Twins, Conjoined Thoracopagus
1 2017-07-27T18:02:48+00:00 Historical Medical Library of The College of Physicians of Philadelphia c90233dd07144836ce2dedca73e59366be819522 3 1 Like many conjoined twins, these two boys were stillborn. Staff at a medical school found the jar hidden away in a closet and donated it to the Mütter Museum. Gretchen Worden (1947–2004), the late director of the Museum, who was fascinated by conjoined twins, nicknamed them Jim and James.Conjoined twins are rare, occurring in only 1 out of every 200,000 live births. Identical twins form when a single fertilized egg divides into two parts, which then grow into separate embryos. If the egg does not fully divide, the embryo begins to split into twins, but does not completely separate. The twin fetuses develop with their skin and some internal organs fused together.
Death rates are high. About 40 to 60 percent of conjoined twins are stillborn; approximately 35 percent live for only one day after birth. If twins do survive birth, they have difficult lives. Modern medicine makes surgical separations possible in some cases, but the operations, which often attract international media attention, are long and complex. Sometimes, difficult decisions are necessary; if major organs are shared, one twin may need to be sacrificed so that the other can live.
These twins are the thoracopagus type, joined at the upper part of the torso and sharing a heart. About 40 percent of conjoined twins are thoracopagus. Twins connected at the lower abdomen (omphalopagus, 33 percent) may share a liver, digestive system, or genitals. A much rarer connection type is craniopagus (6 percent), in which the bodies are separated but the skulls are fused. Chang and Eng Bunker (1811–1874), the famous “Siamese” (actually Thai-American) conjoined twins, were joined at the abdomen by a band of cartilage. Their shared liver and a death cast of their bodies are on display at the Mütter Museum. plain 2017-07-27T18:02:48+00:00 www.cppdigitallibrary.org 2015-12-18T20:08:24+00:00 20_ConjoinedTwins-Wet.EDIT__1.jpg 19th Century Historical Medical Library of The College of Physicians of Philadelphia c90233dd07144836ce2dedca73e59366be819522
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- 1 2017-06-20T20:34:55+00:00 Museums 9 In the eighteenth century, surgeons discovered how to use chemicals, like alcohol or formalin, to preserve human and animal body parts for long periods of time. These anatomical preservations became valuable and useful tools for students learning medicine. plain 2018-10-09T17:46:49+00:00 In the 18th century, surgeons discovered how to use chemicals, like alcohol or formalin, to preserve human and animal body parts for long periods of time. These anatomical preservations became valuable and useful tools for students learning medicine. Instead of learning about the body through images, they could now study actual body parts preserved in jars. Through the 18th and 19th centuries, many medical schools had a museum containing anatomical preservations, as well as bones, drawings, instruments, and other materials, that students could study. Surgeons were especially interested in collecting “monstrous births” during this period. This is because gestation, the development of the fetus during pregnancy, was not well understood. This is why most medical museums, like the Mütter, have teratological collections. These bodies were important clues to answering questions about human development. Unlike images in books, however, not everyone could see anatomical preservations. Many of these museums weren’t truly “public,” like the Mütter is today; instead, they were restricted to physicians, surgeons, and students.
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Monstrosities of a Mother’s Making
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The idea that the power of thought could affect an unborn fetus was commonly held among medical practitioners before and up through the beginning of the early modern period. Yet it was only in the 17th Century when this concept of maternal impression took root as a cause of monstrosities.
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Jean Riolan (1580-1657), in his 1649 book, Opuscula anatomica nova, described one such case. A “double-fetus,” more commonly known as a conjoined twin, was born to a mother in 1605. The cause, according to Riolan, was the mother having looked at pictures of demons. Many believed at the time that the devil could directly affect an unborn fetus. In this case, however, the cause was the mother having seen, and then meditated upon, the images of demons that was the cause.
Riolan, was somewhat cautious in his belief in maternal impression. He believed that though the imagination could alter the properties of the fetus, it could not change the species. Fortunio Liceti (1577-1657), a prominent Italian physician, philosopher, and scientist, went further. He did not believe “mutilated monstrosities and those showing excessive parts” resulted from maternal impression; instead Liceti referred to monstrosities as lusus naturae (nature’s game).
As in Paré’s thirteen reasons, it was not always the imagination that caused a maternal impression, but rather an external event. Nicolas Culpeper (1616-1654), was an English botanist, herbalist, physician and astrologer. In his book A directory for midwives (1671) he described various accounts of maternal impression in the chapter “On Monsters.” Culpeper claimed that one woman, Anne Troperim, gave birth to two serpents after drinking from a brook near Basil, having swallowed the spawn of a serpent.