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Mind – does it matter?

Any study that involves Humans has trouble accounting for the mystery that is the human mind. That is why clinical trials are so in favour of the double blind trial; neither the test subject or the person applying the test know whether the person is getting the treatment being tested or the placebo. It should eliminate the role played by the human mind. It is that powerful and yet we often dismiss it with – it’s all in your head.

There is the famous scene at the end of the Harry Potter books where Harry asks if something is real or whether it is all in his head and Dumbledore answers with some snapping rhetoric that the two are not mutually exclusive – just because it’s in your head doesn’t mean it’s not real.

Scientists don’t like the dubious nature of the mind. This drug works so well because it does A, B and C, not because you believe it is going to work. The craze of drinking a tablespoon of cider vinegar doesn’t re acidify your body’s systems because we have a whole physiology that works to stabilise your internal environment. So why do people feel better if they do it? Because they believe it is making an effect. Does it matter that their belief is based on something that some people, think is wrong? That’s the situation with a lot of things in the world and so long as nobody is exploiting their beliefs does it really matter?

Why this reflection this week?

I am studying fascia in the human body as part of my PhD studies. There are a number of different beliefs about what this structure does, connected to established science by varying degrees.

I had a friend who recently broke her wrist and although she has been going through physio she had reached 50 degrees of movement and hadn’t seen any improvement for a few weeks.

Do you want to try something? The science behind it is a little … It certainly won’t do any harm. That was the conversation over a zoom meeting. One week later and she visits the physio again. She is now at 70 degrees of movement. Did the fascial treatment do that? Was it her belief that it was going to make a difference that actually made the difference? It’s not a controlled study. You can’t do double blind trials on treatments where both the person applying it and the person it is applied to will know what has been done. Does it matter?

It’s a challenge to doing the PhD I wasn’t really expecting

Production of a Netter Felt

I recently constructed a felt inspired by a Netter illustration for a friend. The construction was posted on social media with the final piece receiving quite a few comments and likes.

I thought I would break down the process so that you could see how it was done.

Needle felting is an ancient craft that matts together wool fibres by repeatedly stabbing them with a very sharp barbed needle. It can be very therapeutic at the end of a day.

The Netter image started with some wool and a piece of fabric.

The footprint of the image was shaped out using this core wool and felted to the fabric to create a layer of wool fibres on top of the fabric that other structures could be felted onto.

The structures of the collar bone and mandible were built up to mark out the area into which everything else had to fit.

The idea was to make all of the structures within the neck and to build it up like a reverse dissection.

This meant the blood vessels had to be made. I started out making these on pencils but as I progressed with the construction most things had to be trimmed down to size.

Muscles are not a solid block of colour and so three variations of ‘fleshy’ tones had to be mixed up to gives the muscles their colour.

The major blood vessels of the neck acted as landmarks for the other structures, so these were inserted first with a darker background to ensure no white would show through in the final image.

All of the muscles were constructed and then laid out to ensure everything would be close to the correct places before fixing.

Each muscles was then coloured with a selection of the three fleshy tones to give them extra shape and shading. Working from the deepest structure, the muscles were added onto the fabric.

The finer blood vessels and nerves were small strands of coloured topps wool that were anchored in place and then twisted to produce a fine fibre before tacking into position along the course with a fine felting needle.

The adding of the hyoid bones with the digastric attachments and the trapezius framed the rest of the dissection.

Wool can be felted into any shape. The direction of the needle stabs dictates which dimension will reduce in size. Utilising this it was possible to felt the reflected cut end of the sternocleidomastoid muscle and the innervation and blood supply on its deeper surface.

The collar bone and deltoid area was built up to finish the bottom of the picture and the submandibular gland, adipose layer and flesh finished the image at the top edge, before it was sprayed with hairspray, framed and sent off to its new home.

Crucifixion

There is one week of the year where it is fitting to talk about crucifixion and so as we enter Holy Week, I want to talk about the weirdest anatomical argument ever.

