Speaker 1: Hey, welcome to Stuff to Blow Your Mind. My name
Speaker 1: is Robert Lamb and I'm Joe McCormick. And this is
Speaker 1: one of our from the Vault selections from days of Old.
Speaker 1: That's right, this is an older episode of Stuff to
Speaker 1: Blow Your Mind. This in this particular episode originally published
Speaker 1: January seven, two thousand sixteen, and it is titled The
Speaker 1: Stone of Madness. I think this may have been my
Speaker 1: most embarrassing skit performance on the show. Well, we were
Speaker 1: playing characters from a Bosch painting, so we were supposed
Speaker 1: to sound grotesque. If even if we can't look grotesque,
Speaker 1: you always gotta have fun being a little boshy. Yeah. Yeah,
Speaker 1: I love episodes like this because this is another one
Speaker 1: of those where we have art and history and early
Speaker 1: ideas about human biology all coming together into a nice package. Yeah.
Speaker 1: So those are some of the best ones, right, art,
Speaker 1: history and paleo science. Yes, and this one was also
Speaker 1: almost a video, is that recall? I think somebody was
Speaker 1: turning us into cartoons, and mercifully that didn't happen. Yeah,
Speaker 1: because the skit that you mentioned here, they were they
Speaker 1: were creating an animated version of that with grotesque versions
Speaker 1: of of ourselves. God save us from the unflinching gaze
Speaker 1: of the animator. All right, Well, on that note, let's
Speaker 1: dive in. Welcome to stuff to blow your mind from
Speaker 1: how stuff works? Dot com. Maybe, why, my good fellow,
Speaker 1: you look a bit mad. I am a bit mad.
Speaker 1: Do you know? Are you a physician? Well, of course,
Speaker 1: didn't you notice my physician's cap? You mean that beautiful
Speaker 1: tin funnel? Yes, yes, of course. Now if you would,
Speaker 1: can you point to the part of your body that
Speaker 1: feels insane right here in the scuttle dock, right right here?
Speaker 1: Then that's where the stone of madness awaits us? Can
Speaker 1: you can you remove it? Dot why? Certainly? Just have
Speaker 1: a seat and allow me to trepen your cranium just
Speaker 1: large enough to remove the stone. Better make it a
Speaker 1: big hole, doc. I'm about as mad as they come.
Speaker 1: I'm a man to rats to a bowl of pork,
Speaker 1: a chest to take. Sometimes I wake up in a
Speaker 1: field and I think I'm a dog. I started chasing
Speaker 1: the local clergy around it. Yes, yes, it's going to
Speaker 1: be all right. Now, just let me reach inside and ah,
Speaker 1: there it is the stone of madness and folly, the
Speaker 1: source of your mental maladies. Surgically removed. That'll be five
Speaker 1: silver Here you go. But can I can I keep
Speaker 1: the stone? Of course you can. Hey, welcome to stuff
Speaker 1: to blow your mind. My name is Robert Lamb and
Speaker 1: I'm Joe McCormick. I hope you enjoyed our little skit.
Speaker 1: That is our attempt to audibly capture the spirit of
Speaker 1: a particular painting, namely, uh, the cutting of the stone
Speaker 1: or the extraction of the stone of madness or the
Speaker 1: cure of folly, whatever you want to call it, by
Speaker 1: Hieronymous Bosh. Um. This is a painting from around four
Speaker 1: and it depicts uh, this sort of crazy but highly
Speaker 1: allegorical uh surgery taking place. Yeah, if you have never
Speaker 1: seen this painting, you should look it up. I'm gonna
Speaker 1: do my thing and tell you to google an image,
Speaker 1: but you really should see it to go with this episode.
Speaker 1: It will be on the landing page of of the
Speaker 1: web version of this episode. But yeah, it's a painting
Speaker 1: by Hieronymous bosh It's usually dated to around fifteen hundreds sometime.
Speaker 1: We read one source that said it had to be
Speaker 1: after fifteen o two other people dated to the fourteen nineties. Um.
