Myrtle The Four-Legged Girl

Jun19

Mrs. Josephine M. Bicknell died only one week before her sixtieth birthday; she was buried in Cleburne, Texas, at the beginning of May, 1928.

Once the coffin was lowered into the ground,her husband James C. Bicknell stood watching as the grave was filled with a thick layer of cement; he waited for an hour, maybe two, until the cement dried completely. Eventually James and the other relatives could head back home, relieved: nobody would be able to steal Mrs. Bicknell’s body – not the doctors, nor the other collectors who had tried to obtain it.

It is strange to think that a lifeless body could be tempting for so many people.
But the lady who was resting under the cement had been famous across the United States, many years before, under her maiden name: Josephine Myrtle Corbin, the Four-Legged Girl from Texas.

Myrtle was born in 1868 in Lincoln County, Tennessee, with a rare fetal anomaly called dipygus: her body was perfectly formed from her head down to her navel, below which it divided into two pelvises, and four lower limbs.

Her two inner legs, although capable of movement, were rudimentary, and at birth they were found laying flat on the belly. They resembled those of a parasitic twin, but in reality there was no twin: during fetal development, her pervis had split along the median axis (in each pair of legs, one was atrophic).

Medical reports of the time stated that

between each pair of legs there is a complete, distinct set of genital organs, both external and internal, each supported by a pubic arch. Each set acts independently of the other, except at the menstrual period. There are apparently two sets of bowels, and two ani; both are perfectly independent,– diarrhoea may be present on one side, constipation on the other.

Myrtle joined Barnum Circus at the age of 13. When she appeared on stage, nothing gave away her unusual condition: apart from the particularly large hips and a clubbed right foot, Myrtle was an attractive girl and had an altogether normal figure. But when she lifted her gown, the public was left breathless.

She married James Clinton Bicknell when she was 19 years old, and the following year she went to Dr. Lewis Whaley on the account of a pain in her left side coupled with other worrying symptoms. When the doctor announced that she was pregnant in her left uterus, Myrtle reacted with surprise:

“I think you are mistaken; if it had been on my right side I would come nearer believing it”; and after further questioning he found, from the patient’s observation, that her right genitals were almost invariably used for coitus.

That first pregnancy sadly ended with an abortion, but later on Myrtle, who had retired from show business, gave birth to four children, all perfectly healthy.

Given the enormous success of her show, other circuses tried to replicate the lucky formula – but charming ladies with supernumerary legs were nowhere to be found.
With typical sideshow creativity, the problem was solved by resorting to some ruse.
The two following diagrams show the trick used to simulate a three-legged and a four-legged woman, as reported in the 1902 book The New Magic (source: Weird Historian).

If you search for Myrtle Corbin’s pictures on the net, you can stumble upon some photographs of Ashley Braistle, the most recent example of a woman with four legs.
The pictures below were taken at her wedding, in July 1994, when she married a plumber from Houston named Wayne: their love had begun after Ashley appeared in a newspaper interview, declaring that she was looking for a “easygoing and sensitive guy“.

Unfortunately on May 11, 1996, Ashley’s life ended in tragedy when she made an attempt at skiing and struck a tree.

Did you guess it?
Ashley’s touching story is actually a trick, just like the ones used by circus people at the turn of the century.
This photographic hoax comes from another bizarre “sideshow”, namely the Weekly World News, a supermarket tabloid known for publishing openly fake news with funny and inventive titles (“Mini-mermaid found in tuna sandwich!” “Hillary Clinton adopts a baby alien!”, “Abraham Lincoln was a woman!”, and so on).

The “news” of Ashley’s demise on the July 4, 1996 issue.

Another example of a Weekly World News cover story.

To end on a more serious note, here’s the good news: nowadays caudal duplications can, in some instances, be surgically corrected after birth (it happened for example in 1968, in 1973 and in 2014).

