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Science / Medicine : The Kidney Bean Procedure and Other Tales : Medical oddities: The British Medical Journal publishes its annual collection of bizarre, offbeat and humorous reports. Ever hear the one about the bell ringers?

TIMES SCIENCE WRITER

The 82-year-old blind man had recently developed urinary incontinence as a result of receiving diuretics from his physician. During a visit by a childhood friend, an Australian shepherd, the friend mentioned that he had cured a similar problem by inserting a dry kidney bean to block the leakage.

The shepherd said he replaced the bean every 24 hours, using specially adapted blunt-ended tweezers. Before the friend returned to Australia, he gave the blind man some of his own beans.

When the blind man tried to remove the first bean with tweezers two days after its insertion, his poor sight made the retrieval process extremely difficult, according to urologist Anup Patel of Charing Cross Hospital in London. Instead of removing the bean, the man pushed it further into the urethra.

Embarrassed at his predicament, the man did not seek help until three days later, “when his penis had become swollen and painful and micturition was ‘difficult,’ ” Patel wrote in the most recent edition of the British Medical Journal.

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The bean, which had sprouted, was subsequently removed in three pieces and the patient returned to health. Treatment with the diuretics was halted, and the patient had no further need for beans.

Patel noted that urinary incontinence is a troublesome problem in elderly men, particularly those treated with diuretics, and that the dry bean “is a novel and ingenious concept based on the ball valve stopcock principle, and this case shows that it is effective.” But, he concluded, “it is not without potential hazard, especially in the unwary elderly patient with compromised vision or poor manual dexterity.”

Each year, the editors of the British Medical Journal save all their bizarre, offbeat and humorous medical reports for their Christmas issue, providing a pleasant break for the sober, somber parade of conventional studies. This year’s issue was not among the best, but it did provide a few moments’ relief from medical tedium.

Consider a survey by orthopedic surgeon John S. Fox and his colleagues at the Cleveland Clinic Foundation in Ohio. Previous reports in the BMJ, they wrote, suggested that “the orthopedic surgeon is a man of enormous build and great strength, if perhaps a little slow; (and) that orthopedic surgery requires brute force, ignorance and a perception of pain.”

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To study this perception, they asked the question: “Are orthopedic surgeons really gorillas?” To answer this question, they sent “an unbiased and totally ethical” letter to the head nurses at major hospitals across the United States asking for information about the glove sizes of orthopedic surgeons and other surgeons. “As an adjunct study, glove sizes of locally available gorillas were measured.”

With results obtained from 483 surgeons, they found that the average glove size for male general surgeons was 7.4 while that for orthopedic surgeons was 7.7. For females, the corresponding sizes were 6.5 and 6.9. The glove sizes for a gorilla in the natural history museum and one in the local zoo were greater than 9.5. A third “gorilla was not cooperative and despite many attempts would not allow measurement.”

Concluded the researchers: “At best, results could only support the contention that orthopedic surgeons are bigger gorillas than are general surgeons.”

Radiologist A.C. Lamont and surgeon N.J.M. London of the Leicester Royal Infirmary in Leicester conducted what they believe to be the first general survey of injuries to bell ringers.

Bell ringing, they wrote, is “an art peculiar to the English-speaking world. It is estimated that there are 40,000 bell ringers in England alone and that 3,000 towers are rung every Sunday.” They found that many injuries were caused by “the most notorious hazard of bell ringing--the high-speed lift. This occurs when the bell (becomes unbalanced) and the hapless ringer who forgets to release the rope is whisked upward at a speed approaching 90 kilometers per hour (55 m.p.h.).”

A typical incident was reported by an Australian correspondent who noted that the 1,000-pound bell he was ringing went out of balance, lifting him abruptly. “I could hear voices (not the spiritual kind) telling me to ‘Let go! Let go!’ and all I could think was I am not going to drop that far onto the cement floor, so I kept going right to the top until my right hand hit the hole and my head hit the ceiling. I had no choice but to let go at this stage because the rest of me wouldn’t fit through the hole (in the ceiling).”

The writer suffered bruises and a broken finger but was probably fortunate. Another man in similar circumstances fell 15 feet to the floor and broke his leg. A woman had a concussion and severe facial injuries when she hit her head on a table in the ringing chamber. One ringer was killed when his head hit a beam in the ceiling, another from a concussion caused when the rope caught his foot.

Letting go is not necessarily much better. One 80-year-old ringer was nearly scalped when the rope wrapped itself around his forehead. Four others suffered near-hangings in similar accidents. Two children had teeth knocked out when the rope flicked their face.

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Far more common among the bell ringers, however, were fractured fingers, rope burns, abrasions and bruises. Lamont and London concluded that about 1.8% of bell ringers were injured each year.

“The most inexplicable of associated deaths occurred at the high tower of a large country church, which was open to visitors during a ringing outing,” the authors wrote. “During the peal a visitor committed suicide by jumping from the roof of the tower. A ringer commented, ‘I didn’t think our Steadman Caters was that bad.’ ”


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