The year is 1801 and three member of the Royal Academy in London are arguing about the anatomical correctness of works of art. In particular the sculptor Thomas Banks and painters Benjamin West and Richard Cosway think that such greats as Michaelangelo had not accurately depicted the body of Christ on the cross.

There seemed only one way to settle this argument – they planned to crucify someone and see what it looked like! The three of them approached the surgeon Joseph Constantine Carpue to see about obtaining a body. This was in 1801 and the regulations about the use of human remains came into being in 1832. It was quite common to get casts made of human bodies that had been flayed to expose the first layer of muscles. These écorchés were considered important for artistic education. People look on these models now and wonder at the detailed work of the sculptors, not realising it is the cast of a dead person.

As it transpired, Carpue had a suitable subject.

In October, Carpue had been called to the Chelsea Hospital where an old Irish captain called James Legg had argued with another pensioner called Lamb. Legg had subsequently burst into Lamb’s room and challenged him to a duel. Lamb had thrown down the gun refusing to fight and Legg had shot him in the chest. Legg was clearly suffering from what we would now class as dementia but an insanity plea was not successful and he was to be executed for murder in November.

A building was erected close to the place of execution and as soon as the execution had taken place the still warm body was nailed to a cross and a cast made. It was important to the artists that the body was still warm and would sag as they felt some of Michaelangelo’s inaccuracies had come in from recreating crucifixions with stiff corpses.

Banks, Thomas; Anatomical Crucifixion (James Legg); https://www.royalacademy.org.uk/art-artists/work-of-art/O1350 Credit line: (c) (c) Royal Academy of Arts /

Once cool the body was removed to the surgeon’s rooms where the body was flayed and another cast made so that the positions of the muscles were visible.

The two casts were displayed in Thomas Bank’s studio before moving to the Royal Academy. In 1822 they were moved to Carpue’s anatomical museum and then to another sculptors studio. By 1917 the écorché cast had been returned to the Royal Academy. The location of the first cast is unknown.

I’m not sure what comments to make about this story other than to wonder that that was ever considered a suitable way to settle that argument. Does it matter if art is anatomically correct? I don’t recall anyone picking holes in a Picasso because it didn’t look like a face, or Dali because watches don’t actually melt.

Is it because some art is close enough to reality that the assumption is the artist was trying to be accurate and failed.

Does it matter? Does it matter enough to start crucifying people?

Reflection and Focus

It’s been a year today since the UK went into lock down for the COVID pandemic. There is a nation wide minute silence at midday.

It’s a time to reflect on things that have occurred over the past year. The changes we have had to made, the concept of having to do things before we are completely ready. We have made some changes which we will continue to adopt.

I’ve taken 2021 as a year to concentrate on growth, reflection and focus.

      When I started on my anatomical journey several years ago the plan was always to try and take anatomical knowledge back to the fitness industry and help improve knowledge of the human body.  It hasn’t been a straight journey.  Along the way I have moved into massage therapy, I’ve had some fantastic educational opportunities and I have met some fantastic people.  I would now describe myself as an atomists – I’m not sure that was ever the plan.

I’m now starting on a PhD project looking at why we have different understandings of the human body.  I’m going down rabbit holes I never knew existed.

For years I have only fed back to the fitness industry in odd articles, presentations, one or two workshops.  I couldn’t produce any more because I wasn’t ready.  I needed more time to get all my ducks in a row.

Not any more – lets start now.  Start small, its not great but if I wait until I’m completely ready I am never going to do anything.

Here it is – the first You Tube video looking at how some people are taught about the pelvis and why it might even be making it harder.

Bony Pelvis Video

Come to Life

I had to share this fantastic piece of work by Chris Rynn who has brought the cover of my book on William Burke to life.

Chris performed the original facial reconstruction of William Burke for my Book cover about the murderers who supplied bodies for anatomical dissection in the 1820’s in Edinburgh.

The reconstruction was based on the skull which is in the Anatomical Museum of the University of Edinburgh and also the life and death masks which are also held in the museum.

The new AI that was released last week has allowed a sense of life to be given to the reconstruction.

If you want to find out more about Burke you can get hold of the book on the shop page here or on amazon.

