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Archive for the 'Doctors' Category

Guichard Duvernay, pioneer of Otology (1648-1730)

By H Dominic W Stiles, on 14 September 2018

Guichard Joseph Du Verney (5 August 1648 – 10 September 1730) was a pioneer of otology.  He was born in Feurs, in the south of France, and studied at Avignon as a doctor befoire moving to Paris.  He became Court Anatomist – a post created for him (Hawkins, p.9).  As Hawkins says, “Duverney’s treatise is remarkable not only for its anatomical presentations, but also for its author’s thoughts on the physiology and pathology of the ear” (ibid).  Neil Weir and Albert Mudry say that it was also significant that it was published in French rather than Latin.  He was also, they continue, the first to show that the boney external meatus developed from the tympanic ring; that the Eusachian tube was a channel wherby the air in the tympanum was renewed; he explained bone conduction; he was the first to use the term boney labyrinth for the whole inner ear.  He produced his brilliant drawings without the aid of a microscope (Weir & Mudry, 2013 p.38-9).

That his book was translated to English over fifty years after his death, says a lot about how valuable it was considered.  We have copies of both the original, and the translation.

Le Vestibule est une cavité presque ronde, creusée dans I’os pierreux et d’environ une ligne et demie de diamètre. II est scitué derrière la fenestre ovale, et revestu par dedans d’une membrane parsemée de plusieurs vaisseaux : on y remarque neuf ouvertures dont il y en a une de laquelle il a déja esté parlé, sçavoir la fenestre ovale qui donne entrée de la quaisse du tambour dans le vestibule ; les huit autres lont dans la cavité de ce vestibule. La première mene dans la rampe superieure du limaçon ; il y en a’cinq qui donnent entrée dans les trois canaux demi-circulaires ; et les deux dernieres laissent passer deux branches de la portion molle du nerf auditif.

Je donneray des noms aux conduits demi – circulaires pour les distinguer, et je les nommeray par rapport à leur situation.  J’appelle le premier Supérieur parce; qu’il embrasse la partie superieure de la voute du vestibule ; le sécond Inferieur, parce qu’il entoure partie inferieure ; et le troisième qui est plus en dehors et sîtué entre les deux autres seranommé le Mitoyen. (1683, p.32-3)

The Vestibulum is a Cavity almost round, formed out of the Os Petrosum, and about a Line and a half in diameter. It is situated behind the Fenestre Ovalis, and covered on the Inside by a Membrane, furnished with a great many Vessels.  There are nine Foramina in it, of which one has been already described, viz. the Fenestre Ovalis, which forms an Entrance from the Tympanum into the Vestibulum; the other eight are in the Cavity of the Vestibulum: The first leading into the upper Range or Scala of the Coclea; there are five more which afford Entrance to the three Semi-circular Canals; and the two last through which two Branches of the Portio Mollis of the Auditory nerve pass.

I shall give Names to the  three Canales Semicirculres to distinguish them, and I shall take those Names from their situation: The first  I call the Superior, because it takes up the upper Part of the Arch of the Vestibulum; the second Inferior, because it surrounds lower Part; and the third, which is placed more towards the Outside, and is situated betwixt the other two, Medius. (1737, p.32)

Hawkins says that Du Verney “was a true forerunner of Helmholtz, putting forward a resonance theory before its time” (Hawkins, p.9).  It seems that he also dissected an elephant, in front of King Louis XIV in 1681.  The book is full of beautiful plates, some reproduced here.  I showed it to a UCLH otologist, and he was amazed by their quality.  Unfortunately no portrait of him appears to survive.

