Ep. 5 Sir Astley Cooper, Skeletons, cases Dr David has worked on, and some facts about comparative anatomy which will shock and delight.

We talk about giraffes, Sir Astley Cooper the surgeons surgeon, we hear how a milk maid and a rural Dr changed all of our lives, bodysnatchers, the man who wrote Grays Anatomy is a tale that will fascinate and delight.  And David drops in some history going back to the 13th century.

Yes another eye poppingly interesting meander through the fascinating world of The Real Anatomist with Dr David Robson. 

We finish with a brief look at the amazing human skeleton - teeing us up nicely for Ep. 6 which will be out on 1st November. 

Enjoy and please share and subscribe. Thank you. 

Dr David Robson is a practicing Anatomist who lives and works in Edinburgh. 

Click here to contact Dr David Robson directly

Transcript

SPEAKER_01 0:02

You're listening to The Real Anatomist podcast with myself, Alison Craig, and Dr. David Robson, MD, MA, who is The Real Anatomist. If you like the podcast, please subscribe and share. Thanks. Welcome along to episode four of The Real Anatomist. And this month, we are going to be talking about Sir Astley Cooper, another incredibly interesting historic character within the world of anatomy. Edward Jenner, a doctor who lived in the centre of England and changed part of the medical world, which has affected us all. And we touch on so many other topics within the conversation because we always just sit down and have a good chat over a cup of tea. And I have to say, I apologise for the number of times I say extraordinary, but it is. So here we are. Enjoy. Well, welcome along to The Real Anatomist. My name's Alison Craig and I'm in conversation with Dr. David Robson, MDMA, who is a practicing anatomist in the city of Edinburgh in Scotland. And thank you to everybody that's been in touch and giving us lovely feedback about the podcast. It's just lovely to know that people are enjoying it all over the world. So thank you. Yes, thank you. Yeah. So we, at the end of last month's podcast, discussed the next person that we were going to be digging deep into in history of anatomy which is a guy Astley Cooper.

SPEAKER_03 1:37

Sir Astley Paxton Cooper was born in Norfolk in 1768 died in London in 1841 and he was the most eminent surgeon of his day he was what you were known as a surgeon's surgeon so he was the best of the best It's a long story, but I'm going to take out the interesting bits for you.

SPEAKER_01 2:04

That was the cup of tea coming over, because obviously it's going to be a good session. That's a

SPEAKER_03 2:07

good session. In 1817, Astrid Cooper successfully performed the first ligation of the abdominal aorta, which had never been attempted or done before. And you've got to remember this was in the days before anaesthetic. and it was carried out because the patient, who was only 35, had an aneurysm, which is a clot, a dilation of the common iliac artery leading down into his leg, and Ashley Cooper successfully ligated the abdominal aorta, and the person survived the operation. In 1820, Ashley Cooper successfully removed an infected sebaceous cyst from the head of George IV and then a monarch. And for that, he became a baronet. In 1828, Ashley Cooper became what is known as a surgeon's surgeon. And now this is a position only granted by the monarch. And it's still enforced today. Monarchs still have a surgeon, surgeon, as well as a king's honorary surgeon or a king's honorary physician. But surgeons, surgeons, you can trace the history back to the 13th century.

SPEAKER_01 3:33

Hang on. The 13th century?

SPEAKER_03 3:35

Yeah. Particularly to the year 1253, when Henry III was the reigning monarch. And he gave rise to this position. And in them days, the surgeon's surgeons were surgeons, military surgeons. And they were the best of the best. So that's a bit of history of the history of the surgeon's surgeons.

SPEAKER_01 3:59

Yeah, but 1253. 1253,

SPEAKER_03 4:02

and it's gone on ever since.

SPEAKER_01 4:03

So every monarch has had their... A surgeon's surgeon. A surgeon's surgeon, right.

SPEAKER_03 4:09

Ashley Cooper became a surgeon's surgeon in 1828, as I just said. And he was a surgeon's surgeon for... George IV, William IV, and Queen Victoria. Gosh, so he was really... He really was. He was an exceptional surgeon. He was the top of the tree. So that's a bit of the background of Sir Ashley Cooper. And of course, as was mentioned in a previous podcast, he authenticated... a wax skeleton that had been made by Joseph Townie, a young wax modeler. And he signed a certificate of that authenticity in April of 1825.

SPEAKER_01 4:47

So it's fascinating that these episodes of the podcast, even though we're not planning this, as it were, they will all connect up, which gives us a real sort of timeline of how anatomy has... There's a

SPEAKER_03 5:00

timeline. There's a reason for that I'm doing it in this region, in this position. You asked me if Anyone else did any type of work like this that we're doing now?

SPEAKER_01 5:12

Well, I think a lot of people ask that. I mean, just last week, my other half, my husband, was in. He'd had a knee problem for ages, and he was thinking, oh, no, it probably means I'm going to have to go under the knife. But he came in, saw you, and you sorted him out. So it always strikes me that you save an awful lot of people from having to go through surgery and certainly do your best to help people avoid that. We always do

SPEAKER_03 5:38

our best.

