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When he was standing on the gallows prior to his execution in October of 1892, Dr. Thomas Neill Cream (aka Dr. Neill or the Lambeth Poisoner), a serial killer and poisoner, started his last words with “I am Jack the . . .” and then he was hung for murder in England before he could finish the sentence. Nevertheless this led to speculation that he might have been the infamous Jack the Ripper, and it wasn’t the first time he’d called that name into his legal proceedings. It took way too long to put Dr. Neill away. A year before his execution, an inquest was called by the coroner in the death of Matilda Clover, a 27 year old sex worker that was found dead after a night with Dr. Neill. This was initially dubbed a “natural” death due to alcohol withdrawal. A prominent physician in London, named Dr. William Broadbent, received a letter soon after Matilda’s death stating the writer knew she was murdered by Broadbent and would keep quiet for £25k. Dr. Broadbent was innocent but following the deaths of many other sex workers on Lambeth street, other weathy members of the community were receiving letters accusing them of murder, complete with details of each crime. Hence the coroner called the inquest to re-examine the cause of death. He found it to be strychnine poisoning. Dr. Neill chose to show up at the inquest and produced a letter which he read aloud. It stated that he, Dr. Neill is innocent, and was signed by “Jack the Ripper.” Weird flex since nobody asked Dr. Neill to show up and the letter was obviously a ridiculous forgery. Considering that before all of this, Dr. Neill was imprisoned in Joliet Prison in Illinois, USA during the years of the Ripper killings, it seems unlikely that Dr. Neill, a murderer in his own right, was being truthful with his last words. Go figure. Max Doctor with a mustache.
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 Strychnine This commonly referenced poison came up in our most recent episode about Thomas Neil Cream, the Lambeth Poisoner. Strychnine is a naturally occurring product in the seeds of the Strychnos nux-vomica plant. Charming name! Initially used as a rodent and bird poison, it’s not surprising that strychnine is very toxic to humans as well. As a poison, strychnine has a peculiar mechanism of action that is similar to how the toxin from the tetanus bacteria works. In the connection between our nerve endings and our muscles (the synaptic gap), when we want to contract a muscle, the chemical acetylcholine is sprinkled from the nerve to the muscle, causing contraction. Other inhibiting substances, such as glycine, are released to help stop muscle contractions. Strychnine stops the inhibiting substances from working, causing uncontrolled muscle contraction in high enough doses. If this happens, one cannot breathe which is the predominant cause of death with this poison. It can also cause metabolic disturbances and muscle breakdown (rhabdomyolysis) as well as seizure-like activity. All that is bad, medically speaking. Though he used other substances, such as chloroform, strychnine was a favorite go-to choice for the late 19th century serial killer/physician, Dr. Thomas Neill Cream. He would either prescribe it under false pretenses or convince people to take it, causing numerous deaths in multiple countries. Image: https://www.wired.com/2012/01/the-science-of-mysteries/ Max Doctor with a mustache. Kuru is a neurodegenerative disease that was observed to occur among indigenous peoples in Papua New Guinea in the South Pacific. Many of these tribes practiced forms of ritualistic cannibalism and researchers in the early to mid 20th century noticed a peculiar set of neurological problems developing among these people These included movement disorders, unusual behaviors (such as inappropriate laughing fits), difficult walking, and rapidly progressive and ultimately deadly dementia. A virologist, named Daniel Carleton Gajdusek, and an accompanying medical doctor, Vincent Zigas, started looking into the disease in 1957. They initially thought it was a genetic disorder. In 1967, researchers formed the hypothesis that the disease may have been linked to ritualistic cannibalism. The practice was banned by the Australian government overseeing Papua New Guinea at the time and the incidence of kuru was decreasing, further lending credibility to the link between eating human tissue and spread of this disorder. Improving upon his earlier work, Gajdusek found that exposing a chimpanzee to the brain tissue from a deceased tribes-person who died from kuru, led to the development of the disease in that same chimpanzee, years later. Though the transmitting agent was not understood, Gajdusek won a Nobel Prize in Physiology or Medicine in 1976 for demonstrating that kuru could be transmitted–thus showing it was not a genetic condition. In the 1960’s and 1970’s, researchers made the association with the appearance of brain tissue affected by kuru to those found in other unusual diseases such as scrapie–a neurodegenerative condition seen in sheep and goats. This led to the suspicion that the diseases were linked or at least spread in a similar way. Research seemingly excluded other infectious agents–such as bacteria or viruses–as being the cause of these types of diseases. In 