And luckily, pouring cement is no longer needed in order to prevent jackals from stealing an extraordinary body like the one of Josephine Myrtle Corbin Bicknell.

The Homunculus Inside

Jan27

Paracelsus‘ homunculus, the result of complicated alchemic recipes, is an allegorical figure that fascinated the collective uncoscious for centuries. Its fortune soon surpassed the field of alchemy, and the homunculus was borrowed by literature (Goethe, to quote but one example), psychology (Jung wrote about it), cinema (take the wonderful, ironic Pretorius scene from The Bride of Frankenstein, 1935), and the world of illustration (I’m thinking in particular of Stefano Bessoni). Even today the homunculus hasn’t lost its appeal: the mysterious videos posted by a Russian youtuber, purportedly showing some strange creatures developed through unlikely procedures, scored tens of millions of views.

Yet I will not focus here on the classic, more or less metaphorical homunculus, but rather on the way the word is used in pathology.
Yes beacuse, unbeknownst to you, a rough human figure could be hiding inside your own body.
Welcome to a territory where the grotesque bursts into anatomy.

Let’s take a step back to how life starts.
In the beginning, the fertilized cell (zygote) is but one cell; it immediately starts dividing, generating new cells, which in turn proliferate, transform, migrate. After roughly two weeks, the different cellular populations organize into three main areas (germ layers), each one with its given purpose — every layer is in charge of the formation of a specific kind of structure. These three specialized layers gradually create the various anatomical shapes, building the skin, nerves, bones, organs, apparatuses, and so on. This metamorphosis, this progressive “surfacing” of order ends when the fetus is completely developed.

Sometimes it might happen that this very process, for some reason, gets activated again in adulthood.
It is as if some cells, falling for an unfathomable hallucination, believed they still are at an embryonic stage: therefore they begin weaving new structures, abnormal growths called teratomas, which closely resemble the outcome of the first germ differentiations.

These mad cells start producing hair, bones, teeth, nails, sometimes cerebral or tyroid matter, even whole eyes. Hystologically these tumors, benign in most cases, can appear solid, wrapped inside cystes, or both.

In very rare cases, a teratoma can be so highly differentiated as to take on an antropomorphic shape, albeit rudimentary. These are the so-called fetiform teratomas (homunculus).

Clinical reports of this anomaly really have an uncanny, David Cronenberg quality: one homunculus found in 2003 inside an ovarian teratoma in a 25-year-old virginal woman, showed the presence of brain, spinal chord, ears, teeth, tyroid gland, bone, intestines, trachea, phallic tissue and one eye in the middle of the forehead.
In 2005 another fetiform mass had hairs and arm buds, with fingers and nails. In 2006 a reported homunculus displayed one upper limb and two lower limbs complete with feet and toes. In 2010 another mass presented a foot with fused toes, hair, bones and marrow. In 2015 a 13-year-old patient was found to carry a fetiform teratoma exhibiting hair, vestigial limbs, a rudimentary digestive tube and a cranial formation containing meninxes and neural tissue.

What causes these cells to try and create a new, impossible life? And are we sure that the minuscule, incomplete fetus wasn’t really there from the beginning?
Among the many proposed hypothesis, in fact, there is also the idea that homunculi (difficult to study because of their scarcity in scientific literature) may not be actual tumors, but actually the remnants of a parasitic twin, incapsulated within his sibling’s body during the embryonic phase. If this was the case, they would not qualify as teratomas, falling into the fetus in fetu category.

But the two phenomenons are mainly regarded as separate.
To distinguish one from the other, pathologists rely on the existence of a spinal column (which is present in the fetus in fetu but not in teratomas), on their localization (teratomas are chiefly found near the reproductive area, the fetus in fetu within the retroperitoneal space) and on zygosity (teratomas are often differentiated from the surrounding tissues, as if they were “fraternal twins” in regard to their host, while the fetus in fetu is homozygote).