SPEAKER_01 5:38

If we

SPEAKER_03 5:38

can, we will.

SPEAKER_01 5:39

Yeah.

SPEAKER_03 5:40

Well, it was Pat, my wife, who reminded me that I used to tell her a story. And it's a story of a gentleman called John Grosvenor. John Grosvenor was born in 1724 and died in 1823. And John Grosvenor, in Oxford, and he was an anatomical surgeon. But he was renowned for treating his patients only by using his hands, particularly for stiff joints, stiff muscles, and he'd use manipulation and massage, and it didn't matter whether the bone was broken. He would reset it, and he was the best at it. He was also a part-time lecturer at Oxford University. So John Grosvenor did this, and then after 1823, it all disappeared. So in a roundabout way, Pat and I brought it back.

SPEAKER_02 6:34

Yes.

SPEAKER_03 6:35

Hence we only used the hands.

SPEAKER_02 6:37

But with an in-depth knowledge of anatomy and physiology, you must have that.

SPEAKER_03 6:42

If not, don't do it, otherwise you'll do more wrong than good. You know,

SPEAKER_01 6:45

it's interesting you say that you only work with your hands, which is something that I, because I've known you for such a long time now, take for granted. But we haven't actually said that, have we, until this point. So you don't ever use any instrument. There is no machines. Nothing, it's all just...

SPEAKER_03 6:59

The only instrument I may use is a towel.

SPEAKER_01 7:03

Right.

SPEAKER_03 7:04

And that's just purely for the knees.

SPEAKER_01 7:05

Yeah, which is incredible.

SPEAKER_03 7:07

Apart from that, there's no machines, no nothing.

SPEAKER_01 7:11

So when Sir Astley Cooper, Baronet, obviously gives somebody like Joseph Towne the rubber stamp, if you like, he's saying, this guy knows what he's doing, that's about the highest praise in the land.

SPEAKER_03 7:23

It is for a modeler, yeah.

SPEAKER_01 7:25

And so a monarch then has, so he was the surgeon's surgeon for three consecutive monarchs.

SPEAKER_03 7:32

George IV, William IV, and Queen Victoria.

SPEAKER_01 7:35

Which is extraordinary.

UNKNOWN 7:37

Uh-huh.

SPEAKER_01 7:38

And he, as you see, was performing these very invasive operations, I suppose by the nature of the fact they are operations, they're invasive, but without anaesthetic. That's right, there was no anaesthetic at all. And how did he get the knowledge to sort out these

SPEAKER_03 7:54

problems without... Because he used to dissect the cadaver when he used to get the chance.

SPEAKER_01 7:57

So that is, that's the missing link. If you

SPEAKER_03 8:00

remember that in one of the previous podcasts, I mentioned about the famous broken hair trial in 1829.

SPEAKER_01 8:07

Remind us. Yes,

SPEAKER_03 8:08

please. Birkenhead trial was the trial that occurred in Edinburgh. after Burke and Hare were arrested, charged with unfortunately murdering people to get their bodies to pass over to the anatomists for their anatomical schools. Hare turned King's evidence and Burke was hung by the neck until dead in Surgeon Square and was publicly dissected. After that, it was felt that a law had to be passed to try and stop the resurrection men or the body snatchers. Sir Ashley Cooper was the man that actually helped to instigate that.

SPEAKER_02 8:42

Right.

SPEAKER_03 8:43

parliament and said he could get anybody at any time and dissected no problem whatsoever so because of that it was decided that a law would be passed and it was passed on august the 1st 1832 when william iv was the reigning monarch and if you remember five years later in 1837 william iv died and his niece a young girl victoria at the age of 18 became queen So you can see how the story is all

SPEAKER_01 9:15

linked up. Yeah, yeah, absolutely. So was it at that point then that people, because I know now people, if they choose to, when they die, can leave their body to medical science. Is that where that...

SPEAKER_03 9:28

All comes from.

SPEAKER_01 9:29

All comes from. Yeah,

SPEAKER_03 9:31

from the anatomy.

UNKNOWN 9:32

Right.

SPEAKER_03 9:32

And that's why you have an inspector of anatomy, and his job is to go around to medical schools to make sure that everything is being adhered to by law.

SPEAKER_01 9:41

Right. Gosh. Now, we've talked about the fact that when you were a five-year-old boy, you got a copy of Grey's Anatomy and read it, which still, you know, the stuff of Hollywood, but there we are, that is the truth. Who was Grey of Grey's Anatomy?

SPEAKER_03 10:00

Henry Grey was a young lad who was born in London in 1827 and unfortunately died in 1861, which is interesting because that's the same year that Prince Albert died.

SPEAKER_01 10:14

Right.

SPEAKER_03 10:15

Queen Victoria's, who has been died in 1861.

SPEAKER_01 10:18

So he wrote Grey's Anatomy after Astley Cooper had performed these operations and they'd been through all the anatomical investigations.