1982, neurologist and biochemist Stanley B. Prusiner purified what appeared to be an infectious protein molecule at the University of California, San Francisco. This was a landmark discovery that added the term “prion” to the medical lexicon. The word comes from a combination of “protein” and “infection.” He later won a Nobel Prize in 1997 for this work. Prions are fascinating and terrifying. They are single proteins that are folded or configured in such a way that they cause normal similar proteins to change shape to mimic the prion’s structure. This causes those normal proteins not only to malfunction, but to cause neighboring proteins to change in similar fashion. This seems to particularly affect neurologic tissues and many now identified prion diseases–such as kuru–share characteristics of causing rapid neurologic damage over time. Unlike bacteria or viruses, prions do not hold or need genetic material to replicate themselves. Prions can exist in the environment for years. Normal disinfectants and hygienic procedures do not get rid of prions. Diseases caused by prions are often called “transmissible spongiform encephalopathies.” Spongiform refers to the appearance of brain tissue under a microscope as damaged or sponge-like with holes. Encephalopathy refers to a condition impairing brain function. Though many people may not have heard of kuru or scrapie, Mad Cow Disease may be the most recognizable prion disorder in popular knowledge. Research is ongoing to discover a treatment or cure for these diseases. To date, there is none and prion diseases are fatal. As frightening as this all sounds, the good news is that these diseases are very rare. The most common prion disease in humans in the U.S. is called Creutzfeldt-Jakob disease and even it is a one-in-a-million diagnosis. Look forward to an episode in the near future on a similarly fascinating topic. Stay tuned! Sources: -https://en.wikipedia.org/wiki/Kuru_(disease) -https://www.cdc.gov/prions/cjd/index.html -Kuru, The First Human Prion Disease: https://www.mdpi.com/1999-4915/11/3/232/htm Images: -Chimpanzee Brain with kuru: Courtesy of D. Carleton Gajdusek via https://www.mdpi.com/1999-4915/11/3/232/htm -Dr. Carleton Gajdusek: Courtesy of D. Carleton Gajdusek via https://www.mdpi.com/1999-4915/11/3/232/htm -Histology slides with kuru-infected brain tissue: https://www.sciencedirect.com/topics/nursing-and-health-professions/kuru MaxDoctor with a mustache. Treatment of carbon monoxide poisoning 100 years ago. Courtesy of the American Journal of Public Health (NY) 1922 Apr; 12(4): 355-358. The authors “insist on the vital importance of eliminating carbon monoxide poisoning from the blood as rapidly as possible.” This is absolutely still the treatment 100 years later–albeit with more nuance these days. They then recommended the use of a Tissot army face mask (think gas mask) delivering oxygen from a gas tank and doing so for at least 3 hours. While this would be reasonable treatment even by today’s standards, they did have some odd items recommended. Later the article suggested the patient “should be kept quiet for fear of heart failure for some time after recovery.” Reasonable enough until you add the next line calling for the use of “stimulants.” If you are worried about heart failure, it is best to avoid whipping the heart with stimulants. Carbon monoxide (CO) is an odorless gas that is quite deadly. It comes from the combustion of natural gas and as a byproduct of combustion in a car engine–among other sources. Hemoglobin is the protein within our red blood cells that carries oxygen around the bloodstream. Imagine a globby protein molecule grabbing an oxygen molecule and wandering about the body to give that oxygen to an organ in need. The problem is that hemoglobin loves carbon monoxide even more than oxygen. When the environment contains high levels of CO gas, our hemoglobin will grab and hang onto the CO more tightly–so-to-speak–than it does oxygen. Our bodies can’t use CO the same way we use oxygen so when CO levels in the blood are rising, our oxygen levels are decreasing. Initially mild symptoms such as headache or fatigue can progress to brain or heart damage if not death if someone is exposed to high enough levels for a long enough period of time. So the treatment is to flood the body with as much oxygen as possible so that, even though the hemoglobin loves to hang onto CO, oxygen is so abundant that eventually it replaces the CO molecules being held in the red blood cells. One of the main differences in treatment these days includes improved methods of oxygen delivery. We now have oxygen masks that can deliver much higher concentrations than old masks. Additionally we use hyperbaric oxygen treatments for some CO poisoning cases. This involves putting a patient into a high pressure super-oxygen rich environment to further speed the elimination of CO from the hemoglobin in the bloodstream. The faster the CO is gone, the more likely long term consequences are likely avoided. So here we have a case where the old treatment is still good. Now, it’s just a bit more refined and better understood with the benefit of the past 100 years of research. #histmed #medicalhistory #medicalfacts #carbonmonoxide #occupationalhealth Max Doctor with a mustache. |
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