The study of these anomalous formations might provide valuable information for the understanding of human development and parthenogenesis (essential for the research on stem cells).
But the intriguing aspect is exactly their problematic nature. As I said, each time doctors encounter a homunculus, the issue is always how to categorize it: is it a teratoma or a parasitic twin? A structure that “emerged” later, or a shape which was there from the start?

It is interesting to note that this very uncertainty also has existed in regard to normal embryos for the over 23 centuries. The debate focused on a similar question: do fetuses arise from scratch, or are they preexistent?
This is the ancient dispute between the supporters of epigenesis and preformationism, between those who claimed that embryonic structures formed out of indistinct matter, and those who thought that they were already included in the egg.
Aristotle, while studying chicken embryos, had already speculated that the unborn child’s physical structures acquire solidity little by little, guided by the soul; in the XVIII Century this theory was disputed by preformationism. According to the enthusiasts of this hypothesis (endorsed by high-profile scholars such as Leibniz, Spallanzani and Diderot), the embryo was already perfectly formed inside the egg, ab ovo, only too small to be visible to the naked eye; during development, it would just have to grow in size, as a baby does after birth.
Where did this idea come from? An important part was surely played by a well-known etching by Nicolaas Hartsoeker, who was among the first scientists to observe seminal fluid under the microscope, as well as being a staunch supporter of the existence of minuscule, completely formed fetuses hiding inside the heads of sperm cells.
And Hartsoeker, in turn, had taken inspiration precisely from the famous alchemical depictions of the homunculus.

In a sense, the homunculus appearing in an ancient alchemist’s vial and the ones studied by pathologists nowadays are not that different. They can both be seen as symbols of the enigma of development, of the fundamental mystery surrounding birth and life. Miniature images of the ontological dilemma which has been forever puzzling humanity: do we appear from indistinct chaos, or did our heart and soul exist somewhere, somehow, before we were born?

Little addendum of anatomical pathology (and a bit of genetics)
by Claudia Manini, MD

Teratomas are germ cell tumors composed of an array of tissues derived from two or three embryonic layers (ectoderm, mesoderm, endoderm) in any combination.
The great majority of teratomas are benign cystic tumors mainly located in ovary, containing mature (adult-type) tissues; rarely they contains embryonal tissues (“immature teratomas”) and, if so, they have a higher malignant potential.
The origin of teratomas has been a matter of interest, speculation, and dispute for centuries because of their exotic composition.
The partenogenic theory, which suggests an origin from the primordial germ cell, is now the most widely accepted. The other two theories, one suggesting an origin from blastomeres segregated at an early stage of embryonic development and the second suggesting an origin from embryonal rests have few adherents currently. Support for the germ cell theory has come from anatomic distribution of the tumors, which occurs along the body midline of migration of the primordial germ cell, from the fact that the tumors occur most commonly during the reproductive age (epidemiologic-observational but also experimental data) and from cytogenetic analysis which has demonstrated genotypic differences between omozygous teratomatous tissue and heterozygous host tissue.
The primordial germ cells are the common origins of gametes (spermatozoa and oocyte, that are mature germ cells) which contain a single set of 23 chromosomas (haploid cells). During fertilization two gametes fuse together and originate a new cell which have a dyploid and heterozygous genetic pool (a double set of 23 chromosomas from two different organism).
On the other hand, the cells composing a teratoma show an identical genetic pool between the two sets of chromosomes.
Thus teratomas, even when they unexpectedly give rise to fetiform structures, are a different phenomenon from the fetus in fetu, and they fall within the scope of tumoral and not-malformative pathology.
All this does not lessen the impact of the observation, and a certain awe in considering the differentiation potential of one single germ cell.