SPEAKER_03 10:27

That's right, because Henry Grey wasn't born until 1827 and studied at St. George's

SPEAKER_01 10:32

Hospital. Okay, that's what I was wondering. So he studied anatomy. He

SPEAKER_03 10:35

was a medical student at St. George's. And the interesting thing about Henry Grey was... As a young surgeon at the age of 25, he was elected a fellow of the Royal Society. At 25? At 25, which is unusual.

SPEAKER_00 10:50

Yeah.

SPEAKER_03 10:52

And he got the triennial prize from the Royal College of Surgeons on a paper that he did on the nerves and connections of the human eye with comparative illustrations. And then following that, he was awarded the Astley Cooper Prize for an essay on Teutlon, The Uses and Functions of the Spleen, of which he also received 300 guineas. Which was a king's ransom in those days. Which was a king's ransom in those days. And he decided to write a book. The sad thing is he was only 34 when he died. And Grey at that time was looking after his nephew, who was 10 years of age. who unfortunately had smallpox. Smallpox is this extremely dangerous infection. Killed over 300 million people worldwide. 300 million? Yeah, there was no cure for it at that time. You'd get a rash, a fever. Two or three days later, these little spots, these pustules would start to appear on the skin, particularly on the arms, the hands and on the face. Unfortunately, that's what killed Henry Grey. Smallpox used to spread all over, and you can actually trace the history of the smallpox infection way back to ancient Egypt to mummies over 2,500 years. This is in the days then. It had been found in that, and it found evidence of smallpox. The pot marks. Another doctor who was a student of John Hunter, whom we mentioned earlier on in one of the poems, was a country doctor called Edward Jenner. Jenner was born in 1749 and died in 1823, which was also, if you remember, the same year that John Grosvenor died, 1823. The interesting thing was that Jenner had seen, because he lived on a farm near a farm and that, and cow maids used to develop cow pox, which was a skin infection, eruptions and

SPEAKER_02 13:13

stuff.

SPEAKER_03 13:16

The person that developed cow pox never developed smallpox. And Edward Jenner wanted to know why, so he did a lot of research. He inoculated a young lad, took cowpox, made it into a vaccine, and in 1796 became the world's first vaccine.

SPEAKER_01 13:43

And it was a successful vaccine. It was

SPEAKER_03 13:45

a successful vaccine, yeah. And it laid the foundations for the eradication of smallpox.

SPEAKER_01 13:51

And presumably everything else,

SPEAKER_03 13:52

if they showed that. So Jenna is regarded as the father of immunology.

SPEAKER_01 13:58

Goodness me. See, as somebody who has been immunised since I was a kid and obviously lived through everything that everybody does in their lives, these names don't mean anything to me, but they should be held up surely as the reason that we're all walking talking and alive.

SPEAKER_03 14:15

Yeah, it was the world's first vaccine. And Edward Jenner had actually laid the foundations for it in 1796.

SPEAKER_01 14:22

And where was he from?

SPEAKER_03 14:24

He was from Kent.

SPEAKER_01 14:27

Just checking he wasn't another Scot. No, he wasn't. Because everybody seems to be Scottish. And he was

SPEAKER_03 14:34

a pupil of John Hunter for two years.

SPEAKER_01 14:36

Oh, so he was a pupil of a Scot.

SPEAKER_03 14:38

No, he was a pupil of a Scot, yeah. And John Hunter died in 1793. Edward Jenner carried on his research. But he would write letters to John Hunter when he was down in his little practice there. And John Henry Rovers here, don't ask why. Do it. Just do it. Just do it. So he did.

SPEAKER_01 15:03

That's always, you know, it's a great sort of philosophy for life, really, isn't it? Because if people didn't just do it. Don't keep asking why. Just do it. Give it a try. If it works, it works.

SPEAKER_03 15:13

If it doesn't, it doesn't. Well, Edward Jenner did. And

SPEAKER_01 15:17

he was living, maybe he was living, rudely in England. And, you know, obviously the idea of it just stimulated his mind. Just stimulated his

SPEAKER_03 15:24

mind as to why. And it was these cow maids who developed cowpox, but never developed smallpox.

SPEAKER_01 15:31

And even the communication, you know, because it would have taken so long to write a letter, wait for a reply. All of that would have taken such a long time. It just shows the absolute dedication and focus of all of these. Oh yeah, you had the dedication and the focus. Yeah.

SPEAKER_03 15:44

Oh yeah. So without Edward Jenner, we wouldn't have had the eradication of smallpox.

