Year: 2009

The Boston Globe has an excellent article on the moment when a a group of huddled doctors turned a side-show curiosity into the medical revolution of surgical anaesthesia.

16th October 1846, Boston, Massachusetts, was when the first operation under anaesthesia was conducted in with a brave patient and liberal doses of ether.

The piece is interesting because it notes that the pain killing properties of certain gases or vapours, like laughing gas (nitrous oxide) and ether, were already well known, but the use of them in an operation needed a fundamental change of attitude in the medical establishment.

This was largely due to the fact that pain was considered beneficial during an operation, as it ‘stimulated’ the patient and supposedly made them less likely to die, but because that experiencing pain was considered to be morally virtuous.

Removing pain through ‘artificial’ means was therefore considered ethically dubious and consequently regarded by suspicion by the high horse riding doctors of the time.

Interestingly, the article notes that some of these views continue to this day in attitudes regarding anaesthetics and ‘natural’ childbirth:

Before 1846, the vast majority of religious and medical opinion held that pain was inseparable from sensation in general, and thus from life itself. Though the idea of pain as necessary may seem primitive and brutal to us today, it lingers in certain corners of healthcare, such as obstetrics and childbirth, where epidurals and caesarean sections still carry the taint of moral opprobrium.

In the early 19th century, doctors interested in the pain-relieving properties of ether and nitrous oxide were characterized as cranks and profiteers. The case against them was not merely practical, but moral: They were seen as seeking to exploit their patients’ base and cowardly instincts. Furthermore, by whipping up the fear of operations, they were frightening others away from surgery and damaging public health.

The article is by Mike Jay who wrote the The Air Loom Gang, a biography of madman, spy and accidental architect James Tilly Matthews.

The biography is one of my favourite books of all time and was interested to see that Jay has another book just out called The Atmosphere of Heaven about a Victorian medical society who pioneered the study of laughing gas.

Link to Boston Globe article ‘The day pain died’.

An upcoming article for the Journal of Forensic Sciences gives a fascinating insight into the rituals and methods of the Sacra Corona Unita (United Holy Crown) Mafia group from Southern Italy through the post-mortem examination of the bodies of their victims.

Many of the victims are members of the Sacra Corona Unita themselves, giving an insight in the organisation’s “mystical approach to all ceremonies among members. Tribal rituals, secret codes, and theatrical punishments transformed the ‘onorata societ√†’ into a kind of distorted Masonic lodge”.

The article recounts the oath of the criminal fraternity and the significance of their tattoos, as well as describing a study on 83 murder victims. Strikingly, each of the victims who were Mafia victims themselves had a ritual object left with them.

As usual in mafia organizations, each member had a nickname, and ritual symbolic objects were found beside the buried bodies that referred to the member’s lifetime. For instance, the horns of a bullock were found beside the body of the son of an SCU member named the “Bull” and a mouse beside the body of a member known to be a police informer, known as the “Prostitute.

The murder and burning of the bodies of the victims conformed to the symbolic code understood by all the members. It made explicit reference to the membership ceremonies that warn that the unfaithful will be burned to ashes (just like the holy picture burned during the ceremony).

This technique, obviously, also has some strategic advantages because it makes the possibility of identifying the victim more unlikely and eliminates any traces left by the executors. This mode of operation is called “lupara bianca” (white lupara): “lupara” is a gun with a sawn-off barrel with a high lacerating power at short distance, “white” means a “murder with disappearance of the body.”

Link to article.
Link to DOI entry for same.

When scuba divers start swimming deep under water they can sometimes start feeling dreamy, light-headed and mentally fuzzy, an effect nicknamed ‘rapture of the deep’ but better known as nitrogen narcosis.

It is caused by changes in the way nitrogen, one of the gases in the divers’ air tank, dissolves in the body when under high pressure from the depth of the water.

No-one is quite sure exactly how it affects the brain, but many divers have noted the similarity between nitrogen narcosis and being drunk.

Psychologist Malcom Hobbs was intrigued by this connection and conducted a study [pdf], published last year in Undersea and Hyperbaric Medicine, to investigate the psychological similarity between the two states.