Du Verney, Traité de l’organe de l’ouie, contenant la structure, les usages & les maladies de toutes les parties de l’oreille. A Paris, : chez Estienne Michallet, ruë S. Jacques à l’image S. Paul. 1683

Traité de l’organe de l’ouie… on Google Books

Du Verney, A treatise of the organ of hearing: : containing the structure, the uses, and the diseases of all the parts of the ear./ Translated from the French of the late Monsieur Du Verney, of the Royal Academy of Sciences, Counsellor Physician in Ordinary to the late King of France, and Professor of Anatomy and Surgery in the Royal Physick-Garden at Paris. Translated by John Marshall. 1737

Desai, Sapan S & Dua, Anahita, History of Research in the Vestibular System: A 400-Year-Old Story.  Anatomy &  Physiology 2014, 4:2 DOI: 10.4172/2161-0940.1000138

Hawkins, Joseph E., Auditory Physiological History: A Surface View. Chapter 1, p.1-28, in  Santos-Sacchi, Joseph R., Physiology of the Ear. 2001

Weir, N. and Mudry, A., Otorhinolaryngology: an illustrated history, 2013

https://fr.wikipedia.org/wiki/Joseph-Guichard_Du_Verney

New books at the Ear Institute Library

By Gareth L Jones, on 24 July 2018

Summer has brought a bumper delivery of new books to the libraries, and in this post I would like to bring to your attention the new titles to be found in the Ear Institute collection.
First I’d like to whet your appetites with some of the titles that caught my eye during processing. A full list of books will follow.

Basic Otorhinolaryngology

Basic Otorhinolaryngology, Second Edition, Thieme 2018, by Rudolf Probst, Gerhard Grevers and Heinrich Iro. Located at WV 100 PRO.
An accessible introduction to the core concepts of otorhinolaryngology and head and neck surgery. Completely updated chapters on audiology and vestibular disorders.

 

 

 

 

Clinical Reference Guides

Otolaryngology Head and Neck Surgery Clinical Reference Guide, Fifth Edition, Plural 2018, by Raza Pasha, Justin S Golub. Located at WV 100 PAS.
Rhinology and Allergy Clinical Reference Guide, Plural 2018, by Brent A Senior, Yvonne Chan. Located at WV 300 SEN.
Facial Plastic and Reconstructive Surgery Clinical Reference Guide, Plural 2017, by Shaun S Desai. Located at WE 705.600 DES.

An update for the Pasha pocket guide, and new titles in a similar format for two other disciplines.

 

Scary Cases in Otolaryngology

Scary Cases in Otolaryngology, Plural 2017, by Michael P Platt, Kenneth M Grundfast. Located at WV 150 PLA.

Arriving too early for Halloween, nonetheless Scary Cases could be an invaluable resource, presenting difficult cases and building a discussion around clinical management, prevention, and the legal and ethical aspects of these cases. An extension of the annual Scary Cases Conference held by the Bostion University School of Medicince since 2011.

 

 

 

SataloffClinical Assessment of Voice, Second Edition, Plural 2017, by Robert Thayer Sataloff. Located at WV 500 SAT.
Treatment of Voice Disorders, Second Edition, Plural 2017, by Robert Thayer Sataloff. Located at WV 500 SAT.
Vocal Health and Pedagogy, Third Edition, Plural 2017, by Robert Thayer Sataloff. Located at WV 500 SAT.
Voice Science, Second Edition, Plural 2017, by Robert Thayer Sataloff. Located at WV 500 SAT.

Dr. Sataloff and his band of authors have been extremely productive of late, providing new editions of his voice books. These feature numerous updates to previous editions, reflecting changes in medicine and voice science.

 

SPSS Survival GuideSPSS Survival Manual, Sixth Edition, McGraw-Hill 2016, by Julie Pallant. Located at WA 950 PAL.

A lifeline for students and researchers grappling with SPSS statistics software, this sixth edition is fully revised to accomodate changes to IBM SPSS. My personally-favoured choice for library users asking for SPSS advice!

 

 

 

Springer Handbook of Odor

Springer Handbook of Odor, Springer 2017, edited by Andrea Buettner. Located at WV 301 BUE.

Unfortunately not available in a scratch-and-sniff edition, this is the definitive guide to all aspects related to the study of smell and their impact in human life.

