Funtabulously Frivolous Friday Five 278 – GoT Version

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the  Funtabulously Frivolous Friday Five 278 but with the final series of Game of Thrones upon us we are doing a GoT version, loosely linking medical trivia with the TV series (don’t cringe too much but feel free to add your suggestions to the comments section).

Question 1

“You know nothing Jon Snow!” – Ygritte (Game of Thrones). Who was John Snow in the field of medicine, and who suggested that he knows nothing?

Reveal the funtabulous answer

John Snow (1813-1859) was a British physician, widely acclaimed as the “father of epidemiology”

Dr Snow pioneered an observational study on cholera epidemics in London between 1854-1857 and later published ‘On the Mode of Communication of Cholera’, a paper which managed to trace an outbreak of cholera to the Broad St pump in London.

It was the Lancet who effectively suggested he ‘knows nothing‘ as they failed to recognise this epidemiological achievement in his obituary, and their editorial at the time (1855) was not exactly supportive…

The Lancet wishes to correct, after an unduly prolonged period of reflection, an impression that it may have given in its obituary of Dr John Snow on June 26, 1858. The obituary briefly stated:

Dr John Snow: This well-known physician died at noon, on the 16th instant, at his house in Sackville Street, from an attack of apoplexy. His researches on chloroform and other anaesthetics were appreciated by the profession.

The journal accepts that some readers may wrongly have inferred that The Lancet failed to recognise Dr Snow’s remarkable achievements in the field of epidemiology and, in particular, his visionary work in deducing the mode of transmission of epidemic cholera. The Editor would also like to add that comments such as “In riding his hobby very hard, he has fallen down through a gully-hole and has never since been able to get out again” and “Has he any facts to show in proof? No!”, published in an Editorial on Dr Snow’s theories in 1855, were perhaps somewhat overly negative in tone.

[The Lancet 2013]

In somewhat of a loose connection to Jon Snow from GoT you can see from the image below that in the late stages of cholera, patients develop cyanosis, a bit like a white walker!

blue stage cholera
blue stage cholera

Question 2

It’s not all doom and gloom for Kit Harrington in the world of medicine, his relative invented something revolutionary to public health. What was it?

Reveal the funtabulous answer

The toilet

John Harrington was Kit Harrington’s great grandfather and invented the flushing toilet, not Mr Crapper (who was a plumber and owned the world’s first bathroom and toilet showroom).

The American’s sometimes call the toilet the “John” maybe in reference to its original inventor? [Reference]


Question 3

While on such important issues which Monarch famously died on the toilet and why?

Reveal the funtabulous answer

King George II died while on the commode on October 25, 1760. His death was one of the first well documented cases of thoracic aortic dissection.

According to Horace Walpole‘s memoirs, King George “rose as usual at six, and drank his chocolate; for all his actions were invariably methodic. A quarter after seven he went into a little closet. His German valet de chambre in waiting heard a noise, and running in, found the King dead on the floor.”

The King’s post mortem report in the “Transactions of the Royal Society” of 1761 read:

“The lungs were in a natural state, free from every appearance of inflammation or tubercle, but upon examining the heart, its pericardium was found distended with a quantity of blood nearly sufficient to fill a pint cup, and upon removing this blood a round orifice appeared in the middle of the upper side of the right ventricle of the heart, large enough to admit the extremity of the little finger. Through this orifice, all the blood brought to the right ventricle had been discharged into the cavity of the pericardium. The auricles and ventricles were found absolutely void of blood, either in a fluid or congealed state. The two great arteries of the right ventricle were stretched beyond their natural state and in the trunk of the aorta, we found a transverse fissure about an inch and a half long, through which some blood had recently passed under its external coat and formed an elevated ecchymosis. This appearance showed the true state of an incipient aneurysm of the aorta.”

Aneursyms were often the end result of syphilis in those days….

Tywin Lannister and George the II are not the only ones to come to a sticky end while on the ‘throne’:

  • Duke Jing of Jin, China, 581 BC – died falling into the toilet pit.
  • King Edmund II of England, 1016 – possible stabbed from under the toilet seat.
  • Godfrey IV, Duke of Lower Lorraine, 1076 – assassinated on the toilet.
  • Wenceslaus III of Bohemia, 1306, murdered with a spear.
  • Catherine the Great 1796, died of a stroke .
  • Mirza Ghulam Qadian 1908, died of dysentery along with many others in the world as diarrhoea remains one of the leading causes of death in some countries.
  • Evelyn Waugh 1966, died of a heart attack.
  • Lenny Bruce, Judy Garland, Elvis Presley, Don Simpson and Robert Pastorelli have all died of a drug overdose while on the toilet.

Question 4

What disease turns your tissue to bone?

Reveal the funtabulous answer

Fibrodysplasia ossificans progressiva.

It is an extremely rare connective tissue disease. It is a severe, disabling disease with no cure or treatment and is the only known medical condition where one organ system changes into another.

The disease is caused by a mutation of the body’s repair mechanism, which causes fibrous tissue (including muscle, tendon, and ligament) to be ossified spontaneously or when damaged. Okay so not quite like Greyscale but its the best I could come up with a short notice.

By Joh-co (talk · contribs) – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27142114

Question 5

House Targaryen carry a trait of insanity, king Aerys II known as the ‘mad king’ may be an ideal candidate for the psych ward ticking many boxes for paranoid schizophrenia. King George the III of England was also labelled mad but what was his diagnosis?

Reveal the funtabulous answer

Bipolar

It’s been popular belief that he suffered from porphyria with symptoms of pain as well as blue urine. Alan Bennett’s long running play was even adapted into a film helping perpetuate the myth. It is far better for the royalty to be seen as having a physical illness rather than a mental illness.

St George’s University London analysed thousands of King George’s letters and discovered that during episodes of his illness his sentences were much longer than when he was well. He often repeated himself, his vocabulary became more complex, creative and colourful not too dissimilar to someone suffering a manic episode.

Observers noticed at times of illness he spoke “incessant loquacity” and had a habit of talking until the foam ran out of his mouth.

So what about the blue urine? George’s medical records show he was given medicine based on gentian, a plant which has deep blue flowers. It is not too unreasonable to believe that like beets and food colouring today that can turn your urine red the same would not be true for this remedy and the subsequent blue hue.

Reference: BBC – Fit to Rule


…and finally, enjoy season 8.


FFFF More More

FFFF

Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Burnaby Hospital in Vancouver. Loves the misery of alpine climbing and working in austere environments. Supporter of FOAMed, toxicology, tropical medicine, sim and ultrasound

One comment

  1. i wait expectantly for your FUNTABULOUS FRIDAY column every week
    it is amusing educational and a delight to read

    please keep it up

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.