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New Device Can Reanimate Disembodied Hearts

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Over 2400 heart transplants are performed in U.S. each year, but a new machine that revives hearts that have stopped beating could put that number much higher.

The “Organ Care System” works by securing a heart in a sterile chamber controlled for temperature and humidity conditions similar to that of the human body. The device infuses blood from the original donor with oxygen and nutrients, running it into the heart to keep it alive and healthy. In the first successful series of transplants using the device, surgeons described waiting two minutes after the hearts had stopped beating before removing them from the donors. Within 20 minutes they had them hooked up to the machines where the hearts would start beating again successfully.

This technology allows doctors to preserve donor hearts they would have previously considered useless. When a patient dies from a lack of blood and oxygen flow to their brain, or what's called a "circulatory death,” the heart and the rest of the organs have been starved of oxygen, and muscle cells are beginning to die. It’s for this reason that organ donations could only be accepted from people whose brains had “died” before the rest of their bodies, leaving a healthy heart behind.

The $250,000 system from Transmedics could change all that by reviving hearts that would have otherwise gone to waste and keeping hearts alive outside the human body for longer periods. It has already led to 15 successful heart transplants in Europe and Australia, and the same technology could be applied to saving lungs, livers, and kidneys as well. Clinical trials are still underway in the U.S., but doctors predict the machine will increase the number of heart donations by 15 to 30 percent. That's technology worth celebrating, even if the idea makes you squeamish.

[h/t: MIT Technology Review]

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Courtesy New York Academy of Medicine Library
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History
10 Treasures From the New York Academy of Medicine Library
A urine wheel from Fasciculus Medicinae
A urine wheel from Fasciculus Medicinae
Courtesy New York Academy of Medicine Library

Tucked away on a side street near Central Park, the New York Academy of Medicine Library is one of the most significant historical medical libraries in the world. Open to the public by appointment since the 19th century, its collection includes 550,000 volumes on subjects ranging from ancient brain surgery to women's medical colleges to George Washington's dentures. A few weeks ago, Mental Floss visited to check out some of their most fascinating items connected to the study of anatomy. Whether it was urine wheels or early anatomy pop-up books, we weren't disappointed.

1. FASCICULUS MEDICINAE (1509)

The Fasciculus Medicinae is a compilation of Greek and Arabic texts first printed in Venice in 1491. While it covers a variety of topics including anatomy and gynecology, the book begins with the discipline considered most important for diagnosing all medical issues at the time: uroscopy (the study of urine). The NYAM Library's curator, Anne Garner, showed us the book's urine wheel, which once had the various flasks of urine colored in to help aid physicians in their diagnosis. Each position of the wheel corresponded to one of the four humors, whether it was phlegmatic, choleric, sanguine, or melancholic. The image on the left, Garner explains, "shows the exciting moment where a servant boy brings his flasks to be analyzed by a professor." Other notable images in the book include one historians like to call "Zodiac Man," showing how the parts of the body were governed by the planets, and "Wound Man," who has been struck by every conceivable weapon, and is accompanied by a text showing how to treat each type of injury. Last but not least, the book includes what's believed to be the first printed image of a dissection.

2. ANDREAS VESALIUS, DE HUMANI CORPORIS FABRICA (1543)

Andreas Vesalius's Fabrica
Frontispiece of Andreas Vesalius's Fabrica
Courtesy New York Academy of Medicine Library

Andreas Vesalius, born 1514, was one of the most important anatomists who ever lived. Thanks to him, we moved past an understanding of the human body based primarily on the dissection of animals and toward training that involved the direct dissection of human corpses. The Fabrica was written by Vesalius and published when he was a 28-year-old professor at the University of Padua. Its detailed woodcuts, the most accurate anatomical illustrations up to that point, influenced the depiction of anatomy for centuries to come. "After this book, anatomy divided up into pre-Vesalian and post-Vesalian," Garner says. You can see Vesalius himself in the book's frontispiece (he's the one pointing to the corpse and looking at the viewer). "Vesalius is trying to make a point that he himself is doing the dissection, he believes that to understand the body you have to open it up and look at it," Garner explains.