Speaker 1: As we mentioned in the past. When we dealt with
Speaker 1: the some of Bosh's work, there's there's so little known
Speaker 1: about him that it's there's a certain amount of mystery
Speaker 1: involved in all of this, And one of the great
Speaker 1: things about it is the mystery of what motivated this painting,
Speaker 1: because because what's happening in the painting, the cutting of
Speaker 1: the stone of Badness. You have a patient in the
Speaker 1: sort of the center left of the frame, who seated
Speaker 1: in a chair in the middle of a field, and
Speaker 1: he looks quite distressed, and he's reclining back in the
Speaker 1: chair as a man in a pink robe with a
Speaker 1: tin funnel on his head cuts into the patient's scalp. Yes,
Speaker 1: and the man, the man with the tin funnel on
Speaker 1: his head, who's doing the cutting, he looks fairly serene,
Speaker 1: wouldn't you say? Yes, he seems he's he seems dedicated
Speaker 1: to the task at hand here, which you could interpret
Speaker 1: as concentration and and you know, knowing what he's doing,
Speaker 1: or you could interpret as a kind of callousness and
Speaker 1: insensitivity to this man's apparent grunting. He looks like he's
Speaker 1: in the middle of really good grunt. Then to the
Speaker 1: right of the guy reclining in the chair. He's having
Speaker 1: his head cut open. You have what appears to be
Speaker 1: you think this is a monk. Yeah, it looks very
Speaker 1: much like a monk. Yeah, he's got a shaved top
Speaker 1: of his head and he's in some black garments. And
Speaker 1: then to the right of the monk there is a
Speaker 1: woman with her head covered by a cloth, in a
Speaker 1: dress straped over her, with a book sitting on top
Speaker 1: of her head that's clasped with a clasp. So what
Speaker 1: on earth do we make of this painting? I should
Speaker 1: also note that there is text with this painting, right
Speaker 1: if you have the appropriate zoomed out version, and it
Speaker 1: says this translation, of course, master cut away the stone.
Speaker 1: My name is Lubert Duss Lubert Dass. Yeah, and this
Speaker 1: is apparently a fool in Dutch literature of the time.
Speaker 1: And then the the observer that the viewer of this
Speaker 1: particular piece would have known that. Yeah, I think at
Speaker 1: the time, calling calling a character Lubbert is kind of
Speaker 1: like us calling a character Cletus or something like that.
Speaker 1: It's like a it's like a joke and a Dutch cletus,
Speaker 1: if you will. Yeah, So that's the the one of
Speaker 1: the key paintings that we're gonna keep referring back to.
Speaker 1: But but we've see an overall trend uh in medieval art, um, yeah,
Speaker 1: medieval and early modern art in Europe that seems to
Speaker 1: be following this theme set up by Bosh, or at
Speaker 1: least first interpreted by Bosh. As far as we know,
Speaker 1: this theme of cutting out the stone of madness. So
Speaker 1: in the previous painting we had the guy with the
Speaker 1: tin funnel hat cutting the guy's head. He seems to
Speaker 1: be in the process of removing this titular stone, the
Speaker 1: stone of madness, whatever that is. But there are other paintings.
Speaker 1: There's of course, a cutting of the Stone of Madness
Speaker 1: by Brugal. Right, yeah, Peter Brugal the Elder lived a
Speaker 1: fifteen fifteen to fifteen sixty nine, responsible for a number
Speaker 1: of fabulous pieces that I'm sure everyone's familiar with it
Speaker 1: and they've even had on your dorm room wall in college.
Speaker 1: I know I did, uh, And this one shows this
Speaker 1: one has a number of individuals and several different neurosurgical
Speaker 1: procedures going on in very crude and horrific fashion. Now
Speaker 1: we can point out that this painting. You should also
Speaker 1: look this one up so you can see it for yourself,
Speaker 1: but it's much more chaotic than the last one. The
Speaker 1: last one is a sort of a concentrated scene of
Speaker 1: a single cutting taking place. This is it's a mad
Speaker 1: house there. There are people all over having their heads
Speaker 1: examined and cut, and the multiple people doing the cutting.
Speaker 1: There's just general chaos. People are squatting and squirming in
Speaker 1: the background and trying to peek in and see what's
Speaker 1: going on. It's it looks like a bad scene. Yeah,
Speaker 1: and and definitely remember the mad house of it, because
Speaker 1: we'll come back to that. The third painting we want
Speaker 1: a reference here is is Won by a Quentin Massy's
Speaker 1: uh he lived fourteen six to nine. And this one
Speaker 1: is called an Allegory of Folly. And this one is
Speaker 1: probably it's probably my favorite of the three, just because
Speaker 1: it's so monstrous and weird. Yeah. Now it doesn't depict
Speaker 1: a surgery, but it is depict It follows the same
Speaker 1: theme of the Stone of Madness. There seems to be
Speaker 1: So you see a guy here, he looks like he
Speaker 1: is perhaps mentally unsound in some way, and he is
Speaker 1: clutching a staff that what is going on at the
Speaker 1: top of the staff. Robert, Well, there there are evidently
Speaker 1: a number of different symbols going on in this piece.