SPEAKER_01 15:49

And probably, you know, the idea of immunisation. As you say, he was the father of the whole thing. He

SPEAKER_03 15:57

became known

SPEAKER_01 15:57

as the father of immunology. Yeah, immunology. And the fact that although... there has been so much information gathered and so many more advances in technology and all the way that people do communicate that there is just still this the oldest and still the textbook that everybody immediately refers to and thinks about in anatomy

SPEAKER_03 16:18

is

SPEAKER_01 16:19

Grey's and it's

SPEAKER_03 16:20

in its I think it's in its 40th edition

SPEAKER_01 16:24

and you knowing as much as you know about are there parts that need to be updated the

SPEAKER_03 16:32

new editions of Grey's Graze has x-rays in and scans in and it has a lot of serology, embryology, cytology. It's a vast book. The first edition of Graze was purely surgically applied anatomy. The first edition is still considered to be the best. He was in the process of doing a second edition. unfortunately lost his life in the second edition he was going to dedicate that to Benjamin Brodie who later became Sir Benjamin Brodie who was Grey's mentor in one respect and did a lot to help Grey Benjamin Brodie Benjamin Brodie is known in anatomy which we'll cover in some previous next podcasts and that for a very tiny little ligament attached to the upper end of the humerus

SPEAKER_00 17:21

right

SPEAKER_03 17:22

called the transverse humeral ligament or the ligament of Brodie they are or O-D-I-E. Okay. Well, that's an Edinburgh name, Brodie.

SPEAKER_01 17:31

That's a name from this area. He

SPEAKER_03 17:35

was an expert on knees, Brodie was.

SPEAKER_01 17:37

Was he? Yeah. So they're all connected. I don't mean

SPEAKER_03 17:42

bones. No, no. If you look at it and you study it and you see who was studying with who and where they studied it, it's interesting to see how they're all interconnected in one form or another.

SPEAKER_01 17:55

I mean, I know that you, over a long period of time, I think it was a number of years, wrote and have written, and you drew the diagrams as well of the anatomy, you know, so you have got the Robson's Guide to Anatomy, haven't you?

SPEAKER_03 18:11

Yeah, it's a book that I did when my partner and I lived in Tenerife.

SPEAKER_01 18:15

It's kind of an act of, you know, you're passing your knowledge on, and it's fascinating, even as somebody, as a layman like myself, to see those drawings and to, you know, equate that to the to you, to me, to whoever, is absolutely fascinating. And if somebody wants to get a hold of the books, can they?

SPEAKER_03 18:34

Yeah, it's on

SPEAKER_01 18:35

Amazon. It's on Amazon?

SPEAKER_03 18:35

Yeah, they can download it. It's an electronic book.

SPEAKER_01 18:38

Right, okay, great. Well, that's really important because I think a lot of people are responding to what you're talking about and to be able to see that. It's the

SPEAKER_03 18:46

oldest, newest anatomy book.

SPEAKER_01 18:48

The oldest, newest anatomy book. Yeah, because it's

SPEAKER_03 18:50

all

SPEAKER_01 18:50

old. Yeah.

SPEAKER_03 18:51

In other words, it's the way it's written. Instead of making one big textbook, Pat said, Chris, we're traveling on a train. When you're on a train, you'll always see people looking at magazines. And Pat said, instead of doing a big book, why don't you do it in parts?

SPEAKER_01 19:09

That's great.

SPEAKER_03 19:10

Like a magazine.

SPEAKER_01 19:11

It's a marketing genius. No, but it's true. It's such a good idea. Yeah,

SPEAKER_03 19:14

it is. That's what we did. So Robson's approach to anatomy is actually seven books. But it means if you're only interested in one particular area, then you just buy that

SPEAKER_00 19:23

one particular part.

SPEAKER_03 19:25

The first one is the skeleton, and then it's the back, and then it's the upper limb, and then it's the thorax, until you end up with the leg. But each book finishes in order for the next book to start. So after the first book, which is the human skeleton, the next book is the back, which is unusual. And the reason I did it that way was because without a back, we haven't got a body.

SPEAKER_01 19:49

Right.

SPEAKER_03 19:50

Basically.

SPEAKER_01 19:50

Yeah. I suppose that's true. I hadn't really thought about that. Yeah.

SPEAKER_03 19:54

Because your head sits on the top, your legs are attached to the bottom. And anteriorly, you've got your viscera and your heart. Laterally, you have your limbs.

UNKNOWN 20:01

Yeah.

SPEAKER_03 20:02

But without the back, you haven't got anything.

SPEAKER_01 20:04

You can get, yeah. Well, the head, clearly, the brain, and the back. That's it. And then you do it.

SPEAKER_03 20:09

So we did it in seven parts. If you put the whole book together, it's 1,600 pages.

SPEAKER_01 20:16

Yeah, that's a big read on a one...

SPEAKER_03 20:19

But that's the shortened version.

SPEAKER_01 20:20

Right.

SPEAKER_03 20:21

That's 1,600 pages.

SPEAKER_01 20:23

Yeah.

SPEAKER_03 20:23

I could have made it a lot bigger, but I didn't.

SPEAKER_01 20:27

That says you

SPEAKER_03 20:27

don't want to make it too big.

SPEAKER_01 20:30

But I

SPEAKER_03 20:31

enjoyed doing it. I used to do it every Sunday. Every Sunday for about eight hours, sitting at a breakfast table like this, with pencils and paper, and that was it.

