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Question of the Week: What is Pelvimetry?

By Lisa Plotkin, on 10 September 2014

Lisa PlotkinLast Saturday I was engaging at the Grant Museum of Zoology where I started talking with two visitors about the history of science. As a Victorian historian, my doctoral research specifically looks at the historyof Victorian medicine and its relationship to women and the articulation of the healthy female body. There couldn’t be a better setting to discuss those themes than the Grant Museum- the only remaining zoological university collection in London, which houses a dizzying array of zoological specimens dating back to the early nineteenth-century. The museum’s founder, Robert Edmond Grant, is particularly known for his influence on the young Charles Darwin, when the latter studied under him at Edinburgh University.

As I was discussing Darwinian science with the museum visitors, one of them brought up phrenology- a not totally unexpected turn as visitors often bring up the history of eugenics when I am discussing my work. First developed in the late eighteenth century, but reaching the pinnacle of its popularity in the mid-19th century, phrenology is the pseudo-science of skull measurement in order to determine a person’s character, intelligence, and overall mental capacity. Distinct, but not unrelated to craniometry (which is the measurement of cranial features to classify people according to race and temperament) phrenology had a big impact on the concept and understanding of “race” in the Victorian period.

pelvimeter1

A pelvimeter. © Dittrick Medical History Center

This is when I introduced the word “pelvimetry” into the conversation only to receive puzzled looks. What is pelvimetry? Well, from its root word “pelv” and the fact that I am a woman’s historian you might be able to hazard a guess. In obstetrics today, pelvimetry is the measurement of the female pelvis in relation to the birth of a baby. However, in the Victorian period pelvimetry was also used to measure the female pelvis to determine racial characteristics, and to provide a medical explanation as to why a woman’s worth was inextricably linked to her reproductive system, as opposed to her brain.

Or, as the obstetrician Francourt Barnes remarked in 1884, “If woman excels by the pelvis, man excels by the head.” In keeping with this line of reasoning, the eugenics advocate Havelock Ellis ranked the races according to pelvic type and size: the oval (European), the round (American), the Square (Mongol), and the Oblong (African), emphasizing the underlying claim that the oval or European pelvic size was conducive to the healthiest brain development in babies. In this way, the female pelvic type corresponded racially to the male brain size. Craniometry and pelvimetry in easy complement, both asserting the superiority of Europeans, while at the same time stressing sexual difference to cast women as sexual and men as cerebral.

To learn more about pelvimetry see: The Female Body in Medicine and Literature (ed) Andrew Mangham and Greta Depledge or come and find me in one of UCL’s three museums- lisa.plotkin.10@ucl.ac.uk.

 

 

 

 

 

 

Question of the week: Do other animals have belly buttons?

By Stacy Hackner, on 19 March 2014

Stacy Hackner_Thumbnail

by Stacy Hackner

This question was thrown at me at the end of a conversation about juvenile bone growth, and I was completely blindsided. I know my cat definitely has a bump in the place his navel should be, and I assumed all placental mammals have them.

Further research shows that indeed, all placental mammals start with a belly button (or navel, or umbilicus if you’re scientific). The navel is the remnant of the umbilical cord, which attaches a fetus to the mother’s placenta to deliver nutrients in utero. Thus animals that hatch from eggs don’t have them – this includes marsupials like kangaroos and wombats, which have not evolved a placental structure and instead incubate their young in a pouch. However, in most other mammals (and certain humans) they’re obscured by fur, and in some species they are a thin scar rather than a small bump, and fade over the course of the animal’s lifetime.

beluga

Umbilicus evident on a Grant Museum specimen of a fetal beluga whale.

 

The Biomechanics of Breasts

By Stacy Hackner, on 24 February 2014

Stacy Hackner_ThumbnailBy Stacy Hackner

Have you ever wondered what biomechanics has ever done for you? Well, if you’re a runner, it can tell you a lot about your gait and efficiency. It tells us why people with long legs are good at running and people with long arms are good at swimming, and the forces they use per stride or stroke. It can teach us proper runner techniques. If you’re a female runner, you may have encountered a problem biomechanical researchers are actively working to solve: bouncing breasts.