 

 

 

 

Here is the full list of books processed in July 2018.

SPSS survival manual Pallant WA 950 PAL
Advanced technologies for the rehabilitation of gait and balance disorders Sandrini WE 103 SAN
Clinical facial analysis Meneghini WE 705 MEN
Skull base surgery of the posterior fossa Couldwell WE 705.500 COU
Facial plastic and reconstructive surgery Desai WE 705.600 DES
Practical facial reconstruction Kaufman WE 705.600 KAU
Facial plastic surgery Larrabee WE 705.600 LAR
Facial reconstruction after Mohs surgery Thornton WE 705.600 THO
Head, neck, and dental emergencies Perry WE 706 PER
Contemporary management of jugular paraganglioma Wanna WE 707 WAN
Tracheostomy De Farias WF 490 DEF
Gland-preserving salivary surgery Gillespie WI 230 GIL
Dysphagia Leonard WI 250 LEO
Atlas of head and neck endocrine disorders Giovanella WK 250 GIO
Reoperative parathyroid surgery Tufano WK 300 TUF
Skull base cancer imaging Yu WN 180 Yu
Atlas of postsurgical neuroradiology Ginat WN 200 GIN
Head and Neck Ultrasonography Orloff WN 208 ORL
Otolaryngology head and neck surgery Pasha WV 100 PAS
Basic otorhinolaryngology Probst WV 100 PRO
Atlas of topographical Seagal WV 101 SEA
Infections of the ears, nose, throat, and sinuses Durand WV 140 DUR
Scary cases Platt WV 150 PLA
Robotic head and neck surgery Goldenberg WV 168.162 GOL
Robotics and digital guidance in ENT – H&N surgery Lombard WV 168.162 LOM
Temporal bone histology and radiology atlas Chandrasekhar WV 201 CHA
The temporal bone Piras WV 201 PIR
Tinnitus and stress Szczepek WV 272 SZC
Temporal bone cancer Gidley WV 290 GID
Rhinology and allergy Senior WV 300 SEN
Springer handbook of odor Buettner WV 301 BUE
Mastering advanced rhinoplasty Gubisch WV 312 GUB
Rhinoplasty Rollin WV 312 ROL
Endoscopic sinus surgery Wormald WV 340.505 WOR
The power of the voice Abitbol WV 500 ABI
Measuring voice, speech, and swallowing Ludlow WV 500 LUD
Voice disorders Sapienza WV 500 SAP
Clinical assessment of voice Sataloff WV 500 SAT
Treatment of voice disorders Sataloff WV 500 SAT
Vocal health and pedagogy Sataloff WV 500 SAT
Voice science Sataloff WV 500 SAT
Neurolaryngology Sittel WV 500 SIT
Speech and Voice Science Behrman WV 501 BEH
Anatomy and physiology of speech and hearing Rousseau WV 501 ROU
Functional histoanatomy of the human larynx Sato WV 501 SAT

“there is nothing, as I have said, in this mortal life except inanity, emptiness, and dream-shadows” – Girolamo Cardano 1501-76

By H Dominic W Stiles, on 1 June 2018

Girolamo Cardano (1501-76), or Hieronymus Cardanus, or Jerome Cardan, to use the Italian, Latin and English forms of his name, was born in Pavia.  His family lived in Milan during its occuption by the French.  His father was a lawyer.  Jerome was a sickly child, and seems to have had more than his fair share of accidents.  He attended the academy at Pavia, now the university, where he first lectured on Euclid (Cardano, p.11-13).  When he was twenty-five he became a doctor of medicine in Padua.

Attempting to make money from gambling, Cardano was the first person to work out the science of probability, though he did not get the credit for being first as he wanted the advantage of keeping the information to himself, and did not publish it in his lifetime.