SPEAKER_01 20:40

Because I know over your career you have declared quite a few different parts of the body that nobody else has declared before, which is fascinating. And are those findings within the book... Or sometimes I suppose they would be, it happens all the time, doesn't

SPEAKER_03 20:59

it? It happens all the time. You can never tell. You can dissect a body and you think that is the standard plan. Unfortunately, nature obviously says, no, no, that's too easy. We'll make it a bit more complicated. So it throws some, again, it'll throw an extra muscle in or it might throw an extra digit in.

SPEAKER_01 21:16

Yeah. Handy if you're a piano player.

SPEAKER_03 21:19

Exactly, or an extra bone in the spine or an extra rib. or a nerve may be going in the wrong place, or an artery may take an unusual course.

SPEAKER_01 21:28

So there's really not, I mean, there is a standard, but... There's a standard, the plan is there. Yeah.

SPEAKER_03 21:33

But it's not. But it's diverse, you know, as the textbook says. That's why, really, the body, the cadaver, is your textbook.

SPEAKER_01 21:42

Yeah. And that's what doesn't happen now, isn't it? The

SPEAKER_03 21:45

textbook is supplementary reading. It's the body because if you dissect the body, you get a true understanding of the relationship of one structure to the other.

SPEAKER_02 21:53

Yeah.

SPEAKER_03 21:54

And there's nothing to beat that.

SPEAKER_02 21:57

Yeah.

SPEAKER_03 21:57

You can have all your computer models and you can have all your plastinated models, but to sit and dissect a cadaver and get the end result, it's a fascinating journey. It's like... It's a journey of you. It's a story of you. It's a story of the human body.

SPEAKER_01 22:17

Yeah, and I think that's what I find absolutely fascinating that, you know, you research all the time. You're up at five in the morning. You're just, your subject you love and you can never stop learning, which is... It's a hobby. It's a hobby, but it's, but the depth of knowledge that you have, that's the thing. It's, you know, you... I think it's because if you're

SPEAKER_03 22:37

interested in it, you remember it.

SPEAKER_01 22:40

Yeah.

UNKNOWN 22:41

Mm-hmm.

SPEAKER_01 22:41

But it's still, you know, the door knocks and somebody comes in from Australia or, you know, it's the other thing that fascinates me about this is people find their way here with word of mouth. You know, you don't tell

SPEAKER_03 22:52

people. It's all word of mouth. I have never advertised

SPEAKER_01 22:55

it. Which is extraordinary because... It's all

SPEAKER_03 22:58

just been done word of mouth. It started with Pat's clinic.

SPEAKER_01 23:01

Yeah.

SPEAKER_03 23:02

And everybody used to get recommended to go and see Pat.

SPEAKER_01 23:04

But it is amazing, though, because that's worldwide. Pat

SPEAKER_03 23:07

has looked after top celebrities. I can't give any names, but she's looked after top celebrities. And had a tremendous reputation. And then Pat and I got together and I said, no, no, you can't do it without a knife or an eel. And Pat said, no, you can. And she did a shoulder. And then she said, but with your in-depth knowledge of anatomy, you should be able to do it as well. So we did. Develop your own techniques. Yeah, all the techniques that Pat and I use are unique to us.

SPEAKER_01 23:35

Yeah.

SPEAKER_03 23:37

And you can't pass them on.

SPEAKER_01 23:38

Such a shame! I want everybody to know! You know? You

SPEAKER_03 23:42

can't pass the techniques on because it's always having the knowledge

SPEAKER_01 23:45

of

SPEAKER_03 23:47

the anatomy and the physiology. It's have you got it in the feeling of your hands.

SPEAKER_01 23:52

Yeah. So, yeah, it's an intangible thing. It's an intangible thing,

SPEAKER_03 23:55

yeah. It's the feeling.

SPEAKER_01 23:57

Which for an anatomist is interesting because anatomy is so, you know, practical in a way. Anatomy is

SPEAKER_03 24:02

supposed to be a precise subject.

SPEAKER_01 24:04

Yeah.

SPEAKER_03 24:05

It really is.

SPEAKER_01 24:05

But you're mixing that then with, yeah, absolutely, with the feeling. The feeling. Yeah.

SPEAKER_03 24:11

Yeah, because you're feeling with your fingers. Yeah.

SPEAKER_01 24:13

But what happens is I... She just

SPEAKER_03 24:15

can't do that. Yeah. You know, you could come in with your... my arm, my elbow, whatever. And if you put a machine on it, the machine's not going to be able to detect

SPEAKER_01 24:25

or

SPEAKER_03 24:26

find out.

SPEAKER_01 24:27

I mean, sometimes I walk in and you go, you're out. And I go, what? You go, you're out. Yeah,

SPEAKER_03 24:32

because Pat and I have done the job for that long. You can see it. As

SPEAKER_01 24:36

soon as somebody walks in. It's

SPEAKER_03 24:37

like sometimes on the television, you'll see somebody on the television. I'll say to Pat, oh, she's got an extra part. I say, give over. I say, but she's there. You can't miss it. You can see it. You can't help it because it's a hobby.

SPEAKER_01 24:49

Yeah.