Speaker 1: There's so much uh, there's so much symbology uh at
Speaker 1: play and in these these paintings, and we we don't
Speaker 1: have time to to to tease it all apart. But yeah,
Speaker 1: he has a staff that has like a small individual
Speaker 1: that is with their with exposed buttocks emerging from the staff.
Speaker 1: He has a rooster on his head. Uh, and he's
Speaker 1: see he doesn't seem in pain by his natness. He
Speaker 1: seems a little uh mischievous, the mused. Uh. No, he
Speaker 1: seems to be contemplating the act of marrying two rats
Speaker 1: to a bowl of port. Yes. And on his forehead
Speaker 1: there is a lump that you can see, it's a
Speaker 1: visible lump fulging from his forehead that appears to be
Speaker 1: this stone. It's the stone of madness. Yeah, it looks
Speaker 1: very much in a way. It also looks kind of
Speaker 1: like a third eye, which is I think something that's
Speaker 1: kind of neat about this piece that if you look
Speaker 1: at it with other artistic traditions uh loaded into your head,
Speaker 1: it kind of makes you wonder about you know, the
Speaker 1: whole difference between enlightenment and madness, which which will be
Speaker 1: a thing we come back to. But yeah, it looks
Speaker 1: like the stone of madness is not only in this
Speaker 1: individual's head, but it's poking through. Yeah. And so these
Speaker 1: are just a few examples, but this seems to be
Speaker 1: a general theme emerging in in medieval and early modern
Speaker 1: European art of of the stone of madness being a
Speaker 1: stone in the head associated with madness as they would
Speaker 1: understand it, and the the act of cutting for the
Speaker 1: stone to get it out. But does this refer to
Speaker 1: a real physical thing in any way, and does the
Speaker 1: act of cutting for it represent a surgical procedure that
Speaker 1: really took place. It's an interesting, uh mystery to consider
Speaker 1: because ultimately have like three possibilities here. One is that yes,
Speaker 1: there's something going on here to some physical malady in
Speaker 1: the head that is being removed. Okay. Another possibility is
Speaker 1: that this is all a Charlatan's game, right, that that
Speaker 1: a quack is coming along and saying, oh, you have
Speaker 1: a problem, Well, I can take care of that. I
Speaker 1: can remove the source of it. It's like cranial psychic surgery,
Speaker 1: you know, origin the psychic surgeon would kind of scoop
Speaker 1: on your stomach for a minute, and then sneak some
Speaker 1: chicken guts into his hand and pretend to be pulling
Speaker 1: things out of your body. Exactly in this case, you'd
Speaker 1: have somebody cutting at your head and then by sleight
Speaker 1: of hands, sneaking a stone into the hand and saying, well,
Speaker 1: look what I pulled out of your brain? You know,
Speaker 1: here's the problem. Yeah, it would be Yeah, in this case,
Speaker 1: it would be precisely psychic surgery. Imagine a lot of
Speaker 1: people have seen this depicted in the movie Man in
Speaker 1: the Moon of the movie about Andy Kaufman, where he
Speaker 1: goes and this is performed for him and yeah, and
Speaker 1: they would often sometimes it would be chicken up, but
Speaker 1: other times it would be inorganic objects. And so you're
Speaker 1: throw in a little You're throw in a little magic,
Speaker 1: a little superstition, and you can easily imagine this scenario
Speaker 1: in which this essentially a medieval witch doctorre of Swords
Speaker 1: of Charlotton comes in, Ah, here's the stone, I've removed it,
Speaker 1: and now you're well, yeah. Another option would be that
Speaker 1: there wasn't actually a stone in the head, so there
Speaker 1: wasn't a real problem that was being addressed. Here, and
Speaker 1: it wasn't quackery, but it was just somebody who was
Speaker 1: well meaning thought that there was some kind of thing
Speaker 1: that could be done to the head or something removed
Speaker 1: from the head to actually cure people, and it just
Speaker 1: didn't work. You know, they were wrong, but they were
Speaker 1: well meaning. So that's what we're gonna explore in today's episode.
