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Why eating people is wrong (and other medical discoveries)

The medical role of rollercoasters, cannibalism, stamp collection and spit & polish were all celebrated in the 2018 IgNobel Prize awards

Most medical breakthroughs come from hard work, persistence and insight. Others result from dumb luck or happy accidents.

Some of the more unexpected contributions to science are celebrated each year in the Ig Nobel Awards ceremony - a tongue-in-cheek alternative to the real Nobel prizes, organised by the science humour magazine Annals of Improbable Research and reported in the BMJ.

Among this year's winners was urological surgeon David Wartlinger, who found that riding a rollercoaster can cure kidney stones. One of his patients went on the Big Thunder Mountain Railroad rollercoaster and passed a kidney stone when he got off the ride. The same thing happened when he repeated the ride a second and third time. 'Control' patients who used different rollercoasters demonstrated that it wasn't the speed or size of the ride that mattered, it was the shaking movement that helped to dislodge the stones. Wartlinger is not yet advising urologists to prescribe trips to Disneyland, but his finding shows that what starts with a bizarre anecdote can end up part of mainstream medical knowledge. All aboard the Lithotripsy Express.

The history of medicine is full of innovations that result from serendipity. Most famous, perhaps, is Edward Jenner's invention of vaccination following the chance finding that milkmaids were immune to smallpox. He reasoned that this was because they had been exposed to the closely-related cowpox, which he then used as the basis of a smallpox vaccine. (The word vaccine comes from vacca, the Latin name for 'cow').

The antibiotic era began when Alexander Fleming returned from holiday to his messy lab and found an unexpected mould growing on a culture dish. Noting that bacterial growth was inhibited around the mould, Fleming isolated the microbe and used it to produce penicillin. Fleming admitted: "Sometimes one finds what one is not looking for." If his workplace had been more tidy he may not have made the discovery. But it was Fleming's experience that identified the infection-killing potential of the mould, and made him follow his observation through. As fellow bug-hunter Louis Pasteur put it: "Chance favours the prepared mind."

This year's Ig Nobel Award for Reproductive Medicine went to 3 other urologists (what is it with urologists?), who discovered a way to assess male impotence using postage stamps. They instructed patients to wrap a strip of stamps around their penis before going to bed (no mention of first or second class, or where they woke up the next morning). If the men experienced normal erections during the night, the perforations between the stamps were broken. If the stamps remained intact, they'd missed the post.

Medical historians may remember that the first treatment for erectile dysfunction came from another happy accident. Men taking sildenafil to treat angina reported a welcome improvement in their cardiac circulation, together with an unexpected bonus in the trouser department, and so Viagra was born.

The Ig Nobel Award for Nutrition was won by researchers investigating why some people have the urge to eat each other. They concluded that cannibalism must have a cultural role because it makes no sense on nutritional grounds, unless you're dieting. The calorie content of a human body is disappointingly low compared to other animals. A 50kg man contains only 4.5kg of edible protein, which is barely more than a KFC bucket meal, so you might as well stick to chicken.

The case against cannibalism began with an earlier medical discovery. A neurodegenerative disease known as kuru was found to be common among the Fore people of Papua New Guinea. Researchers suggested that it was spread by family members eating their dead relatives. Not while they were fresh, mind; the relatives were buried for days until they were half-eaten by maggots, then they dug up the corpse and ate the remains, with the maggots as a side dish. (Serving suggestion: don't try this at home).

A virologist called Daniel Gajdusek made the breakthrough discovery that kuru was transmitted by an infectious agent in the brains of the victims. This was later identified as a prion (misfolded protein), and therefore related to BSE ('mad cow disease'), Creutzfeld-Jakob disease in humans, and variant CJD, which is caused by eating meat contaminated with BSE. His work on kuru earned an actual Nobel prize for Gajdusek.

Not all of this year's Ig Nobel Awards celebrated eureka moments. Some just endorsed common sense. Every child who has had their face wiped with a saliva-soaked handkerchief knows that mother's spit is the universal solvent. This was confirmed by Portuguese researchers who showed that human saliva is an excellent cleaning agent because it combines water, which has a washing action, and alpha-amylase, which has an enzymatic effect. It is good at removing dirt from many surfaces, including grubby children, even though it's less sterile than human urine, which the Romans used to wash their clothes and clean their teeth.

Everyday medicine is an empirical science, and a good doctor is always on the lookout for the unexpected. But it's the gradual accumulation of knowledge that enables an experienced doctor to see the significance of something that a younger doctor might miss. Most GPs would echo the response of another GP (the golfer Gary Player) when he was accused of being lucky. "The more I practice, the luckier I get."

Unexpected discoveries are not confined to medicine, of course. Anyone who works in the creative industries knows the value of keeping an open mind. It's not enough to observe surprising events, though. It's also necessary to see their significance, and link cause with consequence. Serendipidity is a great short cut, but you still need to do the groundwork.

©2018 Life Healthcare Communications

9th May 2019



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