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Thanks to advances, conjoined twins now have a chance at separate lives

When surgeons separated 4-year-old conjoined twins Kendra and Maliyah Herrin earlier this month, they completed the first surgery to separate twins with a single good kidney. (The girls also shared a single pair of legs, a pelvis and one liver.) The history of conjoined twins is full of firsts -- and these are accumulating ever more rapidly as growing numbers of doctors, families and twins themselves opt for separation.

Elena Conis

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Up until the 20th century, conjoined twins were rarely separated, except when one twin died.

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The first surgery to successfully separate two living twins was performed in Switzerland, in 1690. The doctor tied a cord around the strip of flesh that joined them at the abdomen, tightening it each day until he could cut the twins apart with a knife.

Medicine in the 17th century and earlier didn’t allow for surgeries much more complex than that. So for the most part, such twins stayed intact.

Many lived healthy, though somewhat shortened, lives. Mary and Eliza Chulkhurst, joined at the lower back, lived into their 30s in medieval England, becoming locally renowned for their acts of charity. When Mary died at 34, Eliza refused to be separated and died six hours after her sister.

They were followed by French twins born in 1495 who were joined at the head and who lived to age 10, and conjoined Hungarian sisters born in 1701 who learned three languages fluently before dying at 21.

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In the 1800s and 1900s, conjoined twins became money-making curiosities. Millie and Christine McCoy, born into slavery in 1851 and joined at the back, were bought, sold and kidnapped repeatedly and ended up in P.T. Barnum’s circus, billed as the “Two-Headed Nightingale.”

Chang and Eng Bunker, for whom the term “Siamese twin” was coined (they were from Thailand, once known as Siam), also became a P.T. Barnum attraction. (They eventually left show business for farming life, fathering nearly two dozen children between them by the time they died at age 63.)

Though one in 100,000 births results in conjoined twins, most are stillborn or die shortly after birth. Of those who do survive, many -- even the most difficult cases -- are now separated. (In L.A., in June, surgeons separated twins fused from chest to pelvis, and, three years ago, ones joined at the head.)

Twins sharing a heart were first successfully separated in 1979 -- although one died of liver and kidney failure a week later. Since then, surgeons have also successfully performed a complex operation that had long been impossible: separating twins whose brains are fused together.

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