Speaker 1: We're gonna be talking a little bit about medieval surgery.
Speaker 1: We're gonna be talking about trepi nation. Uh, We're gonna
Speaker 1: be talking about, oh, the removal of actual stones from
Speaker 1: the body, uh, particularly in the Middle Ages, And we'll
Speaker 1: get back around to what what experts think this painting
Speaker 1: and this really, this this artistic tradition is really saying. Well,
Speaker 1: I think first we should take a look at the
Speaker 1: general atmosphere of surgery in the Middle Ages and then
Speaker 1: bridging into the early Modern period here. One of the
Speaker 1: things that I think about about when we think back
Speaker 1: on medieval medicine is that it's easy for us to
Speaker 1: look back and make fun of people in the Middle
Speaker 1: Ages for believing and ridiculous cures, you know, like, oh,
Speaker 1: you've got migraines, you need to look at an ugly
Speaker 1: baby for thirteen minutes and then sprinkle some ground up
Speaker 1: bore tusk in your eye. I mean, we all know
Speaker 1: that's not gonna work. It seems ridiculous to us, Like,
Speaker 1: how did people fall for that? They must have been
Speaker 1: so stupid. But I'm not sure that's the case, because
Speaker 1: considering the known alternatives at the time, this superstitious kind
Speaker 1: of try anything approach starts to make more sense. In
Speaker 1: the Middle Ages, if you were smart, the known alternatives,
Speaker 1: especially surgery, were often a last resort, and especially elle surgery. Yeah,
Speaker 1: to open up the body is particularly the body, Kennedy
Speaker 1: was what was a very dangerous proposition. Yeah, so you
Speaker 1: may have heard about this term barber surgeon, right, you've
Speaker 1: probably heard the story that you know, why why did
Speaker 1: barber polls have this spinning red and white kind of
Speaker 1: twirl on them? Is it because they love candy canes
Speaker 1: and Christmas? Or is it is it just an accident?
Speaker 1: Well no, you know that the fact you probably heard
Speaker 1: about that is that that came from you know, blood letting,
Speaker 1: essentially saying this is a place where you can get
Speaker 1: your blood let So what While the scientific ignorance of
Speaker 1: people in in medieval Europe is sometimes I think a
Speaker 1: little bit overstated, like sometimes we underestimate just how smart
Speaker 1: people in the past were about things. Medieval surgery was
Speaker 1: still probably about as scary as you're imagining. One of
Speaker 1: the things about the time is that academic physicians, the
Speaker 1: people who really studied the body the closest equivalent to
Speaker 1: what we would think of as doctors today. These would
Speaker 1: be to learn it into visuals who had some degree
Speaker 1: of access to medical texts. Yeah, they studied in universities,
Speaker 1: they knew what was up. They may have done dissections
Speaker 1: and stuff like that, but much of the actual cutting
Speaker 1: in surgery was not done by these people. So you
Speaker 1: had your experts who were the physicians, and then separately
Speaker 1: you had these barber surgeons or these traveling surgeons who
Speaker 1: were more just kind of like skilled people who you know,
Speaker 1: they have a skill they can apply, so I can
Speaker 1: cut hair, I can cut stones out, I can hear cataracts.
