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Specimen of the week: Trichobezoar

By Katie Davenport-Mackey, on 29 March 2019

Our blog this week is from Subhadra Das, Curator of Science Collections at UCL Culture.

Today’s specimen of the week comes from UCL Pathology Collections. The Collections are displayed at the UCL Pathology Museum at the Royal Free Campus of the UCL Medical School in Hampstead. The museum includes a medical teaching collection of nearly 3,000 specimens of human remains illustrating the history of disease. To open up these specialist medical displays to a wider audience, we’ve developed a trail of 10 specimens of well known diseases. As the museum only opens to the public for special events, we’re sharing the trail as part of the Specimen of the Week series.

This week’s specimen is a trichobezoar — a mass of undigested hair from the stomach and large intestine of a young girl. As with most of the specimens in UCL Pathology Collections, we know little about the person the specimen comes from beyond their sex and their age, but this rare condition provides an interesting window into the practice of medicine, and its cultural significance extends into the realms of magic.

Trichobezoar was first described as a medical condition in 1779. The term combines the words ‘tricho’, meaning hair, with bezoar, a word likely Persian in origin, meaning ‘antidote’. Undigested solid masses taken from the stomachs of animals (usually goats) were considered to have magical, curative properties, a history used to great effect by J.K. Rowling in the Harry Potter books. The word has been combined with others to indicate particular types of masses in the digestive system. For example a phytobezoar is composed of vegetable fibres, and a lactobezoar is composed of congealed milk.

When a trichobezoar extends from the stomach into the small intestine, as with our specimen, it is called Rapunzel Syndrome, a term first used in 1968. While a rare condition, trichobezoar more commonly occurs in young females, and is the result of trichophagia (‘hair’ + ‘eating’). An associated condition is trichotillomania, or hair pulling, which is a condition on the obsessive-compulsive spectrum. Trichobezoar has been associated with mental illness from its earliest days. While reports and articles in medical journal about trichobezoars have changed over the last two centuries — they are now much easier to diagnose and treat — they tend to begin with a description of the patient as having some form of mental or intellectual disability. This is despite the fact that trichobezoars have been found to occur in young males, older females and people who work as hairdressers. As a medical condition, our specimen sits at the intersection of partriarchal views of the female body as inherently not normal.

Perhaps the best attempt to redress this balance was “Bad Eggs”, episode 2 of Season 12 of Buffy the Vampire Slayer. [Spoiler] In this story the bezoar is reimagined as a living thing — a metaphor for pregnancy and parenthood — which is eventually falls victim to female power and retribution when Buffy kills it. The history of trichobezoar is a lesson to us all to remember that medicine exists within society, and that we should all pay more attention in Potions class.

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