References
Kurman JR et al., Blaustein’s pathology of the female genital tract, Springer 2011
Prat J., Pathology of the ovary, Saunders 2004

The premature babies of Coney Island

Dec1

Once upon a time on the circus or carnival midway, among the smell of hot dogs and the barkers’ cries, spectators could witness some amazing side attractions, from fire-eaters to bearded ladies, from electric dancers to the most exotic monstrosities (see f.i. some previous posts here and here).
Beyond our fascination for a time of naive wonder, there is another less-known reason for which we should be grateful to old traveling fairs: among the readers who are looking at this page right now, almost one out of ten is alive thanks to the sideshows.

This is the strange story of how amusement parks, and a visionary doctor’s stubbornness, contributed to save millions of human lives.

Until the end of XIX Century, premature babies had little or no chance of survival. Hospitals did not have neonatal units to provide efficient solutions to the problem, so the preemies were given back to their parents to be taken home — practically, to die. In all evidence, God had decided that those babies were not destined to survive.
In 1878 a famous Parisian obstetrician, Dr. Étienne Stéphane Tarnier, visited an exhibition called Jardin d’Acclimatation which featured, among other displays, a new method for hatching poultry in a controlled, hydraulic heated environment, invented by a Paris Zoo keeper; immediately the doctor thought he could test that same system on premature babies and commissioned a similar box, which allowed control of the temperature of the newborn’s environment.
After the first positive experimentations at the Maternity Hospital in Paris, the incubator was soon equipped with a bell that rang whenever the temperature went too high.
The doctor’s assistant, Pierre Budin, further developed the Tarnier incubator, on one hand studying how to isolate and protect the frail newborn babies from infectious disease, and on the other the correct quantities and methods of alimentation.

Despite the encouraging results, the medical community still failed to recognize the usefulness of incubators. This skepticism mainly stemmed from a widespread mentality: as mentioned before, the common attitude towards premature babies was quite fatalist, and the death of weaker infants was considered inevitable since the most ancient times.

Thus Budin decided to send his collaborator, Dr. Martin Couney, to the 1896 World Exhibition in Berlin. Couney, our story’s true hero, was an uncommon character: besides his knowledge as an obstetrician, he had a strong charisma and true showmanship; these virtues would prove fundamental for the success of his mission, as we shall see.
Couney, with the intent of creating a bit of a fuss in order to better spread the news, had the idea of exhibiting live premature babies inside his incubators. He had the nerve to ask Empress Augusta Victoria herself for permission to use some infants from the Charity Hospital in Berlin. He was granted the favor, as the newborn babies were destined to a certain death anyway.
But none of the infants lodged inside the incubators died, and Couney’s exhibition, called Kinderbrutanstalt (“child hatchery”) immediately became the talk of the town.

This success was repeated the following year in London, at Earl’s Court Exhibition (scoring 3600 visitors each day), and in 1898 at the Trans-Mississippi Exhibition in Omaha, Nebraska. In 1900 he came back to Paris for the World Exhibition, and in 1901 he attended the Pan-American Exhibition in Buffalo, NY.

L'edificio costruito per gli incubatori a Buffalo.

The incubators building in Buffalo.

The incubators at the Buffalo Exhibition.

But in the States Couney met an even stronger resistence to accept this innovation, let alone implementing it in hospitals.
It must be stressed that although he was exhibiting a medical device, inside the various fairs his incubator stand was invariably (and much to his disappointment) confined to the entertainment section rather than the scientific section.
Maybe this was the reason why in 1903 Couney took a courageous decision.

If Americans thought incubators were just some sort of sideshow stunt, well then, he would give them the entertainment they wanted. But they would have to pay for it.

Couney definitively moved to New York, and opened a new attraction at Coney Island amusement park. For the next 40 years, every summer, the doctor exhibited premature babies in his incubators, for a quarter dollar. Spectators flowed in to contemplate those extremely underweight babies, looking so vulnerable and delicate as they slept in their temperate glass boxes. “Oh my, look how tiny!“, you could hear the crowd uttering, as people rolled along the railing separating them from the aisle where the incubators were lined up.

