifiable laws to explain these phenomena. Hooke had the rough idea of what was going on, Newton had the detailed explanation.

** Not to be confused with his son, Joseph Lister, the pioneer of antisepsis.

TMI Friday: Remember, Remember

This week, fireworks will pepper the skies across England. Now, how does the old poem go ?

Remember Remember the 5th of November, 

Gunpowder treason and plot,

I know of no reason

To celebrate Gunpowder treason

By sticking fireworks 

In the place the sun shineth not !

Our story this week focuses on an electric welder who had been suffering from depression. She had made four suicide attempts towards the end of October, but the one we are most interested in is her fifth (unsuccessful) attempt.

She had bought a set of "Sky Rockets" for this attempt. These contain propellant, which allows the rocket to go into the sky, and a bursting charge to spread out and create that characteristic "Firework" pattern. The tip of the firework was around 4cm in diameter. On the night of the 4th of November, this lady decided that she wanted to go out with a bang.

Picture taken by Peripitus

She inserted the firework 5 cm into her vagina and lit it. The firework did not kill her when it exploded, in fact it did surprisingly little damage. She managed to remove some of the shell fragments herself before she went to hospital (No doubt in terrible agony). She sustained some nasty burns to her peritoneum, buttocks and genitalia. Luckily, the firework didn't pierce here abdomen, and caused surprisingly little damage to her internal organs. In fact, over the next 8 months the patient made a full recovery, and received psychiatric help.

Be safe this Guy Fawkes Night. Don't return to firework after it's lit, Always make sure you are at a safe distance from the firework, and please, please don't insert a lit firework into any of your orifices.

Weiler-Mithoff E.M., Hassall M.E. & Burd D.A.R. (1996). Burns of the female genitalia and perineum, Burns, 22 (5) 390-395. DOI: 10.1016/0305-4179(00)00149-2

#MicroTwJC: Vast Viruses !

Viruses ! Is there any word related to microbiology that conjures up the same fear, the same cache of woe than viruses. The very definition can mean "a harmful or corrupting influence", which is presumably why Miley Cyrus's music is often transmitted via "Viral Videos". People know there is something to fear when they hear of a Virus.

So perhaps it is not mistake that so close to Halloween that the Microbiology Twitter Journal Club is getting together to talk about a new species of GIANT VIRUS.

TMI Friday: A Nasty Rash

Urticaria is a disease that causes rashes, and is most commonly caused by allergic reactions. However, there is one form of this disease known as "Dermatographic Urticaria" which occurs because of excessive scratching or stroking of the skin.
This weeks TMI Friday we are looking at a surprisingly unusual cause of Dermatographic Urticaria.

A 30 year-old, married male reported to the ... Department of Skin and VD (venereal disease) with a history of recurrent itching, redness and swelling on the penis 1-5 minutes after masturbation for the last three months. These lesions persisted for 4-6 hours after which they gradually disappeared of their own accord within 24 hours.

 That's right. Excessive "monkey spanking" can give you a nasty rash. These rashes only occurred after masturbation, and not during intercourse with his wife. It should be noted that he wasn't using any kind of cream or "lubrication" to aid his masturbation. One would think that our patient would stop masturbating when they developed Urticaria, and perhaps engage in more intercourse with their wife. The authors of this paper write one sentence to explain it.

... finding masturbation to be more satisfying than normal vaginal intercourse, the patient continued to masturbate.

 Patients with Urticaria and other skin disorders have been suggested to not find sex as fun as everybody else (Which is a fair cop if you are covered from head to toes in painful rashes).
You may think that using a lotion of some sort would have helped this patient, but as was pointed out in a letter to the journal, the symptoms exhibited here are similar to a disease known as "Pressure Urticaria". When pressure is applied to the skin of someone who has this disease, they will develop a rash in the manner described by the authors.

Ghiya B., Mehta R. & Bumb R. (2008). Masturbation: Can it be urticarogenic?, Indian Journal of Dermatology, Venereology and Leprology, 74 (4) 384. DOI: 10.4103/0378-6323.42904

Godse K. (2009). Urticaria and masturbation, Indian Journal of Dermatology, Venereology and Leprology, 75 (5) 516. DOI: 10.4103/0378-6323.55405

TMI Friday: Wiring up your Joystick

When a man goes into a Doctors surgery complaining of pain and uncontrolled bloody urination, there are many things that could be the cause. However, when that story appears on TMI Friday, one can make a few educated guesses. The question here is what exactly did he do to his own member, and why.

