#2 Knuckles and scrotums
If you’re a subscriber, welcome back! If you’re new here, this newsletter is a weekly dive into my internet rabbit hole meanderings — stories that stem from interesting people on the world wide web saying/doing very interesting things. And then me clicking on one link after another.
Let’s get straight to two of my most recent meanderings. Knuckles and Scrotums.
1. Knuckles
Knuckles — those joints in our fingers that we take for granted. But not everyone has them. Or all of them. Like this guy who posted a pic of his hands on Reddit.
He doesn’t have his middle knuckles. Go on, check your own hands. See how the middle part of your fingers are wrinkly? Now check the photo again. His fingers are smoooooth.
Since he lacks those middle finger joints, he can’t make a fist or throw a punch [or do many other things]. This condition has a name — Symphalangism, and as the guy notes, it’s hereditary.
Here’s how one of the first papers describing symphalangism came about.
In January 1906, a patient with a brain tumour came to visit Dr. Harvey Cushing, an American neurosurgeon. Cushing noticed she couldn’t bend her fingers. She had no middle joints. The uncle accompanying her had similar, un-bendy fingers. The girl’s physician, who had married her fifth cousin and had come with the family, said the cousin also had the same “straight fingers”. In Cushing’s view, the lack of joints in the fingers didn’t seem to affect them in any major way. But it was still interesting that three people in one room either had this condition or were married to someone with it. So, Cushing went deep, talked to others from the family, and found that this was indeed hereditary. Eighty four people across seven generations of this one family had some version of “straight fingers”. He could trace it right up to a man named William Brown, who had migrated from Scotland to the US in 1700. Cushing named the condition, which can affect both fingers and toes, symphalangism. It also came to be known as the ‘Brown Curse’. Ten years later, in 1916, Cushing published the family tree and his findings in the journal Genetics.
Cushing’s paper was not the first report of this condition. Nor was it the last. In 1917, Dr. Drinkwater claimed he could trace symphalangism transmitted through 14(!) generations in the Talbot family. Right up to John Talbot, first Earl of Schrewsbery, who died in 1453. [Here’s an interesting discussion on the Talbot fingers]
Symphalangism is rare, but it still runs in many families around the world. Including in India [if you like reading papers, here are 2 examples: paper 1 and paper 2]
Now, this knuckle saga brought back memories of another paper/letter to the editor that I’d once read because I obsessively crack knuckles.
TLDR: For 50 years, Dr. Donald Unger enrolled himself in a self-experiment. He did so because many people told him off for cracking his knuckles - “it’ll lead to arthritis of your fingers!” they said. So, for 50 years, Unger cracked the knuckles of his left hand at least twice a day, but never cracked the knuckles of his right hand [incredible self-restraint]. After 50 years, there was no arthritis in either hand. Which was good, because in 2009, he didn’t have any trouble holding the Ig Nobel Prize that he received for this very important study. Watch his acceptance speech here [starts 1:11:38]:
Unger was 83 when he got the Ig Nobel in 2009. He published the paper in 1998, which means he was around 72 then. Which means he started the experiment when he was in his early 20s!
2. Scrotums
I don’t remember how I ended up on this paper, but here you go.
This case study is about a young boy who applied a pain-relief ointment where he shouldn’t have - on his balls. The next day, he ended up at a hospital with “shortness of breath, chest pain, lightheadedness, vomiting, and malaise”. At least, he was honest with the doctors.
The culprit in this case was methylsalicylate, an ingredient that’s present in many pain-relief creams [think Volini, Tiger balm, Zandu balm].
In general, your skin is a great barrier, and keeps many things from entering your body. But it’s also an organ, supplied by blood vessels. So when you apply creams, medicines, chemicals on it, some part of it does get into your bloodstream, and then to other organs. How much gets absorbed through the skin, depends on lots of factors like what chemical it is, what state the skin is in, and also what area of the body it was applied on. The latter bit in particular caught my attention. Turns out, skin on different areas of the body have different rates of absorption. The winner is the scrotum skin. It’s supposed to be super-absorber, absorbing some chemicals 40-times more than other areas of the body. That is where it went terribly wrong for the boy.
Skin absorption in decreasing order of absorption rate:
Scrotal > Forehead > Armpit ≥ Scalp > Back = Abdomen > Palm = under surface of the foot. [image source Wikipedia]
If applied correctly, in the right area, in the right amount, methylsalicylate is not supposed to be toxic. But if swallowed, or used excessively [like in the case of this young athlete, or this elderly man], or in the wrong areas, or a combination of too much cream in the wrong area [like in the case of the boy], it can get really bad for you.
Problem is, it’s so easy to buy pain-relief ointments over the counter at any pharmacy. And it’s easy to go overboard, if you’re in chronic pain. I am guilty of it. So, ask your doctors where, when and how much of that pain cream to apply, the next time you need it.
Okay folks, those are my last week’s rabbit hole findings. If there’s something you’d like to share, please go ahead and send it. Don’t keep it bottled up.
See you again next week!