3. THOMAS GEMINUS, COMPENDIOSA (1559)

Flap anatomy from Thomas Geminus's Compendiosa
Courtesy New York Academy of Medicine Library

There was no copyright in the 16th century, and Vesalius's works were re-used by a variety of people for centuries. The first was in Flemish printer and engraver Thomas Geminus’s Compendiosa, which borrowed from several of Vesalius's works. The first edition was published in London just two years after the Fabrica. Alongside a beautiful dedication page made for Elizabeth I and inlaid with real gemstones, the book also includes an example of a "flap anatomy" or a fugitive leaf, which was printed separately with parts that could be cut out and attached to show the various layers of the human body, all the way down to the intestines. As usual for the time, the female is depicted as pregnant, and she holds a mirror that says "know thyself" in Latin.

4. WILLIAM COWPER, THE ANATOMY OF HUMANE BODIES (1698)

Illustration from William Cowper's The Anatomy of Humane Bodies
Courtesy New York Academy of Medicine Library

After Vesalius, there was little new in anatomy texts until the Dutch anatomist Govard Bidloo published his Anatomia humani corporis in 1685. The work was expensive and not much of a financial success, so Bidloo sold excess plates to the English anatomist William Cowper, who published the plates with an English text without crediting Bidloo (a number of angry exchanges between the two men followed). The copperplate engravings were drawn by Gérard de Lairesse, who Garner notes was "incredibly talented." But while the engravings are beautiful, they're not always anatomically correct, perhaps because the relationship between de Lairesse and Bidloo was fraught (Bidloo was generally a bit difficult). The skeleton shown above is depicted holding an hourglass, by then a classic of death iconography.

5. 17TH-CENTURY IVORY MANIKINS

17th Century Ivory Manikin
Courtesy New York Academy of Medicine Library

These exquisite figures are a bit of a mystery: It was originally thought that they were used in doctors’ offices to educate pregnant women about what was happening to their bodies, but because of their lack of detail, scholars now think they were more likely expensive collector's items displayed in cabinets of curiosity by wealthy male physicians. The arms of the manikins (the term for anatomical figures like this) lift up, allowing the viewer to take apart their removable hearts, intestines, and stomachs; the female figure also has a little baby inside her uterus. There are only about 100 of these left in the world, mostly made in Germany, and NYAM has seven.

6. BERNHARD SIEGFRIED ALBINUS, TABULAE SCELETI (1747)

Illustration from Bernhard Siegfried Albinus's Tabulae Sceleti
Courtesy New York Academy of Medicine Library

One of the best-known anatomists of the 18th century, the Dutch anatomist Bernhard Siegfried Albinus went to medical school at age 12 and had a tenured position at the University of Leiden by the time he was 24. The Tabulae Sceleti was his signature work. The artist who worked on the text, Jan Wandelaar, had studied with Gérard de Lairesse, the artist who worked with Bidloo. Wandelaar and Albinus developed what Garner says was a bizarre method of suspending cadavers from the ceiling in the winter and comparing them to a (very cold and naked) living person lying on the floor in the same pose. Albinus also continued the dreamy, baroque funerary landscape of his predecessors, and his anatomy is "very, very accurate," according to Garner.

The atlas also features an appearance by Clara, a celebrity rhinoceros, who was posed with one of the skeletons. "When Albinus is asked why [he included a rhinoceros], he says, 'Oh, Clara is just another natural wonder of the world, she's this amazing creation,' but really we think Clara is there to sell more atlases because she was so popular," Garner says.

7. FERDINAND HEBRA, ATLAS DER HAUTKRANKHEITEN (1856–1876)

Circus performer Georg Constantin as depicted in Ferdinand Hebra's dermatological atlas
Courtesy New York Academy of Medicine Library

By the mid-19th century, dermatology had started to emerge as its own discipline, and the Vienna-based Ferdinand Hebra was a leading light in the field. He began publishing this dermatological atlas in 1856 (it appeared in 10 installments), featuring chromolithographs that showed different stages of skin diseases and other dermatological irregularities.

"While some of the images are very disturbing, they also tend to adhere to Victorian portrait conventions, with very ornate hair, and [subjects] looking off in the distance," Garner says. But one of the most famous images from the book has nothing to do with disease—it's a depiction of Georg Constantin, a well-known Albanian circus performer in his day, who was covered in 388 tattoos of animals, flowers, and other symbols. He travelled throughout Europe and North America, and was known as "Prince Constantine" during a spell with Barnum's Circus. (The image is also available from NYAM as a coloring sheet.)