There are a number of incredibly stupid things people will do for sexual gratification, and urethral abuse is one of them. In this case, the big clue came when the doctors performed the physical examination and found a half a centimetre wide and eight centimetre long piece of copper wire protruding from the end of his penis.

apparently, this was the first time he had ever done this, so whilst he managed to get the wire in, he was having a lot of trouble getting it out.

The people of the emergency department attempted to remove it, but since king arthur wasn't available to pull the sword from the bone, they were unsuccessful. An X-ray revealed that the wire had coiled within the patient, making it very difficult to remove. They had to perform surgery to remove the full length of wire. All sixty centimetres of it.

There are some days when I don't know whether to clap or vomit. So I do both, and revel in the delicious spray as it diffracts the light to form a rainbow.

Chattopadhyay S., Das R., Panda N., Mahapatra R., Biswas R. & Jha A. (2011). LONG ELECTRIC WIRE IN URETHRA –AN UNUSUAL PARAPHILIA. CASE REPORT, Jurnalul de Chirurgie, 7 (3) 437-440. DOI:

MicroTwJC: Lasering Bacteria !

This week on Microbiology Twitter Journal Club, we'll be seeing what happens when we hit bacteria with LASERS.

Picture is unrelated

TMI Friday: Do you even lift ?

When I googled penile fracture GIFs, this was the first result

This week in TMI Friday we look at a case study from Taiwan, in which we hear about the many strange and interesting causes of penile fracture.

In the years between 1999 and 2007, there were 13 sufferers of penile fracture reported to Mackay Memorial hospital in Taipei.

For those of you who are not aware of what penile fracture is, it generally only occurs when a penis is fully erect. In this state, it is supported by blood flooding into the corpora cavernosa. This is what causes the penis to harden.  A penile fracture occurs when an extreme force damages the corpora cavernosa , causing the blood to flood out, and for the penis to "Fracture". This fracture is frequently signalled by a cracking noise and an immediate loss of boner. It can be repaired with surgery, although four of the patients refused this treatment, instead opting for icepacks and painkillers.

The most common cause of penile fracture in this study was through violent sexual intercourse, afflicting seven patients. Three patients suffered from penile fracture due to vigorous masturbation. In one unfortunate case, the patient was sleeping, and rolled onto his erection, which was broken by his body weight.

However, the most interesting cases of penile fracture were the final two patients, who suffered their injuries whilst performing a practice known as Chiu Chiu Shen Gong. From what I've read about it, it is a specialised set of exercises devised by martial artists which allows one to lift heavy objects using only the power of one's boner. To perfect this practice no doubt requires dedication, discipline and no doubt a tolerance for pain.

When performing chiu chiu shen gong, a heavy object is lifted by a string which was looped around the penile base with or without scrotal involvement. Penile fracture occurred ........ when the heavy object was suddenly picked up using the penis

What is even more interesting is one of the patients broke their penis, not once, but on two separate occasions whilst attempting to lift heavy weights with their dong. That is dedication, and history does not relate whether they indeed became masters of boner-fu, but in my heart I hope that somewhere, out there, they are using their skills to fight crime.

Shih H.J., Lin W.C., Chan H.K., Yang S., Hsu J.M., Chen M. & Tsei W.K. (2007). Penile Fracture: Analysis of 13 Patients and a Literature Review, Journal of the Taiwan Urological Association, 18 (2) 99-101. DOI:

TMI Friday: Sometimes you shouldn't put a ring on it

"Nocturnal emissions" is the fancy scientific term for orgasms that can occur to people (usually adolescents) during sleep. They are more commonly referred to as "wet dreams", and whilst only real harm they cause comes from having to clean up the mess, they can be quite distressing.
This week, we examine the case from 1931 of a gentleman who suffered from these nocturnal emissions, and came up with a drastic method to deal with them. The man decided that the best way to stop these was to dam the source. He pulled his testicles through a tight hardened steel ring, with the hopes of strangling the source of the sperm.
Five days later, realising his mistake and failing to remove the ring with a hammer and chisel, he admitted himself into hospital. The testicle strangulation had caused fluid to pool within the sack, causing it to swell, making removal of the ring impossible. The doctors applied cold compresses, with the hope that they would cause the testicles to shrink enough to pass through the ring, but to no avail.
There was only one choice left. The doctor called the resident hospital engineer, who noted that the ring was constructed from case hardened steel, and that he would need to use his toughest buzzsaw to remove it properly.
If the prospect of having a high powered whirling blade operate mere millimetres from his delicate parts wasn't enough, the patient also had to worry about heat. The engineer thought this through, and had a solution ready, which he explained to the physician.

