Wellcome Library Images and Finding My Inner Fish

MAL’s very own Beth brought this sweetass article about the Wellcome image collection to my attention recently. The Wellcome Museum in London made 100,000 high resolution medical and art images available under a Creative Commons license. This includes photos, illustrations, manuscripts, paintings, etchings, sculptures, and artifacts.

Images like “Anatomie du Galdiateur” (1812) recall the history of medical illustration and anatomy education, since injured gladiators (and animals like apes) were a source of anatomical knowledge to guys like Galen in an era when human dissection was taboo. A similar situation existed with battlefield injuries, as shown in “Charles Bell,” watercolor of a soldier suffering from a head wound, one of the surgeon’s many depictions of wounded soldiers from the battle of Waterloo (1815). Seeing how injuries to certain areas changed behavior helped us learn functional areas of the brain.

How wonderful! And how daunting, since I had no idea where to start in writing a blog post about the medical photos and illustrations. While there are some examples of the newly released images on the link above, there wasn’t a place to search just for the new images that would interest me. Wellcome is like Getty, and is a large repository of high quality images.

Around this time, I’d palpated a questionable lump on my neck below my ear. I have a lymph node or 2 on the other side that pop out and tingle when I’m sick, but this was kind of new. I had my mom, a nurse, have a look (which is what you do constantly when your mom is a nurse and you are a hypochondriac from reading too many medical books, etc.). She instantly recognized it as a branchial cleft cyst, since my dad had the same exact condition (no wonder he likes swimming!). Obviously, I’m going to ask my doctor about this eventually, but Dr. Google at least confirmed the branchial cleft cyst dx and showed me which of the numbered branchial clefts this was probably from (the first cleft! Which is rare!).

I went from being slightly worried to excited. Annnd I might have Instagramed it immediately, after straining to get a good angle with my phone camera. I am a goddamn fish person! Yes, OK, it’s basically a minor birth defect, but it wasn’t causing me problems and it doesn’t generally have a bad prognosis. Also, it is a fairly small bump, and not disfiguring. At worst, it might get a little swollen after a respiratory infection and need to be drained.

When we are embryos, we have pharyngeal arches that stay that way in fish and form their gills. In animals that evolved after fish, these form structures in the head and neck (for example: the first arch forms the jaws, the second forms parts of the hyoid and facial muscles, and a combination forms the inner ear ossicles!). I learned all this in my comparative anatomy and embryology classes in college, and then also taught them to undergrads as a TA for the same classes. Each arch has a cranial nerve associated with it too, which you can see in sections under a microscope. It’s just one of those cool things about evolution, as anyone who’s read Neil Shubin’s book Your Inner Fish knows.

I decided to do an image search for this structure in the Wellcome collection on a whim. Of course there was a photo, and it was the only one in my search without managed rights. People like to take photos of things like this, as I, myself demonstrated above. This is a photo of a 14 year old girl taken in 1887 with the remains of a branchial fistula on the right side of her neck, situated over the sterno-mastoid muscle. I believe that this means it was from the third + fourth branchial arches together, if I am interpreting the description on Wikipedia properly. Mine is probably connected to my external auditory canal.

Her cyst/fistula was obviously a bit more dramatic, and apparently had cartilage in it. She looks rather irritated or scared, which I think is par for the course for anyone in that era who had to see a doctor.

I think part of my early fascination with the body was a desire to know as much as I could in order to feel less scared and more empowered when mine did weird things. Who knows how/if the doctors at St Bartholomew’s Hospital explained this condition to that 14 year old girl. I’m not sure it would have been comforting in an era when surgery was still somewhat spotty (though luckily it was well after “Ether Day.”) I guess I’m fortunate to be able to think “Cool! Isn’t anatomy weird?” instead of “Why is that doctor coming towards me with an ether-soaked rag?”