I’ve only been a runner since I started my PhD. As you may remember from my last post, I learned from my research that it’s very important for your bone strength to practice weight-bearing activity (sorry, astronauts), which includes running. As professional running goes, for some reason marathon organizers decided to exclude women from participating until the mid 1980s, when just a few women snuck into the Boston and London marathons and achieved quite good times (see Heminsley’s book for an exciting run-down of the sneaking). Since then, women have been participating in most major sports, including (very recently) American football; 36.5% of 2012 London Marathon finishers were female (Brown et al 2013). But sports equipment for women is still catching up, and biomechanics – long applied to gait and stride, torso and head movements – is now being brought in to design a better bra. Most biomechanical studies of breasts involve attaching markers to women on treadmills in clothed and unclothed conditions and filming them with an infrared camera – a slightly awkward study for the volunteers, but it’s worth it for the results.

The breast in three dimensions. Zhou et al 2012.

The breast in three dimensions. Zhou et al 2012.

First, let’s look at a breast from an anatomical perspective. Breasts are composed of milk glands and ducts, fat, connective tissue, and Cooper’s ligaments. The latter are fibers that attach the breast to the underlying fascia and pectoral muscles; throughout life, and in vigorous exercise, they can stretch or break and cause sagging and breast pain. Imagine a laundry line with wet clothes hanging on it – now shake it: that’s what happens during intense exercise. Of course, these forces have been measured, which can be difficult as unlike bones and muscles, they squish and deform, and each of the above types of tissue reacts to running forces differently. During the beginning of a running stride, the breasts are found to accelerate at up to 3 G (where G is the force of gravity – at that point in time, it’s like the breast weighs 3 times as much). This is considerably more than the rest of the trunk, and puts strain on Cooper’s ligaments. You can then imagine that each breast goes through a cycle of acceleration, stasis, and deceleration for each stride, like your head when stopping and starting in a car. For each stride, the breasts move forward into the air and backward into the ribcage, in what is called anterior displacement.

The figure-8 movement of breasts in a digital reconstruction. Image via ShockAbsorber website.

The figure-8 movement of breasts
in a digital reconstruction.
Image via ShockAbsorber website.

Now it gets more serious. In addition to being displaced anteriorly, breasts move in three dimensions. When running, the goal is generally to move forward. In order to do this, you need to move up as well. And with each step, you also sway side to side. Breasts respond to this combination of forces by actually moving in a figure-8, experiencing additional vertical and horizontal displacement. Studies show that it’s these three directions of displacement rather than acceleration that cause breast discomfort and pain; the worst seems to be vertical displacement, which peaks at mid-flight. At this point, the Cooper’s ligaments are basically floating upwards and then being tugged back down during deceleration (not to mention the fat and glands moving about internally). This is important to know for bra design, as many sports bras take the approach of “flattening everything is best” – however, as we’ve now learned, flattening will only reduce anterior displacement! Flattening bras can also cause breast pain, so it’s lose-lose situation.

Now let’s discuss what a bra actually does. The everyday padded bra is an attempt to compromise comfort, sexuality, and stabilization, often emphasizing one to the detriment of the other two. The goal is to hold the breasts in an uplifted position so they appear firm and don’t jiggle around too much while walking or climbing stairs. Sports bras, on the other hand, prioritize stabilization, as they’re to be worn in high-impact activities. Many sports bras take the approach that flatter is better, which as I’ve shown is not quite the case, but they do prevent one kind of displacement. Regular, everyday support bras lift the breasts up, reducing strain on the Cooper’s ligaments, but in tests of treadmill running do little to prevent any kind of displacement. Running bare-chested causes the most displacement, and – in the case of marathons – can lead to a breast injury experienced by men as well, where the nipples chafe against the fabric of the shirt. (This is actually very common, and there are marathoner web forums devoted to sharing prevention tips.) A newer kind of sports bra attempts to encapsulate rather than flatten, and researchers from biomechanics and textile manufacturing have been collaborating on new design. This bra holds each breast separately and matches the figure-8 to the overall movement of the torso, reducing displacement in all three directions.