Rejected by the Milanese College of Physicians (until 1539), he felt snubbed and was forced to make his reputation  in the provinces (see Hannam, p.238).  His philosophy was to allow patients to heal naturally so he did not introduce invasive and painful treatments to patients, rather prescibing rest & sensible eating.  This meant he was more successful than his fellows.  He was invited to Scotland by John Hamilton the archbishop of St. Andrews in 1551, who was very ill, and the archbishop recovered, and was full of praise for Cardano (ibid p.239).

He was rather obsessed by horoscopes, predicting he would die aged 45.  He prepared horoscopes of historical figures, including Jesus, though that later got him into trouble with the Inquisition.

We have a French version of De subtilitate rerumOn natural phenomena, whence the illustrations here.

He was a remarkable and fascinating man, and his memoir makes for a lively and vivid read.  He is resonably honest and certainly phlegmatic.  The behaviour of his sons might have crushed a lesser man, one being a violent criminal, and the other in an unhappy marriage poisoned his wife and was executed.

“I am by no means unaware that these afflictions may seem meaningless to future generations, and more especially to strangers; but there is nothing, as I have said, in this mortal life except inanity, emptiness, and dream-shadows.” (p.83-4)

Below we see the page on the beaver.  For some reason, perhaps connected with the use of Castoreum, according to Aesop’s Fables and then Pliny the Elder, mediaeval tradition said beaver’s would chew off their own testicles to escape hunters.  As a beaver’s testicles are internal, perhaps that contributed  to the myth.

Cardano, Girolama, The Book Of My Life. Translated by Jean Stoner (2002)

Les livres de Hierosme Cardanus medecin milannois: intitulez de la subtilité, & subtiles inuentions, ensemble les causes occultes, & raisons d’icelles. Traduits… Richard Le Blanc, Paris, Pour Pierre Cauelat ruë S. Iaques, à l’enseigne de l’escu de Florence (1584)

Hannam, James, God’s Philosophers (2009)

Tinnitus in the media…

By H Dominic W Stiles, on 9 February 2018

Tinnitus frequently appears in newspapers and online news sources. Because anyone who suffers from a chronic condition can get frustrated, despressed and angry at the inabilty of medical science to cure the condition, that makes people ready to grasp at anything that could give them hope, offering to alleviate or cure the condition. Tinnitus is no exception, and below are a few recent stories that cover it, all in this case from the Daily Mail, though other papers and websites could equally have been included.

It pays to be a little sceptical with health stories.  Always ask yourself the questions –

  • who produced the study or studies behind the story?
  • are they reputable researchers, or are they selling something?
  • has the article given the original source where the study is published?
  • is the newspaper story written by someone who knows what they are writing about, or is it a staff writer who is regurgitating a press release which has a positive spin?
  • If the study is based on a group of patients, was it a small number or a large number?

I am not saying these stories are invalid, but the headlines are never written by the author, and they often disguise the facts.  People come away remembering the headlines, not the complete story.  Read these stories, but with caution.

Do YOU suffer from tinnitus? Study reveals ‘resetting’ brain cells using electric currents can alleviate the misery of phantom sounds
Read more: http://www.dailymail.co.uk/health/article-5232433/Study-reveals-resetting-brain-cells-cure-tinnitus.html#ixzz56cL3gYau

Google alert helps to end a former Royal Marine’s 10-year tinnitus hell: Notification highlighted pioneering IPOD-based therapy that has allowed veteran to ‘function again as a human being’
Read more: http://www.dailymail.co.uk/health/article-5030949/Royal-Marine-tinnitus-finds-relief-IPOD-therapy.html#ixzz56cMfslW7

Fed up with the noise of modern life? FEMAIL reveals how at home EAR YOGA can help
Read more: http://www.dailymail.co.uk/femail/article-5337717/Fed-noise-modern-life.html#ixzz56cV58VzY

“No one can conceive the agony, the unutterable sorrow I was plunged into” – Charles H. Hassall, ‘herbalist’

By H Dominic W Stiles, on 8 December 2017

The herbalist ‘doctor’, Charles H. Hassall F.S.Sc. was born in Stoke in 1848, and in his youth he lived with his grandfather, who was himself a herbalist.  As a boy Charles lost both his sight to some inflammation, and his hearing in his left ear, and partly lost hearing in his right ear.  The interview in The British Deaf-Mute does not tell us if it was known exactly what caused that, but at any rate it was not permanent and he eventually regained hearing in his right ear, and his vision.