8. KOICHI SHIBATA, OBSTETRICAL POCKET PHANTOM (1895)

19th century Obstetrical Pocket Phantom
Courtesy New York Academy of Medicine Library

Obstetrical phantoms, often made of cloth, wood, or leather, were used to teach medical students about childbirth. This "pocket phantom" was originally published in Germany, and Garner explains that because it was made out of paper, it was much cheaper for medical students. The accompanying text, translated in Philadelphia, tells how to arrange the phantom and describes the potential difficulties of various positions.

9. ROBERT L. DICKINSON AND ABRAM BELSKIE, BIRTH ATLAS (1940)

Image from Robert Dickinson's Birth Atlas
Courtesy New York Academy of Medicine Library

Robert Dickinson was a Brooklyn gynecologist, early birth control advocate, and active member of NYAM. His Birth Atlas is illustrated with incredibly lifelike terracotta models created by New Jersey sculptor Abram Belskie. The models were exhibited at the 1939 New York World's Fair, where they became incredibly popular, drawing around 700,000 people according to Garner. His depictions "are very beautiful and serene, and a totally different way of showing fetal development than anything that had come before," Garner notes.

10. RALPH H. SEGAL, THE BODYSCOPE (1948)

The Bodyscope
Courtesy New York Academy of Medicine Library

This midcentury cardboard anatomy guide contains male and female figures as well as rotating wheels, called volvelles, that can be turned to display details on different parts of the body as well as accompanying explanatory text. The Bodyscope is also decorated with images of notable medical men—and "wise" sayings about God's influence on the body.

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7 Health Tips From Ancient Physicians
Portrait of Galen
Portrait of Galen

If you feel bombarded by conflicting advice on how to stay (or get) healthy, you’re not alone. Intermittent fasting, juice cleanses, and low-carb diets are a few of today’s health trends, but fashionable health advice is nothing new. Consider these health tips from ancient physicians, which range from surprisingly relevant to downright absurd. (Just don't consider any of it actual medical advice, of course—that's what modern physicians are for.)

1. PAY ATTENTION TO YOUR DREAMS.

Galen, a Greek physician who treated Roman emperor Marcus Aurelius among others, wrote hundreds of texts about medicine starting around 150 CE. Galen believed that what you dream about can indicate your overall level of wellness and reveal specific ailments you might be suffering from. Before you call him a quack, keep in mind that he acknowledged that some dreams are simply a random assortment of the day’s events, rather than a direct message about the state of one’s health. As he wrote in On Diagnosis in Dreams:

“The vision-in-sleep [dream], in my opinion, indicates a disposition of the body. Someone dreaming a conflagration is troubled by yellow bile, but if he dreams of smoke, or mist, or deep darkness, by black bile. Rainstorm indicates that cold moisture abounds; snow, ice, and hail, cold phlegm. ... But since in sleep the soul does not produce impressions based on dispositions of the body only, but also from the things habitually done by us day by day, and some from what we have thought—and indeed some things are revealed by it in fashion of prophesy ... the diagnosis of the body from the visions-in-sleep that arise from the body becomes difficult.”

2. DON’T CHANGE YOUR DIET TOO QUICKLY.

Line engraving of Hippocrates
Hippocrates

Greek physician Hippocrates, now known as the father of medicine, wrote several works chock full of health advice. In On Ancient Medicine (written around 400 BCE, although the dates and authorship of the text are somewhat disputed), he explains the wisdom of treading slowly when it comes to making adjustments to your diet. As he explains it, some people are used to eating only one meal per day, while others feel better eating two meals per day. If someone who is accustomed to eating once per day suddenly adds another meal to his schedule, disease can occur.

“But there are certain persons who cannot readily change their diet with impunity; and if they make any alteration in it for one day, or even for a part of a day, are greatly injured thereby. Such persons, provided they take dinner when it is not their wont, immediately become heavy and inactive, both in body and mind, and are weighed down with yawning, slumbering, and thirst; and if they take supper in addition, they are seized with flatulence, tormina [abdominal pain], and diarrhea, and to many this has been the commencement of a serious disease, when they have merely taken twice in a day the same food which they have been in the custom of taking once.”