As more women get into sports (which is particularly important for the prevention of osteoporosis), making us comfortable and keeping us engaged should be a high priority for sports equipment manufacturers. Most runners can find shoes that fit, as shoes have been tested and re-designed for the last thirty years, and have a high profile in the press. Despite the increase in women running, 75% of female London marathoners still reported a problem with their sports bra, with the prevalence higher among larger-breasted women. However, proper fitting technical sports bras receive significantly lower press coverage than proper running shoes. Clearly, there is more work to be done!

 

Sources

Brown, N., J. White, A. Brasher, and J. Scurr. 2013. An investigation into breast support and sports bra use in female runners of the 2012 London Marathon. Journal of Sports Sciences 2013:1-9.

Heminsley, A. 2013. Running Like a Girl. London: Huntchinson.

Scurr, J., J. White, and W. Hedger. 2010. The effect of breast support on the kinematics of the breast during the running gait cycle.  Journal of Sports Sciences 28(10): 1103-1109.

Zhou, J., W. Yu, and S.P. Ng. 2012. Studies of three-dimensional trajectories of breast movement for better bra design. Textile Research Journal 82(3): 242-254.

Update: The post originally stated that Cooper’s ligaments connect breast glands to the clavicle; this was incorrect. 

Pulling Teeth: Ovarian Teratomas & the Myth of Vagina Dentata

By Gemma Angel, on 4 March 2013

  by Gemma Angel

 

 

 

 

 

In preparation for our upcoming exhibition, Foreign Bodies, several members of the engagement team went to visit UCL Pathology Collections, to have a look at a collection of foreign objects removed from the human body. We soon encountered a number of other specimens which resonated with the exhibition theme in various ways: From a liver infected with syphilis, to a ruptured oesophagus and the sword swallower’s sword that caused the fatal injury; to a feotus inadvertently discovered during a hysterectomy, which was performed to extract a large tumour on the uterus.

The UCL Pathology Collections comprise over 6,000 specimens dating back to around 1850, many of which have been absorbed from other London medical institutions over the past 25 years, and these are currently in the process of being re-catalogued and conserved. It is a fascinating, not to mention an educationally invaluable collection – not least because it contains many specimens that demonstrate gross clinical manifestations of diseases which are now very rare in the Western world. Some of these diseases, such as syphilis, are unfortunately making a comeback, so it seems more important than ever that medical students are able to recognise the clinical signs of these infections. Pathology collections are a highly valuable medical teaching resource; particularly since these kinds of collections are now unlikely to be expanded in the wake of the 2004 Human Tissue Act.

As with many historical pathology collections, UCL possesses its share of medical anomalies or curiosities. Fragments of preserved skin belonging to a tattooed man certainly seem to fall into the category of the anatomically curious – there is certainly nothing pathological about this specimen. One of the biggest surprises I encountered during my visit to the collections, was the revelation that the female reproductive anatomy can, and occasionally does, grow teeth.

Teratoma with Tooth and Hair

Dermoid cyst (cystic teratoma) with fully developed
tooth and hair. UCL Pathology Collections.

The specimen shown here (right) is a dermoid cyst, or cystic teratoma, which has formed inside an ovary. When I first came across it, I experienced a strong visceral reaction: I didn’t have to be a medical student to recognise that this tooth, entwined in long hair drifting in the liquid-filled vitrine, was out of place – so much so, that the sight of it provoked an immediate and simultaneous sense of revulsion and fascination. The term teratoma is derived from the Greek, tera, meaning monster, and literally means “monstrous growth”; it was easy for me to see how such biological anomalies could become the stuff of nightmares. Despite the ominous name, however, ovarian teratomas are usually benign, and arise from totipotent stem cells which are capable of developing into any type of body cell. One 1941 pathology text describes these tumours as follows:

Dermoid cysts are usually globular in shape and dull white in color. They contain structures associated with epidermal tissues, such as hair, teeth, bone, sebaceous material resembling fat … The following is a partial list of tissues which have been found in dermoids: Skin and its derivatives, sebaceous glands, hair, sweat glands, and bone, especially the maxillae containing teeth. Up to 300 teeth have been found in one cyst … Long bones, digits, fingernails, and skull have been found. Brain tissue and its derivatives, intestinal loops, thyroid tissue, eyes, salivary glands, may occasionally be found. Even rudimentary fetuses have been described, such as a pelvis with hairy pubes and a vulva and clitoris. Brains with ventricles, spinal cords and a few complete extremities, have been observed. [1]

Although teratomas can develop in almost any part of the body – including the brain, neck, bladder, and the testes in men – being confronted with a toothy tumour in the female reproductive organs brought to mind mythic archetypes of the sexually devouring and deadly woman. I was immediately struck by the parallels between this specimen and the image of the vagina dentata. I am not the first to make such an observation,[2] and whilst I am not suggesting that there is any explanatory relationship to be found between the biological phenomena and the myths, it is certainly an intriguing association. The toothed vagina appears in the creation myths and folk stories of many cultures, from Native America, Russia and Japan (amongst the Ainu), to India, Samoa and New Zealand. [3] Funk and Wagnalls Standard Dictionary of Folklore, Mythology and Legend records this entry concerning vagina dentata:

The toothed vagina motif, so prominent in North American Indian mythology, is also found in the Chaco and the Guianas. The first men in the world were unable to have sexual relationships with their wives until the culture hero broke the teeth of the women’s vaginas (Chaco). According to the Waspishiana and Taruma Indians the first woman had a carnivorous fish inside her vagina. [4]

Many 19th and 20th century European interpretations linked the motif to Freudian concepts of castration anxiety, in which young males are said to experience an unconscious fear of castration upon seeing female genitalia. Whilst a Freudian analysis is undoubtedly culturally and historically specific, many vagina dentata legends explicitly articulate male fears of castration in the act of normal sexual intercourse, and warn of the necessity of removing the teeth from women’s vaginas, in order to transform her into a nonthreatening and marriageable sexual partner. A particularly telling collection of stories comes from India, in which the ferocious sexual appetites of beautiful young women are tamed and ‘made safe’ to men through the violent breaking of the teeth hidden inside their vaginas. [5]

Lloyd, Charles Augustus, d 1930. Lloyd, Charles A fl 1880s-1912 (Photographer) : Maori wood carving of the goddess Hine-nui-te-po, and Maui. Original photographic prints and postcards from file print collection, Box 14. Ref: PAColl-6585-10. Alexander Turnbull Library, Wellington, New Zealand. http://natlib.govt.nz/records/22708288

Māori wood carving of the goddess Hine-nui-te-pō and Māui.
Photograph by Charles Augustus Lloyd, c.1880s-1912.
Alexander Turnbull Library, Wellington, New Zealand.

The toothed vagina motif is not exclusively associated with male fears of the ‘castrating female’, however. In some traditions, the terrible power of the vagina dentata lies principally not in fears of the sexual act, but in its associations with death. The Māori legend of Māui and Hine-nui-te-pō is particularly interesting in this respect. Hine-nui-te-pō was the goddess of death and gatekeeper of the underworld, whom the trickster demigod Māui sought to kill in order to win immortality for humankind. When Māui asks his father what his ancestress Hine-nui-te-pō is like, he responds by pointing to the icy mountains beneath the fiery clouds of sunset. He explains:

What you see there is Hine-nui, flashing where the sky meets the earth. Her body is like a woman’s, but the pupils of her eyes are greenstone and her hair is kelp. Her mouth is that of a barracuda, and in the place where men enter her she has sharp teeth of obsidian and greenstone. [6]