SPEAKER_03 24:49

It's like, if you think about it, it's like somebody who's dedicated to golf. What do they live for? Golf, hitting this tiny little white ball with 360 pimples on it and hitting it. Only you would know there was 360 pimples on it. Or a tennis player that dedicated to live for it. Well, it's just that what we do, it's not that we live for it, it's just that it's a hobby, but it's a fascinating hobby because it takes you around the world.

SPEAKER_01 25:17

Well, the other thing is, I know that you've been sitting somewhere just quietly having a sandwich and Pat's spotted somebody that's, you know, maybe got something out of line or whatever and you've gone up and said, my husband, you know, and they start a conversation and you end up fixing them there and then.

SPEAKER_03 25:32

Yeah, if we can. Don't do that so much now.

SPEAKER_01 25:34

No. But they're great stories.

SPEAKER_03 25:38

Yeah, they're great stories but they're all true. Yeah. But this is what makes it all interesting and if you can, but if you can get the anatomy and the physiology across and the importance of it So that you look at, like I say to students, just look at your hands. You can learn a lot just by looking at the hand. Or if you're studying the arm or the limb or the chest, just stand in front of a mirror and look at the body. It's surprising how much you can actually see and how much you can actually learn just by looking in the mirror.

SPEAKER_02 26:13

Right.

SPEAKER_03 26:15

You have to have respect for the person. You have to, because if you remember, when people come to us, we're not using machines.

SPEAKER_00 26:23

There's so much

SPEAKER_03 26:24

going on. And nowadays, you have to be so careful. Of course.

SPEAKER_01 26:28

But you're not, you never, I mean, it has to be a hands-on therapy.

SPEAKER_03 26:34

It has to be hands-on. It is, it's hands-on because we're using our hands, we're not using any machines. But today, unfortunately, you have to be so careful. So if a lady comes in that's never been to us before, Pat's there, Pat's the chaperone.

SPEAKER_01 26:46

Yeah. Well, you have to protect yourself. You have to protect yourself.

SPEAKER_03 26:50

So we do.

SPEAKER_01 26:51

Yeah.

SPEAKER_03 26:51

But we explain to people when they come in that I have to do this or I have to do that. Do you mind if I move this or if I do that?

UNKNOWN 26:58

They don't mind.

SPEAKER_03 26:59

Yeah, they don't mind. They just want you to try and help them out. Of course, yeah. But you still have to explain. Yeah. It's like if a lady has to take her top off, we'll obviously have a vest on underneath. Yeah, yeah. We put a towel under. Yeah. You have to protect their modesty.

SPEAKER_01 27:12

Yeah, of course. Yeah. It's changed days, isn't it? It's changed days nowadays. Although it's protected both parties in some ways, you know. you have to yeah absolutely

SPEAKER_03 27:19

we're just so careful yeah it's a full hand on

SPEAKER_01 27:25

and speaking of you know everything that we've just discussed there it all comes down to well not all of it obviously but the bones the skeleton I know we're going to go into that in the next podcast but give us a brief kind of overview of what we'll be talking about next time if we're talking about the skeleton because to me the skeleton's like you know

SPEAKER_03 27:43

them bones them

SPEAKER_01 27:45

bones them dry bones you know so

SPEAKER_03 27:47

Yeah, we'll go into the skeleton and discuss about the human skeleton. All 206 bones in the human skeleton. That's the basic plan. 206 bones. 308 in a newborn baby.

SPEAKER_01 28:04

What? Hang on a minute, hang on a minute, hang on a minute. My head's just burst there. You just said 206 bones in a human skeleton.

SPEAKER_03 28:14

308 bones. as usual number and a newborn baby.

SPEAKER_01 28:20

And 102 bones

SPEAKER_03 28:23

disappear. But they don't disappear because they fuse to the parent bones.

SPEAKER_01 28:29

Goodness me. Am I looking surprised? The bones are separate, you see?

SPEAKER_03 28:35

Like the hip bone, the iliac bone, that develops in three parts. It's not a bone with one big bone. It's three bones that actually fuse in the acetabulum, the joint cavity. The femur, the greater trochanter, lesser trochanter, they join together. So by the time all that's done and all the bones are totally fused by the age of 25. It

SPEAKER_01 29:00

takes up to 25, does it? For boys and girls?

SPEAKER_03 29:05

And the first bone to develop in the skeleton is the clavicle, or the collarbone, the clivus collarbone. Flip it on its side and it represents a Roman key.

SPEAKER_01 29:18

Hence the word.

SPEAKER_03 29:19

Yeah, clavicle, because it's the most important bone. Because during parturition, when a baby's been born, it's the clavicle that you have to take hold of to bring the baby out.

SPEAKER_02 29:29

Right.

SPEAKER_03 29:32

So it's the first point of development. The centre of ossification, this is the development periods of time for bones. The first centre for that will appear between the fifth and sixth week of interuterine life.

SPEAKER_01 29:43

Goodness me!

SPEAKER_03 29:45

That's right. If anything's going to go wrong, it'll go wrong in the first eight weeks.