3. DRINKING TOO MUCH BOOZE CAN CAUSE PIMPLES.

As Galen explains in the Art of Physick, people with high body heat, red cheeks, and a cheerful disposition have a sanguine complexion. Such people, he argues, are more prone to certain conditions such as fevers and phlegm. Luckily, Galen tells sanguine patients how to achieve an optimal diet and exercise program for their body type. He warns that drinking too much beer, ale, and wine can cause a variety of maladies, including scabs, abscesses, fevers, and red pimples.

“Inordinate drinking of strong beer, ale, and wine, breeds hot rhewms scabs and itch, St. Anthony’s fire [a skin infection], quinsies [an infection behind the tonsils], pleuresies [pain when breathing], inflammations, fevers, and red pimples.”

4. BEANS AND FLOWERS CAN FIGHT DYSENTERY.

In On Regimen in Acute Diseases, Hippocrates lays out an easy plan for fighting dysentery, an intestinal infection that causes severe diarrhea. Luckily, no pharmacists are needed for this treatment, but you will have to track down some beans and plant shoots, if you don’t already have them on hand.

“For dysentery. A fourth part of a pound of cleaned beans, and twelve shoots of madder [a Eurasian plant] having been triturated [ground to a fine powder], are to be mixed together and boiled, and given as a linctus [a medicinal syrup] with some fatty substance."

5. IF YOU’RE PREGNANT, STAY AWAY FROM HAMMOCKS.

Detail of a woodcut depicting ancient herbalists and scholars, including Soranus
Detail of a woodcut depicting ancient herbalists and scholars, including Soranus

Scholars credit Sushruta as one of the earliest surgeons and the author of The Sushruta Samhita, a Sanskrit medical text written sometime around 600 BCE. The text warns pregnant women to avoid certain activities, such as fasting, falling, and taking medicine that causes vomiting. But some of the guidelines may sound strange to modern readers. According to Sushruta, pregnant women should not ride a horse, swing on a hammock, or sit on uneven ground, lest those activities cause the fetus to prematurely detach from the uterus.

“Sexual intercourse during pregnancy, riding on horseback, etc., or in any sort of conveyance, a long walk, a false step, a fall, pressure on the womb, running, a blow, sitting or lying down on an uneven ground, or in an uneven posture, fasting … use of emetics or purgatives, swinging in a swing or hammock, indigestion, and use of medicines which induce the labor pain or bring about abortions, and such like causes tend to expel the fetus from its fixture. These causes tend to sever the child from the uterine wall with its placental attachment owing to a kind of Abhighatam (uterine contraction) just as a blow tends to sever a fruit from its pedicel.”

6. IF YOU DON'T WANT TO GET PREGNANT, TRY SNEEZING.

Soranus, a Greek physician who worked in Rome around the early 2nd century CE, had plenty to say about menstruation, contraception, and abortion. As he wrote in Gynecology, sneezing can expel semen from a woman’s body and serve as an effective birth control method. Just remember to squat before you start sneezing.

“And during the sexual act, at the critical moment of coitus when the man is about to discharge the seed, the woman must hold her breath and draw herself away a little, so that the seed may not be hurled too deep into the cavity of the uterus. And getting up immediately and squatting down, she should induce sneezing and carefully wipe the vagina all round; she might even drink something cold.”

7. USE BURNING IRON TO CURE YOUR HEMORRHOIDS.

Hippocrates wrote at length about hemorrhoids, and his writings on the subject survive to this day. In On Hemorrhoids (400 BCE), he offers several methods to remove the offending piles. One of his tricks, which entails burning the hemorrhoids with pieces of hot iron, requires the patient to purge the day before. Sounds like fun.

“I recommend seven or eight small pieces of iron to be prepared, a fathom in size, in thickness like a thick specillum [speculum], and bent at the extremity, and a broad piece should be on the extremity, like a small obolus. Having on the preceding day first purged the man with medicine, on the day of the operation apply the cautery. Having laid him on his back, and placed a pillow below the breech, force out the anus as much as possible with the fingers, and make the irons red-hot, and burn the pile until it be dried up, and so as that no part may be left behind. And burn so as to leave none of the hemorrhoids unburnt, for you should burn them all up.”

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