Abraham quotes a pamphlet by Hassall on ‘Care of the Eyes’ where he explains his loss of sight:

A physician was consulted who professed to know all about it and prescribed accordingly, with the result that soon the inflammation rapidly spread to the other eye, still he continued to see and proscribe until I was completely dark-blind as it is called.  He then very coolly gave up the case as hopeless, so I was to be blind through all my earthly life for all he seemed to know or care.  No one can conceive the agony, the unutterable sorrow I was plunged into – an earnest, energetic mind just beginning to enquire and expand suddenly checked and held back in chains of darkness.

[…] I then consulted another Doctor.  This gentleman had weak and sore eyes and felt for me; he soon opened the closed pupils so that I could see like the man whose eyes Jesus opened and said that he could “see men as trees walking.” (p.188-9)

Abraham tells us that some twenty-seven or twenty-eight years earlier, Hassall “had the rare and happy experience of being able to restore the speech of a young girl, with a a mixture of oils and various other ingredients.

He went to work for a Dr. Garner in Staffordshire, but to the disappointment of the doctor, Hassall was determined to follow the herbalist path rather than what he termed the allopathic (p.189).  ‘”Well Hassall,” said the Doctor after one of his argumentative conversations, “seeing that you are determined to make a name as a herbalist I would advise you to get a case or two and demonstrate your theories.’

Abraham gives him the title of ‘doctor’ and says Hassall ‘had obtained many diplomas’ including The General Council of Safe Medicine Limited (Incorporated), London; The National Association of Herbalists of Great Britain; The Society of United Medical Herbalists of Great Britain; The British School of Eclectic Medicine; The British Association of Eclectics and Medical Botanists; The Medical Herbalist Defence Union Limited; The International Association of Medical Herbalists (p.189).  One of these must be The National Institute of Medical Herbalists and it would be interesting to see if there are any archival records of him.  The proliferation of diplomas and claim to use the title ‘doctor’ smacks of a desperation for legitimacy, but today we might term him a quack.

He moved to Farnworth, Bolton, in 1881, which is probably where Earnest Abraham met him, when Abraham was a missioner there.  He expanded his premises from 78 Peel Street to include 76 and 80.  By 1911 he called himself a ‘Pharmacy Proprietor’ on the census, rather than ‘herbalist.  Hassall died in Bolton in 1923.

1891 Census – Class: RG12; Piece: 3093; Folio: 88; Page: 25; GSU roll: 6098203

1911 Census -Class: RG14; Piece: 23256

E.J.D.A. [Ernest Abraham], Charles H. Hassall, The British Deaf Mute, 1895-6, Volume 5 p.188-9

[I contemplated whether or not I should write about Hassall, but as Ernest Abraham interviewed for The British Deaf-Mute I think we can cover him, and though his hearing loss was partial he is an interesting example of nin-standard 19th century medicine.]

“Deafness, like gutta serena, is sometimes produced by inordinate seminal discharges” Antoine Saissy 1756-1822

By H Dominic W Stiles, on 22 September 2017

Saissy FrenchBorn on the 2nd of February 1756, in Mougins, near Grasse in Provence, Jean Antoine Saissy had originally intended to become a planter, but coming across some medical books, he determined on a medical career, travelling to Paris to study (Montain, p.8ff).  He was then twenty two years old, with only a village education, combined with his own book-learning (ibid.p.9).  From 1777 to 1782 he studied under various famous professors, including Chopart and Pelletan.  He went on to serve as a physician and surgeon major with the Compagnie royale d’Afrique on the Barbary coast.  He attended to a child of the ‘Dey of Constantinople’ (possibly an error for Bey of Constantin?), who wanted him to stay.  Saissy however, returned to France, and in 1789 (the English version says 1798 which seems to be an error) defended his thesis on inoculation for small pox before the ‘Chirugical College of Lyons,’ and became a Doctor of Medicine with the University of Valence.  He married the daughter of M. Thenance, a doctor who had invented some obstetric forceps, and devoted himself to that area of medicine for a time.  In 1810 he wrote an essay on Croup, one of the first to do so.