In order to accentuate the minuscule size of his preemies, Couney began resorting to some tricks: if the baby wasn’t small enough, he would add more blankets around his little body, to make him look tinier. Madame Louise Recht, a nurse who had been by Couney’s side since the very first exhibitions in Paris, from time to time would slip her ring over the babies’ hands, to demonstrate how thin their wrists were: but in reality the ring was oversized even for the nurse’s fingers.

Madame Louise Recht con uno dei neonati.

Madame Louise Recht with a newborn baby.

Preemie wearing on his wrist the nurse’s sparkler.

Couney’s enterprise, which soon grew into two separate incubation centers (one in Luna Park and the other in Dreamland), could seem quite cynical today. But it actually was not.
All the babies hosted in his attractions had been turned down by city hospitals, and given back to the parents who had no hope of saving them; the “Doctor Incubator” promised families that he would treat the babies without any expense on their part, as long as he could exhibit the preemies in public. The 25 cents people paid to see the newborn babies completely covered the high incubation and feeding expenses, even granting a modest profit to Couney and his collaborators. This way, parents had a chance to see their baby survive without paying a cent, and Couney could keep on raising awareness about the importance and effectiveness of his method.
Couney did not make any race distinction either, exhibiting colored babies along with white babies — an attitude that was quite rare at the beginning of the century in America. Among the “guests” displayed in his incubators, was at one point Couney’s own premature daughter, Hildegarde, who later became a nurse and worked with her father on the attraction.

Nurses with babies at Flushing World Fair, NY. At the center is Couney’s daughter, Hildegarde.

Besides his two establishments in Coney Island (one of which was destroyed during the 1911 terrible Dreamland fire), Couney continued touring the US with his incubators, from Chicago to St. Louis, to San Francisco.
In forty years, he treated around 8000 babies, and saved at least 6500; but his endless persistence in popularizing the incubator had much lager effects. His efforts, on the long run, contributed to the opening of the first neonatal intensive care units, which are now common in hospitals all around the world.

After a peak in popularity during the first decades of the XX Century, at the end of the 30s the success of Couney’s incubators began to decrease. It had become an old and trite attraction.
When the first premature infant station opened at Cornell’s New York Hospital in 1943, Couney told his nephew: “my work is done“. After 40 years of what he had always considered propaganda for a good cause, he definitively shut down his Coney Island enterprise.

Martin Arthur Couney (1870–1950).

The majority of information in this post comes from the most accurate study on the subject, by Dr. William A. Silverman (Incubator-Baby Side Shows, Pediatrics, 1979).

(Thanks, Claudia!)

X-ray Film

Nov7

Chris Munger è un regista che ha diretto una manciata di oscuri titoli negli anni ’70. Attorno al 1968, quando era uno studente di cinema all’UCLA, ha diretto questo cortometraggio sperimentale, in seguito distribuito da Pyramid Films.

In un catalogo, il film viene descritto come un “commento cinico sull’ingenuità romantica rispetto ai nostri corpi, in particolare in termini di relazioni amorose”. Il corto è aperto a molteplici interpretazioni, ma non siamo sicuri che sia corretto leggerci tutto questo disincanto; certo, il finale sembra ammonirci sulla reale portata delle nostre intenzioni (davvero è una decisione quella di innamorarsi, o è il risultato di forze biologiche interne di cui non siamo consci?), ma allo stesso tempo ci sembra che le note del compositore olandese Henk Badings, unite alle immagini a raggi X che sondano le profondità nascoste del nostro essere, creino un senso sospeso di meraviglia e di mistero. Il mistero è, appunto, quello dell’uomo in rapporto al suo stesso corpo, dalla nascita all’accoppiamento e alla nuova vita.

Il film è uno sguardo su ciò che resta normalmente occultato alla vista, quasi alla caccia di indizi, di una spiegazione o di un dettaglio illuminante che risultano però impossibili da trovare: il cinismo sarebbe ridurre l’amore all’anatomia, quando l’anatomia non fa altro che aggiungere profondità al suo segreto.

