I’ve hit a bit of a creative roadblock lately, hence the lack of recent articles. Rest assured, I’ve got many ideas but I’ve been debating with myself on their presentation, analysis and what not. In any case, I’ve stumbled upon some pretty neat stuff – pictures, videos and ideas – in the past few weeks that I felt I needed to share. Not all of it is enough for me to expand upon in one single post so I’ve smushed them all together into what I like to call a ‘Body Horrors’ Amuse-Bouche’ that should be enough to tide you over until I have a more substantial, analytical article next week or so. Behold!
The National Library of Medicine has nearly 70,000 images in the collections of the History of Medicine Division. Depending on what you consider to be a fun-filled afternoon, this is a great place to spend your time leisurely hunting for retro public health posters and looking at pictures of medical procedures, infections and the like. It’s where I recently discovered some truly heartbreaking pictures of three Filipino leprosy patients photographed by a US military surgeon, Major Frank R. Keefer, in the late nineteenth century.
The bacterium Mycobacterim leprae infects the skin the and peripheral nerves resulting in decreased sensitivity. Over time, minor abrasions and injuries to those areas can worsen as the patient fails to sense pain or marked temperature changes and take the necessary precautions to protect oneself. The injuries can worsen and sustain enough cumulative trauma to the point of needing surgical excision or amputation. The patients in the photos here quite obviously have experienced significant deformity and disfigurement due to repeated injuries to their face and fingers.
There’s a few items of note in these images that I’d like to point out that should give you a better understanding of the disease and its symptoms. These patients quite obviously show evidence of serious nasal and ocular deformities as a result of their advanced illness, which I’m quite comfortable in speculating (yes, speculate!) as cases of lepromatous leprosy. M. leprae can infect the nasal mucosa and bone leading to “saddle-nose deformity” in which the nasal septum collapses; these patients seem to have suffered this tragedy along with some serious erosion and ulceration of the remaining nasal tip. Fish-mouth deformity is also common in advanced disease. Repeated ulceration and scarring of the lips can give way to a sort of gaping appearance that we can see in all three of these images.
The ocular damage and blindness are a result of lagopthalmos, in which the eyelids are unable to close completely, or recurrent uveitis (eye) infections. With laopthalmos, the inability to close the eyelids exposes the eye to significant dryness leading to corneal abrasions, glaucoma, uveitis and blindness. You can also see madarosis, or loss of the eyebrows and eyelashes. M. leprae likes living in cooler regions of the body – the eyebrows, cheeks and earlobes, to name a few relatively frosty anatomical locales. These infected regions will lose hair, grow diffuse scaly patches or develop thick nodules and can usher in another commonly associated trait of lepromatous leprosy, leonine fasces, in which the patient gains a lion-like resemblance.
In the image below, the patient’ss hands are contracted into what is commonly known as “claw hands”. Infection of the peripheral nerves has reduced the length of the tendons and a concurrent loss of muscle strength has resulted in the tense, death grip seen in the last picture below. Deadened nerves and trauma have rendered the skin scabrous and shiny as can be seen on the patient’s forearms.
Thankfully, these days we don’t see this level of disfigurement and suffering among those infected with leprosy, if we even see it at all. For most people today, symptoms are usually spotted by a dermatologist or infectious disease specialist before fingers and toes have become sufficiently walloped and need to be amputated. The worst that tends to occur are shiny insensitive rashes on the trunk of the body and legs and loss of sensation in the fingers and toes. The antibiotic regime to treat and cure leprosy is so flabbergastingly simple that it sends the mind reeling to consider the millions of people that have suffered from this disease throughout the history of mankind.
I seem to be spending an unnecessary amount of time watching various parasitic worm-related activities on Youtube. To each their own, I guess. Below is a delightful video of an exploratory surgery conducted on a woman complaining of abdominal pain in Nepal. An ultrasound proved inconclusive as to the cause so surgeons investigated and discovered a rather large obstruction: hundreds of large roundworms known as Ascaris lumbricoides were jam-packed into this poor woman’s large intestine forming an impacting bolus. A. lumbricoides has the honor of being the largest intestinal roundworm on the planet and infects humans in a similar methods as hookworm and whipworm, by penetrating through bare feet on contaminated soil. Don’t watch this if spaghetti and meatballs is the planned dinner menu for the evening.
The website Sociological Images does all-around great stuff examining media from a sociological perspective. Their piece from June 2011 on the virgin/whore binary in venereal disease propaganda from the World War II era is really a treat. An earlier article on the personification of sexually-transmitted diseasesas women is also enlightening. These colorful posters do some very limited Point-A-to-Point-B reasoning in attributing the transmission of venereal disease strictly to women and assuming that soldiers are innocent victims. Only promiscuous women are perceived as the vectors of syphilis and gonorrhea, not a consideration of the behaviors implicit in the spread of sexually transmitted diseases.
Ok, so that’s what I got, guys. I’ll be back shortly with something good, I promise!