He seems to have been a polymath, in 1811 presenting at the Institut de France a ‘memoir’ on the extraction of light by the condensation of gas.  Quite what that means I am not sure.  He also worked on a study of hibernation, with dormice and marmots (ibid p.12 -13).

It was not until the last twelve years of his life that he devoted himself to diseases of the ear.  Weir and Mudry tell us that Saissy was “the first person to propose introducing a piece of catgut into an artificial perforation of the tympanic membrane to avoid its closure.”

In his introduction to deafness, he repeats this curious form of treatment;

A Bavarian bath-keeper, mentioned by Sckinkius,* devised a singular method of curing deafness.  He plunged the patient into a warm bath, to produce turgescence in the little veins which run behind the ear.  When these were sufficiently apparent he opened them with the point of a lancet and drew a considerable quantity of blood, to the great relief of the patients on whom he practised the evacuation.  This remedy may have some success in cases of sanguineous plethora of the organ of hearing. (p.24-5)

As his 4th of 15 listed causes of deafness, Saissy says

Deafness, like gutta serena, is sometimes produced by inordinate seminal discharges.  Sylvaticus cites a remarkable instance of deafness supervening upon excessive indulgence in venereal pleasures. (p.21)

In other words, it makes you deaf as well as blind!  I suppose that he is not thinking of veneral disease, which can have those effects.

Saissy died on the 5th of March, 1822.  He seems to have been rather forgotten but is deserving of better treatment than I have space or time to give him here.

head section LaissyAbove, the only illustration in his book, a section of the head showing it is a vertical section.

As an addendum, it is interesting to note the protection of copyright notice given by the U.S.A. in the front of the English translation from Maryland.

US copyright*Schenkius, a Swiss doctor (1530-98)

Saissy, J.A., Essai sur les maladies de l’oreille interne.  Paris, (1827) [first published in a briefer essay in 1819]

Saissy, Antoine, An Essay on the Diseases of the Internal Ear.  Baltimore, (translated, 1829)

Montain, Biographic Notice, in An Essay on the Diseases of the Internal Ear, p.9-15. 

Mudry, Albert.  The tympanostomy tube: An ingenious invention of the mid 19th century.  International Journal of Pediatric Otorhinolaryngology Volume 77, Issue 2, February 2013, p. 153-157

Weir, Neil, & Mudry, Albert.  Otorhinolaryngology, An Illustrated History, 2013.

 

“The patient bore the operation with great fortitude” – Lochland Shiel’s facial exostosis

By H Dominic W Stiles, on 28 April 2017

In Guy’s Hospital Reports for September 1836, there is an article, “Cases of exostosis of the bones of the face, disease of the cranium, and fractures of the frontal and parietal bones requiring operation, by Mr. Morgan.”   Mr. John Morgan was a pupil of Sir Astley Cooper.  Plarr’s lives of the Fellows, tells us that Morgan “showed an intense interest in natural history, and began to stuff birds and small animals almost as soon as he could use a knife and his fingers.”   We also discover there, that he dissected an elephant named ‘Chum,’ took an awful lot of snuff, and was one of the founders of the Zoological Gardens in Regent’s Park, now London Zoo.  His brother-in-law William Gosse who was a surgeon and was related to Philip Henry Gosse, emigrated to Australia.