[vimeo http://vimeo.com/72703151]

Placentofagia

Feb24

Qualche tempo fa, Nicole Kidman dichiarò di aver mangiato la placenta dopo il suo ultimo parto. (Dichiarò anche di bere la propria urina per mantenersi giovane, ma quella è un’altra storia). Follie da VIP, direte. E invece pare che la moda stia prendendo piede.

La placenta, si sa, è quell’organo tipico dei mammiferi che serve a scambiare il nutrimento fra il corpo della madre e il feto, “avvicinando” le due circolazioni sanguigne tanto da far passare le sostanze nutritive e l’ossigeno attraverso una membrana chiamata barriera placentale, che divide la parte di placenta che appartiene alla mamma (placenta decidua) da quella del feto (corion). La placenta si distacca e viene espulsa durante il secondamento, la fase immediatamente successiva al parto; si tratta dell’unico organo umano che viene “perso” una volta terminata la sua funzione.

Quasi tutti i mammiferi mangiano la propria placenta dopo il parto: si tratta infatti di un organo ricco di sostanze nutritive e, sembrerebbe, contiene ossitocina e prostaglandine che aiutano l’utero a ritornare alle dimensioni normali ed alleviano lo stress del parto. Anche gli erbivori, come capre o cavalli, stranamente sembrano apprezzare questo strappo alla loro dieta vegetariana. Pochi mammiferi fanno eccezione e non praticano la placentofagia: il cammello, ad esempio, le balene e le foche. Anche i marsupiali non la mangiano, ma anche se volessero, non potrebbero – la loro placenta non viene espulsa ma riassorbita.

Se per quanto riguarda gli animali è intuitivo comprendere lo sfruttamento di una risorsa tanto nutritiva alla fine di un processo estenuante come il parto, diverso è il discorso per gli umani. Noi siamo normalmente ben nutriti, e non avremmo realmente bisogno di questo “tiramisù” naturale. Perché allora si sta diffondendo la moda della placentofagia?

La motivazione di questa pratica, almeno a sentire i sostenitori, sarebbe il tentativo di evitare o lenire la depressione post-partum. Più precisamente, la placenta avrebbe il potere di far sparire i sintomi del cosiddetto baby blues (quel senso di leggera depressione e irritabilità che il 70% delle neomamme dice di provare per qualche giorno dopo il parto), evitando quindi che degenerino in una depressione più seria. Sfortunatamente, nessuna ricerca scientifica ha mai suffragato queste teorie. Non c’è alcun motivo medico per mangiare la placenta. Ma le mode della medicina alternativa, si sa, di questo non si curano granché.

E così ecco spuntare decine di video su YouTube, e siti che propongono ricette culinarie a base di placenta: c’è chi la salta in padella con le cipolle e il pomodoro, chi preferisce farne un ragù per la lasagna o gli spaghetti, chi la disidrata e ne ricava una sorta di “dado in polvere” per insaporire le vivande quotidiane. Se siete persone più esclusive, potete sempre prepararvi un bel cocktail di placenta da sorseggiare a bordo piscina. Ecco un breve ricettario (in inglese) tratto dal sito per mamme Mothers 35 Plus.

Consci che l’idea di mangiare la propria placenta può non solleticare tutti i nostri lettori, vi suggeriamo un ultimo utilizzo, certamente più artistico, che sta pure prendendo piede. Si tratta delle cosiddette placenta prints, ovvero “stampe di placenta”. Il metodo è semplicissimo: piazzate la placenta fresca, ancora ricoperta di sangue, su un tavolo; premeteci sopra un foglio da disegno, in modo che il sangue imprima la figura sulla carta. Potete anche spargere un po’ di inchiostro sulla placenta prima di passarci sopra il foglio, così da ottenere risultati più duraturi. E voilà, ecco che avrete un bel quadretto a ricordo del vostro travaglio, da incorniciare e appendere nell’angolo più in vista del vostro salotto.