SPEAKER_01 29:50

Really? Gosh, yeah. Gosh, that's so surprising. I mean, I knew that it took, you know, like brains, you know, took longer to develop, especially boys. I think brains take longer to join back up. Yeah, they can take up to

SPEAKER_03 30:04

21, yes.

SPEAKER_01 30:05

But I had no idea that the skeleton was, took 25? It would be totally, it would be totally fused. I mean, obviously

SPEAKER_03 30:10

you're growing. Yeah, you're growing, you see. Yeah. So by the time you're 25, every bone will have been totally fused together in its correct position. So, right, if you have a long bone, you'll have a head and you'll have the shaft. The head's the epiphysis, the shaft is the diaphysis. And then you'll have the groin end. and the groin end is separate, so it has to join. So that's when you look at it, you'll see on an x-ray, you'll see a ridge, and that ridge is the epiphyseal line and plate where the discline of the bone, which is the groin end of a bone, actually joins with the shaft or the diaphysis. So that's why we have 308 when we're born, but by the time we're all fused together, when we're grown up, we'll have 206.

SPEAKER_01 30:57

Unless

SPEAKER_03 30:58

nature decides to throw a span in the works and say, well, we'll give you an extra vertebra, or we'll give you an extra rib.

SPEAKER_01 31:05

Yes, what about that? But you know, like the very tall people or very small people, or you know, people that are anomalies in terms of whatever the norm is.

SPEAKER_03 31:12

They can still have the normal arrangements.

SPEAKER_01 31:14

Right, but just in a larger or elongated kind of way. If

SPEAKER_03 31:18

you think of it this way, if you look at the neck of a human skeleton, it consists of seven cervical vertebrae.

SPEAKER_02 31:25

Right.

SPEAKER_03 31:27

You look at the neck of a giraffe, it has seven cervical vertebrae.

SPEAKER_01 31:30

Yet again, you've just blown my mind. I

SPEAKER_03 31:35

thought a giraffe would have about 120. No, it has seven. Exactly the same, except they're bigger.

SPEAKER_01 31:41

Well,

SPEAKER_03 31:42

I did

SPEAKER_01 31:43

work that

SPEAKER_03 31:43

big. They're

SPEAKER_01 31:44

bigger, aren't they? But that's extraordinary. Really.

SPEAKER_03 31:49

Yeah. And if... There's one, the giraffe. We haven't done this yet, but anyway, it makes it interesting because we're talking about the giraffe. The recurrent laryngeal nerve in a human in the neck supplies the larynx, the voice box. In the giraffe, the recurrent laryngeal nerve is over a metre long. This is comparative anatomy. And that's why I bring it in, to make it interesting.

SPEAKER_01 32:19

Yeah.

SPEAKER_03 32:20

Because you're making the story interesting.

SPEAKER_01 32:22

But yes, we're

SPEAKER_03 32:23

going back to the skull. We'll cover all of the

SPEAKER_01 32:25

skulls. Yeah, yeah, no, I mean, I'm just like, I mean, I'm an animal fanatic, you know, but I'm just stunned that I hadn't really thought about that in terms of, I just assumed that, you know. So is that because in, you know, everybody's got a different belief system, but we all come from the same root and we all go in sort of different directions, if you like. You know, we've got us as the humans and then you've got the giraffes Human history

SPEAKER_03 32:47

is a fascinating topic. Yeah. It really is, because you can trace it back. One of the oldest skeletons ever found was in 1974.

SPEAKER_02 32:59

Right.

SPEAKER_03 33:00

In the Rift Valley in Ethiopia. And the paleontologist was a guy called Donald Johanson. And it was the last day of the dig, because you only get a... a visa to do the digs, a permit, sorry, a permit for maybe a month, two months, or three months. And it was the last one, and he was driving back through the desert, and in the headlights, he saw a reflection, something sticking up from the sand. And he stopped and he went and had a look at it. And it was a bone.

SPEAKER_01 33:39

Good eyesight.

SPEAKER_03 33:42

So he dug it, dug it all up, got the skeleton, When he got back to base camp with the Bowmans, they had to go to the next state to get the rest of them. They were playing Lucy in the Sky with Diamonds, the Beatles song. So he called the skeleton Lucy. And Lucy, the skeleton of Lucy, and it took them 20 years to find her skull.

SPEAKER_01 34:10

Oh my goodness. Her

SPEAKER_03 34:11

skull wasn't with her.

SPEAKER_01 34:12

She was

SPEAKER_03 34:13

with her family, yeah, Lucy, yeah.

SPEAKER_01 34:14

So where was the skull?

SPEAKER_03 34:16

It was in a different part.

SPEAKER_01 34:18

Good heavens.

SPEAKER_03 34:19

But it took 20 years to find

SPEAKER_00 34:21

it.

SPEAKER_03 34:23

Australia, Pythagoras, Africanus is what it was really named. But it took them 20 years to find the skull. And she was dated to be 3.4 million years old. The interesting thing about Lucy's skeleton was that it actually, originally, we used to go around in all fours. And we were arboreal, which... or boy remains that were swimming through the trees. But Lucy's skeleton actually showed you the transposition of going around on all fours to becoming bipedal, walking on two legs.

