Friday, April 26, 2013

Swallowing knives can be a real pain... two hapless young men learned in the seventeenth century. Amazingly, at least one of them survived the experience and lived on to a ripe old age.

In the old days, medicine was as different from the sterile, white-coated affair it is today, as a mud-plastered tractor is from a shiny Mercedes. The need for hygiene was poorly understood; aseptic techniques were nonexistent; and while many effective plant preparations and mineral compounds could be used to treat a variety of disorders, antibiotics were still hundreds of years down the road. Thus, surgery - even performed by a skillful hand - was always fraught with the danger of infection. This was particularly true in regard to abdominal operations, which usually led to peritonitis - inflammation of the peritoneum, the membrane that lines the abdominal cavity - and a painful, unpleasant death. Surgeons only attempted these operations as a last resort, on patients who faced imminent death anyway - in cases of bowel obstruction, for instance - and such interventions were seen as acts of bravado rather than demonstrations of skill. If the operation, miraculously, was a success - in other words, if the patient somehow survived - both patient and surgeon became instantly famous. Two notorious cases from the first half of the seventeenth century are good examples. 

In 1602, around Easter, a knife swallower was entertaining an audience at a fair in Prague. (Sword and knife swallowing was popular throughout Europe since the Middle Ages - a traditional attraction at festivals and other large gatherings.) As he inserted a blade into his throat for yet another time, something went wrong - and, before the eyes of dozens of horrified spectators, he actually swallowed the knife. Luckily, an itinerant surgeon from Brandenburg, one Florian Mathis, happened to be present at the same fair. He offered to treat the hapless performer by applying magnetic plasters to his abdomen. After seven weeks of this therapy (my sources say nothing about the patient's diet during this time) the knife could finally be localized by palpating the abdomen. Mathis made an incision and took it out - completely rusted.

The second successful removal of a knife from a human stomach took place on July 9, 1635. The surgeon was Daniel Schwabe from Königsberg and his patient was a young farmhand from East Prussia, one Andreas Grünheide, aged 22. This Grünheide had, some days earlier, overindulged in liquor during a country wedding. Feeling nauseous, he tried to make himself vomit by tickling his throat with a pocket knife; however, he somehow managed to accidentally swallow the knife (don't ask me how - he must have been really drunk!) The operation commenced, of course, without any kind of anesthesia. The patient was tied securely down on the operating table; then, in the presence of several medical colleagues, Schwabe cut his abdominal wall open and removed the offending implement. Grünheide survived the operation; afterwards he moved to Landberg and got married. The story of his mishap remained notorious in Germany - so notorious that a popular rhyme circulated about the event for years. (Source: Berndt Karger-Decker, Die Geschichte der Medizin, Patmos Verlag, Düsseldorf 2001).

This portrait of Andreas Grünheide was painted in 1635. It is currently part of the collection of the Senckenberg Foundation (Dr. Senckenbergische Stiftung) in Frankfurt. Andreas - who seems to have been a ruddy, good-natured chap - pulls up his shirt, exposing the abdomen, while the bloodstained knife can be seen in the lower left corner.


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