Lost in Translation

I suspect we all know by now that Tiger Woods has hurt his leg in a car accident.

We can all wonder at the fact that an accident which a decade ago might have resulted in amputation can now be fixed with metal rods and pins.

What a wondrous opportunity to engage the public in understanding a little more about their bodies.

This was the picture from the British press.

TIBULA!

He’s broken his Tibula!

I suppose we shouldn’t be too harsh at least there are two bones in there and they are the correct bones not like this unfortunate runner who is suffering from knee pain, mainly because that is an elbow joint in his leg.

 

The main bone in the leg is the Tibia. Before you correct me that it is the femur, remember there is a difference between the thigh and the leg.

Tibula was an ancient town in Sardinia according to Goggle but actually the same google search brings up several pictures of legs, an article on orthopaedic surgery and getty images, where a search for tibula will bring up clip art and stock images of leg bones.

Maybe as anatomists we ought to be out there being more vocal and acquainting people with the parts of their bodies.

What’s in a name?

This is an acetabulum.

It’s a wide open dish that is used to hold vinegar. This particular one came with a set of flavoured vinegars. Its open and wide so that you can dip your bread into it.

It may seem a strange object to link to anatomy but this highlights one of the things I love about anatomy – the language.

A lot of the terms in anatomy seem very complicated; muscles have big long names, and yet once you ‘crack the code’ those names tell you so much and there is not a single word wasted.

Is it long and straight? – it’s rectus. Does it contain the word superior? Then it will be closer to the head than a similarly named structure that will be called ‘inferior’. Is it anterior? Then there will be one behind it called posterior. Does it contain the phrase ‘levatator’? Then it will lift something.

Once you have cracked the code then you can guess the name of structure by knowing what it does and vice versa.

How does this relate to a dish for vinegar?

There are some structures in the body that are named after structures they look like.

The structure in the middle of this picture is an acetabulum.

It is the socket in the pelvis that the femur (thigh bone) sits in. Hopefully you can see the similarities between the two structures.

Anatomy is littered with these helpful cues that can be used to remember the names of structures. You could refer to the joint above as the hip socket – it wouldn’t remind you of the shape. Would it be easier? – maybe.

I’ve recently discovered that some people are taught about the pelvis in a way that I’m sure their instructors think is helpful. I’m not convinced. Join me in the next post where I’m going to look at the bony pelvis and some of the structures around it.

Another competition prize

The Christmas break gave me the opportunity to finish off a prize for another anatomy related competition.

This skull full of flowers is being offered to the winner of an image competition currently being run by Anatomy Nights.

It is open to anyone, please go and check out the details here. Please let everybody know about the idea and help us flood twitter with anatomically inspired images in February.

I’m hoping 2021 is going to enable me to bring some more content about anatomy that is going to add to your day and your enjoyment of life.

Are you Sitting Comfortably?

Then I’ll begin. 2020 has been a strange year for many of us. A lot of us have lost the commute to work and we are spending longer than ever sitting in front of a screen, often in places that were not designed for office work.

The slouched head forward
posture of the office

We were not great at how we sat in chairs. We slouched and adopted a head forward posture. Now we have to contend with people trying to work with chairs that were not designed for office work, some even forced to use the sofa or the bed. It has been a challenge.

A few weeks ago I had someone complain to me about their sacrum being sore through all this sitting. I didn’t say anything at the time but the comment kept chipping away at the back of my brain.

You shouldn’t be sitting on your sacrum.

Your sacrum is a wedge shaped bone at the back of your pelvis, so called because it used to be believed that it was the sacred part of the body that if planted could grow into another body (!). It is often described as a key stone structure that sits between the two halves of the pelvis and that gravity acts on it to wedge the two halves of the pelvis apart. A belief that is clearly not the case if you look at the position of the pelvis from the side where it can be seen that the sacrum is more like the roof of the pelvic cavity that the back wall – I digress.

It can be seen from this image though, that if you were sitting then you shouldn’t be on your sacrum. So what should you be sitting on?