The case we are looking at, Case 1. Exostosis of the Bones of the of the Face, (the notes taken by Mr. Collin), covers an unfortunate Irish labourer, Lochland Shiel, admitted on the 1st of August, 1835 (Guy’s Hospital Reports, p.403-6).  At the time he was 24 years of age.  Shiel told the doctors that until he was fifteen he had good health, when he noted a small tumor in his right nostril.  He was told by ‘a medical man’ that it was ‘of no consequence.’  However, as we can see in the plate, after nine years it had grown greatly, distorting his face,

the right nostril being enormously expanded and closed by the enlargement of the tumor, which, from its size, completely concealed the eye on that side, and extended downwards into the mouth, being there connected with the palatine and alveolar processes of the right superior maxillary bone; projecting also forwards, so as to press the lip beyond the teeth, to the extent of two inches.  The bones apparently implicated in the disease were the ossa nasi, superior maxillary bone, vomer, and the inferior turbinated and malar bones.
[…]
The poor fellow, when admitted, complained of no pain; and I could not find that his sufferings had given him much inconvenience, during the whole of his disease.The general health appeared good; but he was greatly emaciated, more, I believe, from want of proper food, than from the constitutional effects of his disorder.

Deciding that the tumor was common exostosis, an opinion in which Morgan was supported by Sir Astley Cooper and Dr. Hodgkin, he “removed the morbid excrescence” on the 6th of November.  He first made an incision over the right nostril, to ascertain that it was indeed exostosis.

A semilunar incision was then made, extending over the nostril, from the internal angle of the right eye to the centre of the the upper lip.  A similar incision was made on the outer side, commencing at the angle of the eye, and joining with the other, at the lip.  The integuments were then dissected from around the tumor, , and a metacarpal saw was used for its removal; and as it was of a spongy texture, it offered little resistance to the instrument.  No great quantity of blood was lost during the operation , the exostosis not being very vascular; and it was only found necessary to secure one  vessel, a superficial branch of the transverse facial.  all further disposition to haemorrhage was easily restrained by pressure.

After the tumor had been thus removed, the integuments were brought together by an uninterrupted suture; a dossil of lint was placed over the wound, and confined by adhesive plaster; and over all, a light bread-and-water poultice was applied.

The patient bore the operation with great fortitude; and said afterwards, that he suffered but little pain, excepting when the first incision was made.
[…]
Up to the the present time, the patient has been going on well; all discharge from the face has almost entirely ceased: hardly any exfoliation  of bone has taken place; his general health is restored.  The present appearance of his face is correctly represented in the accompanying plate.  (Guy’s Hospital Reports, 1836)

Shiel

Unfortunately I cannot locate any record of Lochland Shiel on family history records or census returns, though a Locklin Sheels married a Margaret Boyle in Newcastle-under-Lyme on the 22nd of December, 1834.  That might be him.  It could be that he was missed, it could be he spent time in Ireland, or it could be that his name has been wrongly transcribed. If you have any ideas about where in Ireland he was from, or any family, do contribute in the comments.  In the spring of 1842 Shiel died in Birmingham.

We have been unable to learn the particulars of the termination of the case. It may, however, be observed, that his death did not take place til nearly seven years after the operation; so it may fairly be said to have been prolonged by it for nearly that period. It is, however, impossible to look at the cast taken after death without marvelling that life could have been prolonged to such a period. The growth appears to have been simply enormous — larger indeed than the head itself. (Guy’s Hospital Reports, 1842)

I have been unable to find a death record for anyone of his name. Someone must have dissected his remains to make a cast of the tumor – and presumably, his skull. Below is the cast that shows the tumor.  As you can see, it had grown enormously in the following years.  The dotted line points to the tiny space through which Shiel ingested food.

Skull ShielGuy’s Hospital Reports, No 2, September 1836 p. 403-6

Guy’s Hospital Reports, No 15, October 1842 p. 491

A System of surgery v. 3, 1882, p.259

[minor updates 15/10.2018]