Through his study of his 2017 book on the history of heart surgery, medical journalist examined Thomas Morris hundreds of 19th-century journals. One day, a headline on the page opposite to what he read, saw: "Sudden protrusion of the whole intestine in the scrotum." It was a bizarre case from the 1820s where a worker was transferred by a brick wagon. The resulting hernia forced the intestines into his scrotum, yet the worker made a full return.
When he first came across his first amused disgust, Morris was struck by the sheer ingenuity that the doctors showed for the treatment of man's condition. And he found plenty of other similar bizarre cases as he continued his research with people who survived really scary damage – a testament to human resilience. "Doctors, even when they had less than a tenth of the knowledge we do today in dealing with major trauma, can still come up with innovative and ingenious solutions to acute problems," he said.
Many of the most interesting medical cases Morris uncovered can be found in his hugely entertaining compendium of medical odds, The Exploding Teeth Mystery and Other Curiosities from Medical History . Regular readers of his blog (tagline: "make you grateful for modern medicine") will experience stories of a swallowing sailor, a soldier who removed his own bladder stone, a man with flammable belches, a woman who crawled his nose, and a boy who inhaled a bird's larynx and began to sneak like a goose. All are delivered in elegant prose, designed with the author's distinctive turf. Morris has so far retrieved 500 or so of these often jaw-dropping cases, and included only 70 or so in the book. So a sequel (or two) is not out of the question
The titular case relates to numerous 1900s occurrences of people experiencing an increasingly painful toothache, followed by a sudden crack that resembles a gunshot which tooth exploded, provides immediate relief. The outbreak was sufficient to nearly smash a young woman who partially killed her for weeks after.
Why did the teeth explode? Several theories were proposed, such as tooth decay, which caused a build up of gas leading to tooth rupture, perhaps from the chemicals used to make early fillers. But there is no record of any of the patients experiencing exploding teeth that have had fillings. The cause remains a mystery for this day, and nothing has been reported in medical journals since the 1920s, according to Morris.
One of the more memorable cases Morris describes relates to a 25-year-old man in San Francisco who was critically injured in 1858 when an old shotgun exploded in his grip and drove a large slug of iron into his chest. A renowned surgeon of the era, Elias Samuel Cooper, did not have access to modern technologies such as X-ray imaging to help him find the metal that had been placed just below the man's heart.
So he opened the rib and just started to hold around. Initially, he did this without anesthesia, although it was time to get into the thoracic cavity and remove the slug, Cooper mercifully gave some (probably ether). "The thought that a surgeon in 1858 would put his hand under the patient's heart – I never came across anything like that for many years examining heart surgery," Morris said.
"There is a great propensity for people to do really stupid things that involve holding foreign objects in their openings."
An entire paragraph is devoted to dealing with various objects that are stuck in peoples openings – as the 16th century monk who put a perfume bottle into the rectum, probably to "relieve cholic," or so claimed the monk. "There is a tremendous constant propensity for people's ability, especially young men, to do really stupid things that involve holding foreign objects in their openings," Morris said. "There are whole papers on foreign matter from the 19th century and earlier, listing hundreds if not thousands of cases." Modern emergency rooms regularly see this kind of thing, so clearly human nature has not changed much in the following centuries.
Over the decades of the 19th century, surgeons became increasingly bold about what they thought they could do for their patients until several high-profile disasters led to the fate of ethical soul searching to balance innovation with patients need. Among the most notable: a Chinese man suffering from a severely engorged scrotum who chose surgery, although the condition did not appear to be life-threatening. He spent hours in pain on the table, without anesthesia (and a large number of spectators) and eventually died of shock and blood loss.
"This operation subsequently received correspondence in the professional journals afterwards," Morris said. "There were some surgeons who were completely appalling and felt it was a terrible guilt of sending this man to the surgery."
While there is plenty of humor and twitter except in the book, Morris is firmly convinced that it was never his intention to simply suck the doctors practicing in those earlier eras. "I think it's all too easy to laugh at the idea that they used to use leeches or all those poisonous belladonna and deadly nightshade," he said. "Whatever a doctor did in 1780, was part of a thought system, they had been taught by their teachers and passed on to their students. You are talking about people who did not have a tenth of our understanding of microbiological or disease mechanisms. It is wrong to judge historically without regard to this context. "