Speaker 1: In many cases, the authors who wrote surgical treatises of
Speaker 1: the time admitted that they had never performed the operations
Speaker 1: they were describing, And in a way it kind of
Speaker 1: makes sense, because you know, old barber cuts your hair
Speaker 1: or shaves your head. If you're a monk and they
Speaker 1: shave your beard, So they've got the razor. Why not
Speaker 1: apply the razor to other things that need cutting, like
Speaker 1: maybe if they need to extract some bone fragments from
Speaker 1: a club strike, crush wound, or if they need to
Speaker 1: do some blood letting, which truly was very common at
Speaker 1: the time. Yeah. And plus I would imagine their status
Speaker 1: is always is already one in which they have close
Speaker 1: contact to the bodies of others. Uh, whereas I could
Speaker 1: I could imagine that being less the case for you know,
Speaker 1: learned individual. Yeah. And there's even a line in the
Speaker 1: Hippocratic oath, you know, the Hippocratic oaths from Hippocrates, the
Speaker 1: Greek physician. Um, he has a part of the Hippocratic
Speaker 1: Oath that says, and this is for doctors, I will
Speaker 1: not use the knife, not even on sufferers from the stone,
Speaker 1: but will withdraw in favor of such men as are
Speaker 1: engaged in this work. So this is you know, doctor
Speaker 1: saying I'm not going to do any surgery. Uh. Kind
Speaker 1: of strange attitude for us to consider, but that was
Speaker 1: the thought of the time. Yeah, it's hard to imagine
Speaker 1: the medieval barber surgeon TV show. You know, you would
Speaker 1: have the medical dramas playing out, but the the individual
Speaker 1: who has all the theories and all the the learning, uh,
Speaker 1: they're not actually going to do any of the cutting
Speaker 1: that goes to the secondary character. Now this does still
Speaker 1: sort of apply today because of course we still have
Speaker 1: medical specializations. You have somebody who is you know, they
Speaker 1: they focus on maybe family medicine versus somebody who's a neurosurgeon.
Speaker 1: Obviously they wouldn't try to do each other's job, you
Speaker 1: know that they have medical specialization. So that still carries
Speaker 1: through to today to some extent, but we're not in
Speaker 1: this case letting barbers do the neurosurgery. Now, why was
Speaker 1: surgery so dangerous in the Middle Ages and so just
Speaker 1: so generally awful. Well, one of the things that medieval
Speaker 1: surgeons did not have is sterile equipment or even knowledge
Speaker 1: of the knee for antiseptic surgical methods uh like. For example,
Speaker 1: there was a common belief at the time that pus
Speaker 1: was just an important part of the healing process, and
Speaker 1: that there were a few medieval surgeons who who tried
Speaker 1: things like washing wounds with wine. But it really wasn't
Speaker 1: until following Joseph Lister in the eighteen sixties that antiseptic
Speaker 1: surgery started to catch on everywhere and become the new norm.
Speaker 1: So you might have had a few people who got
Speaker 1: the right idea early on, but it was not widespread
Speaker 1: practice to practice antiseptic surgery. So then this is one
Speaker 1: of the reasons, this is the primary reason why any
Speaker 1: opening of the body, any surgical opening, is almost invariably
Speaker 1: going to become infected because of the lack of sterility. Yeah. Yeah,
Speaker 1: putting dirty things deep inside your body, it's not good
Speaker 1: for you, like a like a grubby hand reaching in
Speaker 1: to pull a stone if you're lower active. Who may
Speaker 1: have just been handling chicken guts for all you know,
Speaker 1: I mean, who knows, or collecting dead rats for the
Speaker 1: town's local bounty anyway. So there's that. They also did
Speaker 1: not have effective anesthesia and pain control. And this, I mean,
Speaker 1: you can imagine in your head exactly what the problem is,
Speaker 1: but maybe you're not imagining the extent to which this
Speaker 1: is a problem. It's not just that it hurts for
Speaker 1: the patient. It's difficult to perform internal surgery, even on
Speaker 1: a very willing participant if they're awake. Yeah, if any
Speaker 1: of you have ever um it's even difficult, I think
Speaker 1: for a lot of us to understand because there's a
Speaker 1: level of pain we're talking about here that a lot
Speaker 1: of people have not experienced. And even if you undergo
Speaker 1: surgical procedures thanks to anesthesia, you don't have to experience them.
Speaker 1: But I remember the one time I tried to perform
Speaker 1: a self surgery of a sort. Um, I had a
Speaker 1: tonenail issue which I which I tried to uh like
Speaker 1: an ingrown issue stemming from a injury. Uh. I tried
Speaker 1: to correct it myself, uh and it was just like
Speaker 1: a butter knife and some hemp rope no you know
Speaker 1: I had. And it wasn't, you know, quite surgery by
Speaker 1: any means. But um, I tried to to take care
Speaker 1: of the situation using tweezers, you know, and clippers, and
Speaker 1: the pain was just like blinding, like to where there
Speaker 1: were flashes in my eyes. And then it was okay,
Speaker 1: I need to actually go to to a professional about this.
Speaker 1: But but imagine that extrapolated to not even self surgery,
Speaker 1: but yet surgery on on on any individual where high
Speaker 1: levels of pain are just going to be the norm.
