New Scientist profiles the Wellcome Collection’s Exquisite Bodies exhibit looking at the portrayal of human anatomy in the Victorian era. I can almost guarantee that the next time I’m in London I will be at the Wellcome Collection; looks very interesting.

While I was away on the interview trail a very interesting story hit the media wires. In Colorado a pediatric neurosurgeon went in to sample/remove a tumor from a young child’s brain. What he found was that the tumor contained fully formed anatomical parts. Included was a fully formed foot.

“It looked like the breech delivery of a baby, coming out of the brain,” Grabb said. “To find a perfectly formed structure (like this) is extremely unique, unusual, borderline unheard of.”

[...]

Sam’s parents, Tiffnie and Manuel Esquibel, said their son is at home now but faces monthly blood tests to check for signs of cancer or regrowth, along with physical therapy to improve the use of his neck. But they say he has mostly recovered from the Oct. 3 surgery.

“You’d never know if he didn’t have a scar there,” Tiffnie Esquibel said.

The question is how did this happen.

The Foot In Surgery

Teratomas are a type of germ cell tumor which can occur in the brain. They develop from embryological cell lines and often develop characteristic mature tissue including skin, hair, teeth. Cases have certainly been reported of even more complex structures appearing in teratomas, including eyes. Approximately one hundred cases of a situation called fetus in fetu have been reported. In such cases a born child ends up having parts of his assumed twin growing somewhere inside of him. Fetus in fetu often have even more complex structures, including what often appear as fully formed limbs and organ systems. As in this case.

I’m not sure if a case of fetus in fetu has ever been reported inside the cranium. Still, teratomas often occur there and in some people’s opinion fetus in fetu should be considered a highly rare form of teratoma. In anycase, this is an incredibly rare and interesting discovery. My thoughts are with the family but if the AP report is to be believed the kid is doing well.

A Roll From The Restored Edwin Smith Papyrus

In 1862 an American Egyptologist was far from the war that was engulfing America. In that year Edwin Smith bought a manuscript from an Egyptian collector in Luxor. A prolific collector of Ancient Egyptian manuscripts and finds, Smith was, apparently, never the less not the most gifted translator. He held onto the manuscript for more than forty five years, until his death in 1906 and in that time was not able to make substantial progress in translating the papyrus. At his death his daughter donated the papyrus, and other parts of her father’s collection, to the New York Historical Society.

In 1920 the Historical Society brought on the famous Egyptologist James Breasted to translate the papyrus. His completed translation was published a decade later.

What he translated was pretty fascinating

The papyrus is a medical textbook. Its clarity, conciseness and organization are remarkable for a medical treatise of the time. But perhaps even more impressive is its presentation of incredibly accurate physical examination and anatomical findings; along with rather reasonable treatment options.

It is also the first real neuroanatomical study. The document is broken up into forty eight cases and is an incomplete copy of a previous work. Of the 48 cases, 27 deal with head trauma and another 6 with spinal trauma. In presenting these cases the papyrus is the oldest surviving document to describe the sulci and gyri on the surface of the brain, the meninges, and the cerebral spinal fluid.

Breasted Translated This Hieroglyph As The Membrane Covering The Brain

Consider the following Breasted translation of one of the cases.

Title: Instructions concerning a smash in his skull under the skin of his head.

Examination: If thou examinest a man having a smash of his skull, under the skin of his head, while there is nothing at all upon it, thou shouldst palpate his wound. Shouldst thou find that there is a swelling protruding on the out side of that smash which is in his skull, while his eye is askew because of it, on the side of him having that injury which is in his skull; (and) he walks shuffling with his sole, on the side of him having that injury which is in his skull…

Diagnosis: Thou shouldst account him one whom something entering from outside has smitten, as one who does not release the head of his shoul fork, and one who does not fall with his nails in the middle of his palm; while he discharges blood from both his nostrils (and) from both his ears, (and) he suffers with stiffness in his neck. An ailment not to be treated.

Treatment: His treatment is sitting, until he [gains color], (and) until thou knowest he has reached the decisive point….

Gloss: As for: “He walks shuffling with his sole,” he (the surgeon) is speaking about his walking with his sole dragging, so that it is not easy for him to walk, when it (the sole) is feeble and turned over, while the tips of his toes are contracted to the ball of his sole, and they (the toes) walk fumbling the ground. He (the surgeon) says: “He shuffles,” concerning it…

This appears, per many people’s interpretation, to refer to a closed skull fracture; with a pretty interesting description of some occular motor palsy and an ipsilateral lower extremity paralysis. Of the cases dealing with neurotrauma, they break down like this,

[The neurotrauma cases,] according to our present day terminology would be classified as follows: two compound linear fractures; four compound depressed fractures; four compound comminuted fractures; and one comminuted fracture without external wound. The symptoms and signs of head injury are given in considerable detail. Feeble pulse and fever are associated with hopeless injuries and deafness as well as aphasia are recognized in fractures of the temporal region.

James Breasted attributed the original treatise to Imhotep, the “Father of Medicine.” Such attribution would put the original work (of which the Edwin Smith Papyrus is clearly a transcription of) a 1000 years earlier. That would mean that these description of the brain and its coverings and the cerebrospinal fluid and all these detailed examination findings were recorded more than 5000 years ago.

Pretty incredible.