Sunday, April 29, 2012

Thousands of Swallowed Objects Form Curious Collection

By Marc Hartzman

In a museum filled with preserved abnormal fetuses, giant and dwarf skeletons, and an 8-foot colon, what makes a cabinet full of safety pins, small trinkets and other random items one of the most fascinating exhibits?

For starters, each one of these objects - and there are thousands - was swallowed and extracted. The curious can get a closer look at the carefully catalogued items at the Mütter Museum of The College of Physicians of Philadelphia.

The collection was assembled and donated to the museum by Chevalier Jackson, a pioneering laryngologist of the late 19th and early 20th centuries.

Jackson developed innovative techniques and instruments to safely remove foreign bodies from the esophagus and airways, essentially creating modern endoscopy. He performed this service in Philadelphia, saving thousands of lives, and kept each of the removed objects. While the museum displays a great portion of the items, the actual case studies of the patients are kept at the National Library of Medicine in Bethesda, Md.
As visitors to the museum explore the various drawers, they're left with a sense of astonishment and wonder. How could someone swallow such things? And how did someone get them out?

These questions and more are answered in Mary Cappello's new book, "Swallow: Foreign Bodies, Their Ingestion, Inspiration, and the Curious Doctor Who Extracted Them" (The New Press).

In it, we learn much more - not only about Jackson, but the lives of the people who once ingested the objects on display.
Cappello, a professor of English and creative writing at the University of Rhode Island and a 2011 Guggenheim Fellow, first stumbled upon the exhibit during a trip to see the giant colon display. She remembered initially thinking, what on earth is this?

"Opening the drawers is one thing, dwelling with them is another," Cappello told AOL News. "You rediscover the lives of the people attached to the case histories. It runs the gamut from comic to tragic. In some cases, it's not about accidents, it's about voluntary swallowing, a social history of hunger, confounding human psychology, class, race."

Take, for example, the 1923 case of a baby boy, Joseph B. According to his account, Jackson removed 32 foreign bodies from within the child, including buttons, closed safety pins, bent straight pins, cigarette butts and burnt matches.
Joseph's mother had ignored signs at home, dismissing evidence - such as a button found in her son's stool - by assuming it fell off his clothing. Buried inside the case study, Cappello found what she considered a "throwaway line" offering an explanation:

"According to a statement made by both the father and the mother, the child was cared for by a friend on May 28, and they believe that she deliberately fed these many articles to the child." The question of why this caretaker would have done such a thing is not discussed.

"Jackson wasn't really interested in human psychology," Cappello said. "He was trying to master the foreign body. But he had to leave certain things out of his inquiry. He mastered it as a mechanical problem. But not the problems the foreign body presented to him when it involved human psychology."
While many cases may have involved bizarre psychological circumstances - either by force or self-inflicted - Jackson preached carelessness as the main cause of foreign body ingestion. In a 1937 article, he wrote, "Chew your milk!" He continued to explain that people eat too fast; even milk should be sipped, rolled around in the mouth and mixed with saliva before swallowing.

As for things that should never be chewed - let alone put in the mouth - Jackson found blame in the swallower or someone indirectly related. A sharp-pointed piece of wire in a woman's esophagus "points to the carelessness of using an old broken egg-beater in making the custard pie."

Among his other theories are "Care should be taken, when cooking or serving food, to see that there are no loose pins or buttons in the waist that could fall into the food" and "Chewing of pencils, toothpicks, grass, stalks, straw, etc., apart from general objections, is a source of foreign body accidents."

But Cappello dug deeper.

"Jackson never considered that poor children might have swallowed objects more frequently, not because they were the victims of careless caretakers or lacked self-control but because they were starving," she wrote.

The museum currently is expanding the Jackson collection with Cappello's help as co-curator. It's now housed in a new exhibit case and opens on two sides to allow greater access. According to museum curator Anna Dhody, it soon will add additional pieces, including a variety of Jackson's endoscopy instruments and his illustrated artwork of extraction techniques.

"It's an art object as much as it is a testament to the stories of patients and a testament to the work of this doctor," Cappello said of the exhibit. "A beautiful and intriguing strange work of art."

Source : http://www.aolnews.com

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