Your pelvis is made up of three bones, The ilium, the pubis and the ischium. (It is a long standing point of disagreement as to whether the sacrum is part of the pelvis or not). These three bones fuse in childhood to give us the distinctive hip, or pelvic, bone. At the bottom of the pelvis, on the ishium, we find a bone lump which anatomists call a tuberosity. These tuberosities are called your ischial tuberosities, because they are on the ishium. The exercise industry has decided to make it all a lot simpler and refers to these structures as your sit bones – because you sit on them.

There are a number of muscles that attach to your ischial tuberosities. If you sit on a hard surface and rock backwards and forwards you may be able to sense when you are on your sit bones but if you have a reasonable amount of body fat (and we all need body fat) it may be a challenge to actually palpate them.

view looking upwards between the legs,
front of pelvis at top and sacrum at the bottom

The ischial tuberosities divide the area between your legs into two triangles which anatomists refer to as the urogenital triangle, because it contains the openings of the urinary system and the genital opening, and the anal triangle because … it’s self explanatory.

When you are sitting on your chair you ought to be balanced on your ischial tuberosities thinking about your weight going down through the urogenital triangle rather than the anal triangle. As you sit like this your head will come back into a position over your neck and you ought to get less strain on your neck and shoulders and most of all … no pressure on your sacrum.

Let’s hope we will soon all get back to our ergonomically designed chairs and we can sort out all the aches and pains brought on by home working.

Holiday, murder and landmark milestones.

In this time of lock down I was lucky enough to get away for a few days at the end of August. We went down to the Lake District in England.

To get there you have to pass along this beautiful valley called the Devil’s Beef Tub. The road south from Edinburgh to Moffat runs along side the valley. It twists and turns, passing over bridges and streams that tumble into little waterfalls.

It is at one of these turns and picturesque stone bridges that we can relate it to a mile stone case in forensics and anatomy.

Bella Ruxton, the wife of Buck Ruxton

In 1935 a Lancashire doctor Buck Ruxton took it into his head to murder his wife, Bella, and her maid Mary. Finding himself with two bodies to dispose of he decided to dismember them and dispose of them in the Devil’s Beef Tub. He wrapped them in a local Lancashire newspaper, a fact that would come back to haunt him later, and scattered the 70 pieces of remains into the countryside. Some of them were found by the local police and one of the most famous murder investigations started.

In 1935 forensics was still very much in its infancy. A super team of experts was formed with Glaister, the Glasgow professor of forensics, Smith, the Edinburgh professor of forensics and Brash, the Edinburgh professor of anatomy, leading the way. They very soon reached the conclusion that the bodies had been dismembered by someone who knew what they were doing. Building the grizzly jigsaw soon informed then that they were looking at the remains of two individuals but they still had no idea who, or even what sex the victims were. When they were identified as women the penny dropped that maybe this was related to the two women who had gone missing from Lancashire, reported missing by Buck Ruxton, a man who had the capability to dismember.

The finger tips has been removed from one victim hoping that this would remove the ability to take fingerprints. The other victims hands had decomposed beyond the point of being able to finger print the skin. The newly formed finger print unit in the UK worked with the FBI to take fingerprints from the dermal layers that were left on the hands and managed to produce prints that matched in over 16 positions to those of Mary the maid which they had managed to lift from the house in Lancashire.

This left the puzzle of how to positively identify the other remains. The skull had been recovered but they were struggling to get any identifying features. Then one of the team came up with an idea. At that point it was ground breaking. Now, it is a common feature of masters students projects. Could a picture of the skull be superimposed onto the portrait of Bella. She had a very distinctive jaw line; could it persuade a jury that the remains were her’s?

After much positioning of the skull to match the image above the team were able to produce the picture below

As you can see the ear, the eye socket and the jaw line all match.

It was proof enough for the jury who decided that the remains were those of Bella and her maid Mary.

Buck Ruxton was executed in Strangeways prison in 1936 and the case went down as the first modern murder investigation.

Full details can be found in the book by Tom Wood, Ruxton – the first modern murder but bear in mind it might change your view of that beautiful valley if you travel down that road.