SPEAKER_00 34:57

Oh, really?

SPEAKER_03 34:58

Because of the shape of the pelvis.

SPEAKER_00 35:00

Oh, gosh.

SPEAKER_03 35:01

And the femurs. 3.4

SPEAKER_00 35:04

million years. Then

SPEAKER_03 35:05

about five, six years ago, another skeleton was found, and that was dated to be six million years old.

SPEAKER_01 35:15

Gosh, makes Lucy look like a young thing.

SPEAKER_03 35:17

Yeah, but Lucy's the most famous one.

SPEAKER_01 35:19

And what about this one, the more recent finding then, that was six million years old? What did that show? Were we still in the trees at that point? We

SPEAKER_03 35:26

were

SPEAKER_01 35:27

still in the trees. Right.

SPEAKER_03 35:28

It's Lucy that was the one that actually showed you this transmission.

SPEAKER_01 35:31

The

SPEAKER_03 35:31

change. The change from all fours to bipedal. And then, we've been back here 17 years now,

SPEAKER_00 35:39

haven't we?

SPEAKER_03 35:42

So it's got to be about 10 years ago. In Indonesia, in the islands of Indonesia, on one of the islands, they found skeletons. And in the film, Lord of the Rings, there's people in there called the Hobbits. On this remote Indonesian island, they found the skeletons of little people and they called them the Hobbits. Really? These are small skeletons, yeah. And

SPEAKER_01 36:14

when were they found? Was it quite recently?

SPEAKER_03 36:17

That's got to be about 10 years ago, 10, 12 years ago, like that, yeah. And they were hobbits. And they've

SPEAKER_01 36:22

called

SPEAKER_03 36:22

them hobbits? They were called the hobbits. They were? Uh-huh. They were little skeletons. They were called hobbits. Different to pygmies that you find in Africa and in the Amazon basin. Because pygmies are just small people.

SPEAKER_00 36:33

Yeah. Yeah.

SPEAKER_03 36:39

Yeah, and...

SPEAKER_01 36:41

So did they name them the Hobbits?

SPEAKER_03 36:43

Yeah, that was the scientific name that they were given, they were called the Hobbits.

SPEAKER_01 36:47

Gosh, well the thing is... On this

SPEAKER_03 36:48

island, this island was all vegetation.

SPEAKER_01 36:52

Gosh, so they were

SPEAKER_03 36:53

extinct? They were extinct,

SPEAKER_01 36:54

yeah. And do they know when they became extinct?

SPEAKER_03 36:57

No.

UNKNOWN 36:58

Gosh.

SPEAKER_03 36:59

Not that I know of to know. So that's why the human skeleton in itself is a fascinating story. It's a vast story.

UNKNOWN 37:08

Yeah.

SPEAKER_01 37:09

Well, that's a great starting point, I think, for us next time, isn't it?

SPEAKER_03 37:13

Because basically, if you think of the human fem, it's just a series of bones supplemented by pieces of cartilages. So that cartilaginous bony fem becomes the human skeleton. And the skeleton is... So the skeleton in the animal world, the skeleton is either, the deeper one is the endoskeleton, and the outer one is the exoskeleton. So if you think of a lobster, of a snail, that skeleton is the exoskeleton. And the only remnants of the exoskeleton and the human skeleton are our nails.

SPEAKER_02 38:04

And

SPEAKER_03 38:05

the enamel of the teeth, which is the hardest mineral in the body, is enamel.

SPEAKER_01 38:10

So

SPEAKER_03 38:10

the human skeleton is the deeper layer, which is the endoskeleton.

SPEAKER_01 38:16

You see, the endo of the podcast, we're leaving it with the endo skeleton, but we will start the next time. David, thank you so much. And I have to say, as we're sitting here, we have got, there is a skeleton here, isn't there? In this, I mean, I can see a model skeleton behind you there.

SPEAKER_03 38:34

The little one over there, that's the one I put together for children, that's called Billy Bones. Billy Bones. The one in the bedroom, that's an adult one, that's called Fred.

UNKNOWN 38:44

Oh.

SPEAKER_01 38:45

Well, Fred and Billy Bones will be the stars of the show next time. And the

SPEAKER_03 38:48

real Bones, I keep sipping.

SPEAKER_01 38:49

Yeah. Fascinating. Thank you, David. Thank you so much. Dr David... And Pat, who's just produced a box of chocolates, so I think we'll have a break. But another fascinating conversation. So I'll go into the

SPEAKER_03 39:01

skeleton in more detail next time. And I'll bring a bit of history in as well.

SPEAKER_01 39:05

And if you click on to the show notes, you'll get all the details. And you can drop Dr. David a note or you can drop a note on the podcast homepage if there's anything in the area you'd specifically like to hear David talking about or any questions that you have. And thanks for listening. Until next time. Bye. Bye. You've been listening to To the Real Anatomist podcast with Dr. David Robson, MDMA and myself, Alison Craig. If you've enjoyed the show, please subscribe and share. Until next time. Bye.