The experiment compared the subjective experience and effects on problem solving of alcohol and narcosis, but, also rather elegantly, looked at whether the two effects could be caused by a similar neurobiological process by seeing whether people with high alcohol tolerance also had a high narcosis tolerance.

Hobbs divided a group of divers into experienced and novice divers, as those with more experience should be more tolerant to narcosis, and made a further division between those who drank a lot of booze and those who drank very little, to look at differences in alcohol tolerance.

In the first experiment, they found the interesting effect where experienced divers adapted to the subjective effects of narcosis, but not the behavioural effects. While they felt more in control than novice divers, they actually weren’t. This chimes with an identical effect seen in heavy vs light drinkers.

But crucially, Hobbs also found that those affected to a greater degree by nitrogen narcosis are affected to a greater degree by alcohol on both subjective experiences and performance on the problem solving task (and vice versa), indicating that there is cross tolerance between the two states.

This suggests that they may affect the brain in similar ways. Although more research needs to be done on the actual neurobiology of the two states to be sure of the exact relationship, this study suggests that divers may indeed be ‘drunk’ when experiencing the rapture of the deep.

UPDATE: I just got emailed this interesting snippet by an experienced diver friend (thanks Ben!):

Something extra which happens with narcosis (which deviates from the alcohol analogy) is that, unless you’re already dead, the effects are completely reversible with no discernible side effects (eg hangover). One of the tricks divers use if they recognize narcosis (most often in their buddy than in themselves) is that ascending a few metres will often bring immediate clarity.

Even more interesting is that once clarity is achieved, descent back to the narcotic depth doesn’t necessarily bring back the narcotic effect of the nitrogen, which hasn’t really been explained yet. Theories abound regarding rate of descent and physiological effects of increasing ppN [partial pressure of nitrogen] and how it’s dissolved into various tissues.

Divers have known for years about this and have developed practical methods to deal with its effects (decreasing N content in breathing gases, replacing N with other inert gases etc). Actually, it’s known that oxygen also has a role to play in narcosis (as in nitrous oxide) but since some of it is metabolized, it’s effects are considerably less than the inert gas it accompanies.

I quite like the feeling of a little narcosis; but it does make time fly, and unfortunately time is the real enemy underwater!

pdf of full-text scientific paper.
Link to PubMed entry for same.

One of the new ideas in synaesthesia research is that affected people perhaps don’t develop mixed senses as their brains develop, they just fail to lose them. It seems most children might start with naturally mixed senses before perception becomes segregated through pruning of the fuzzy neural pathways.

I’ve just noted an interesting article in Cognitive Neuropsychology on how this idea actually has long historical routes, and even influenced Mary Shelly’s cryopunk classic Frankenstein.

Although Mary Shelley was only 19 when she wrote her timeless novel, Frankenstein (1818), she combined contemporary philosophical and moral issues with a vision of the danger of emerging sciences that still has relevance today. The specific idea of early unity of the senses, very likely inspired by Rousseau, was articulated by Frankenstein’s creation in his first-person account of his early experiences:

“It is with considerable difficulty that I remember the original era of my being: all the events of that period appear confused and indistinct. A strange multiplicity of sensations seized me, and I saw, felt, heard, and smelt, at the same time; and it was, indeed, a long time before I learned to distinguish between the operations of my various senses. [Mary Shelley, Frankenstein (1818), chapter 11]”

Shelley goes on to present the creature as very humanlike, and it appears here that she wished to show that this extended to the earliest moments of his mental life. With the publication of Frankenstein, the unified-senses idea was thus brought into the popular culture, and Shelley’s words were probably read by some cognitive neuropsychologists in elementary school, even if they paid little heed to the sentiment. The idea also lived on within philosophy and, later, in the science of psychology.

In their professional career, very many cognitive neuropsychologists become acquainted with William James, and indeed the majority should recognize the phrase “one great blooming, buzzing confusion”. Most also recognize this as referring to the world of the infant, but few are probably aware that James was writing about his view that information from different senses is first fused in a child before later segregation.

Link to article.
Link to PubMed entry for same.