[The Engineer].. procured the apparatus and asked me to make arrangements for protecting the scrotum from the heat by drawing a strip of sheet asbestos through between the ring and the skin and by playing a constant stream of water over the surface that was being cut.

This was the 1930's, and no one knew how dangerous asbestos was at the time. But this wasn't the end of the patient's suffering, for there was another quirk of the procedure that the engineer had yet to explain.

[The Engineer]..also warned me that the apparatus, when working, produced a stream of sparks which would necessitate protection both for the patient and for the operator's eyes.

So it was no surprise that the doctor decided to render the patient unconscious for this procedure, which proceeded as dramatically as you might expect.

The heat generated was surprising, and the stream of sparks was projected for fully six feet. Approximately fifty minutes was taken to cut through the ring in two places so that the halves could be separated and removed.

Despite all of these risks, the engineer managed to remove the rings without doing any damage to the patients scrotum, and the patient was able to leave within a day of the ring removal.

Rooke A.B. (1931). Unusual Method of Removing a Foreign Body, British Medical Journal, 702. DOI:

#microtwjc Clostridium difficile

In this week's #microtwjc paper, we discuss a preliminary study that asks whether common acid reflux treatments make Clostridium difficile virulent. 
If ever you have suffered from acid reflux, then you may have been prescribed a "proton pump inhibitor". These act, as you may have been able to guess, on proton pumps within the gut. so what do proton pumps do ?
Proton pumps keep your stomach acidic
In order to keep your stomach acidic, proton pumps act to pump protons (also known as hydrogen ions) into your gut. But in cases where your gut produces too much acid, doctors can prescribe proton pump inhibitors such as Omprezole. They stop the proton pumps, and thus prevent the build up of stomach acid. This de-acidification of the stomach can leave someone vulnerable to gastric infections. A systematic review has shown that proton pump inhibitor treatment is associated with infections by bacteria such as Salmonella, Campylobacter, and Clostridium Difficile *.

TMI Friday: If you lie down with beasts, you get up with diseases

The man arrived at a hospital with severe genital lesions, infection with a disgusting cocktail of different diseases. He said that these lesions started around two months prior to his admittance to the hospital. The question arose as to how he got these lesions.

After some coaxing, the man admitted that he was involved in a few unconventional sexual encounters. Although happily married for 30 years, but the last two months had been rather eventful. I'm going to quote directly from the article.

He had inserted his penis in the cat's mouth and the cat had bitten him causing pain and tenderness. There was no bleeding or ulceration. Subsequently, there was penile injury by a chain-zipper. He subsequently had vaginal intercourse with a bitch 1- 1 / 2 months back which was followed by penile erosions, burning mic­turition and phimosis.

I don't know whether there is anything else I need to say.

  Mittal A., Shennoi S. & Kumar K. (2000). Genital lesions following bestiality , Indian Journal Dermatology Venereology Leprology, (66) 95-96. DOI:

TMI Friday: Quail in fear of fetishes !

The the Japanese quail is a plump and fluffy little creature. Some would say it is adorable, with its round physique and small stature. But this creature hides a dark and dirty secret. It is one of the few animals that can develop a sexual fetish.

Photo of a perfectly normal quail by Ingrid Taylar

The quails deviancy is one of the traits that has made it a target of great interest for scientists studying sexual fetishes.

To give a male quail a specific fetish, the researchers condition them from a young age. Usually, they do this by controlling the adolescent males first interaction with a female. For example, in one experiment, they would expose the males to a sexually receptive female alongside another female that had been artificially adorned with bright orange feathers. Males that were exposed in this way tend to be more likely to copulate with a female with bright orange feathers then males who had not been given this stimulus.

But hold on, it gets even more freaky.

The researchers repeated this experiment once more. This time, they used a slightly different stimulus than before. This time, they conditioned the quails not with a colourfully adorned female quail. This time they used a yellow pound puppy toy. They positioned the toy to mimic the posture of a female quail, and introduced it alongside a sexually receptive female quail. Although the Quails did not wantonly take advantage of the helpless stuffed animal, the researchers found that they were more likely to copulate with a female quail when this stuff toy was present.

Think about that next time your paramour demands that their favourite stuffed toy needs to be present when you "make whoopy" , you may be getting an insight into their earliest sexual experiences. If thay happen to be a quail, that is.

 Domjan M., O'Vary D. & Greene P. (1988). Conditioning of appetitive and consummatory sexual behavior in male Japanese quail., Journal of the Experimental Analysis of Behavior, 50 (3) 505-519. DOI: 10.1901/jeab.1988.50-505