Undeterred by his father’s grave warnings, Māui sets off on his quest with a gathering of bird companions. He proposes to kill Hine-nui-te-pō by entering her vagina and exiting through her mouth whilst she is sleeping, thus reversing the natural passage into life via birth. Māui finds the great goddess sleeping “with her legs apart” such that they can clearly see “those flints that were set between her thighs”, and he transforms himself into a caterpillar in order to crawl through her body. But his bird companions are so struck by the absurdity of his actions, that they laugh out loud and wake Hine-nui-te-pō from her slumber. Angry at Māui’s impiety, she crushes him with the obsidian teeth in her vagina; thus Māui becomes the first man to die and seals the fate of all humankind, who were ever after destined to die and be welcomed into the underworld by Hine-nui-te-pō. In this version of the myth, the vagina dentata appears as an inverse manifestation of the generative, life-giving powers of woman, which Māui attempts to subvert – he endeavours to overcome the forces of life and death, and therefore “by the way of rebirth he met his end.” [7]

Ovarian Dermoid Cyst

X ray of a dermoid cyst, showing a cluster of teeth in the pelvic cavity.

The mythical theme of the vagina-with-teeth can in most cases be read as an attempt to render the potentially dangerous sexuality of women nonthreatening to patriarchal power, through heroic acts of “pulling the teeth”. Some authors have even suggested a correspondence between this mythic construct and practices of clitoridectomy and ‘female circumcision’ in some cultures. [8] Whilst there can be little correlation between ancient stories and the observation of biological phenomena such as dermoid cysts, the removal of these peculiar tumours and their retention in pathology collections nevertheless reminds us of the remarkable complexity and diversity of human understandings of the body, and their wider cultural significance. For those readers interested in the practical removal of teratomas such as those discussed here, a demonstration of the surgical procedure can be viewed in this educational film (contains scenes of graphic live surgery).


References:

[1] Harry Sturgeon Cross and Robert James Crossen: Diseases of Women, St. Louis (1941), p.685.

[2] See, for example, Bruce Jackson: ‘Vagina Dentata and Cystic Teratoma’, in The Journal of American Folklore, Vol. 84 No. 333 (July-Sept 1971), pp.341-342. Available on JSTOR: http://www.jstor.org/stable/539812

[3] Verrier Elwin: ‘The Vagina Dentata Legend’, in British Journal of Medical Psychology, (1943) Vol. 19, pp. 439-453.

[4] Maria Leach (ed): Funk and Wagnalls Standard Dictionary of Folklore Mythology and Legend, Volume 2 J-Z (1950), p.1152.

[5]  Verrier Elwin: ‘The Vagina Dentata Legend’, in British Journal of Medical Psychology, (1943), Vol. 19, pp.439-453. A particularly illustrative example of one of these stories is recounted by Elwin on pp.439-440:

There was a Baiga girl who looked so fierce and angry, as if there was magic in her, that for all her beauty, no one dared to marry her. But she was full of passion and longed for men. She had many lovers, but – though she did not know it – she had three teeth in her vagina, and whenever she went to a man she cut his penis into three pieces. After a time she grew so beautiful that the landlord of the village determined to marry her on the condition that she allowed four of his servants to have intercourse with her first. To this she agreed, and the landlord first sent a Brahmin to her  – and he lost his penis. Then he sent a Gond, but the Gond said, “I am only a poor man and I am too shy to do this while you are looking at me.” He covered the girl’s face with a cloth. The two other servants, a Baiga and an Agaria, crept quietly into the room. The Gond held the girl down, and the Baiga thrust his flint into her vagina and knocked out one of the teeth. The Agaria inserted his tongs and pulled out the other two. The girl wept with the pain, but she was consoled when the landlord came in and said he would now marry her immediately.

[6] Antony Alpers: Maori Myths and Tribal Legends, Pearson Education, New Zealand (1964), p.67.

[7] Ibid, p.70.

[8] See for example, Jill Raitt: ‘The “Vagina Dentata” and the “Immaculatus Uterus Divini Fontis”‘, in Journal of the American Academy of Religion, Vol. 48 No. 3 (Sept. 1980), pp.415-431. Available on JSTOR: http://www.jstor.org/stable/1462869