Speaker 1: You're gonna have to strap the individual down or have
Speaker 1: to ruffians, bring them to a wall or to a bed.
Speaker 1: You gotta hire some thugs to help you with your surgery. Yeah, yeah,
Speaker 1: And so there there were some potions and stuff at
Speaker 1: the time. I mean, obviously people were aware of some
Speaker 1: types of drugs, but the point was that they didn't
Speaker 1: have controllable anesthesia, so they could maybe give you some
Speaker 1: hemlock or you know, these these crazy potions that were
Speaker 1: just as likely to kill you as they were to
Speaker 1: put you under. So so they might have had that
Speaker 1: in some scenarios, or they might have just tried to
Speaker 1: do it with you awake because they knew, you know,
Speaker 1: it looks like people die a lot of times when
Speaker 1: we and that'esthetize them. So this was a problem. Medieval
Speaker 1: surgery just generally bad. Common procedures that were practiced by
Speaker 1: medieval surgeons. Blood letting, that that's a big one. At
Speaker 1: the time. They believed in the you know, humorism, like
Speaker 1: the idea that there were these four humors in the
Speaker 1: body that could get out of balance and you could
Speaker 1: fix some things by letting extra blood out. A big
Speaker 1: thing at the time was the treatment of battlefield wounds,
Speaker 1: such as the removal of arrows and so at the
Speaker 1: time surgery was much much more often external. From what
Speaker 1: we know at least, there's actually sort of a dearth
Speaker 1: of information about what surgeons in in medieval Europe we're doing.
Speaker 1: We don't have quite as much information on this as
Speaker 1: we would like to have, but from the records we
Speaker 1: do have, it seems surgery was very often externals, such
Speaker 1: as the treatment of a surface wound or other problems
Speaker 1: near the outside of the body. And for all the
Speaker 1: reasons we've already stated, internal surgery, going deep inside the
Speaker 1: body for anything was dangerous and rare, though it did
Speaker 1: happen for some extremely problematic things such as bladder stones.
Speaker 1: And we will definitely get back to stones, the bodies,
Speaker 1: the body's lithos in uh in a bit here, but
Speaker 1: I think we should first turn our attention back thinking
Speaker 1: back on on the Bosch painting and the ones that
Speaker 1: followed it to the head. That's right, yeah, because essentially
Speaker 1: what's going on here appears to be going on here
Speaker 1: is that they are uh, they're performing what we now
Speaker 1: call um craniotomy, but what has been historically known as
Speaker 1: a trap nation or trepanning, in which and this is
Speaker 1: just basically the opening of the skull, creating of a
Speaker 1: of a hole in the skull. Now we find evidence
Speaker 1: of trepidation going back to well but before the Middle
Speaker 1: Ages in Europe. I mean, it goes back to prehistoric times,
Speaker 1: so yeah, thousands of years. You see accounts of it
Speaker 1: among the ancient Egyptians, the Chinese, the Indians, the Romans,
Speaker 1: the Greeks, early Meso American civilizations. Uh, there, there's there.
Speaker 1: There are a lot of a lot of interesting work
Speaker 1: has come out of South America and I believe also
Speaker 1: in Papua New Guinea as well. But we've even found
Speaker 1: neolithic remains, human remains that had skulls that it had
Speaker 1: clearly had the operation performed on them and survived. Right,
Speaker 1: there's a hole in the skull and it has been
Speaker 1: smoothed over where the person didn't die from this surgery,
Speaker 1: at least not at least not for a long time. Yeah,
Speaker 1: and so it's it's often been an archaeological, uh mystery
Speaker 1: that individuals have have looked into, you know, what's going
Speaker 1: on with this skull? Is this a wounded did this
Speaker 1: was this just you know, clud with something, or was
Speaker 1: there some sort of a surgical procedure and if there
Speaker 1: was a curical surgical procedure, why did they carry it out?
Speaker 1: Was it both? Were they just purely magical? Were they
Speaker 1: trying to let a demon or spirit out of the head,
Speaker 1: or were they trying to deal with a cranial and
Speaker 1: brain injuries. Because today clinical trepid nation remains a treatment
Speaker 1: for epidural and subdural hematomas. But and plus it gives
Speaker 1: us a basic surgical entry point to the brain itself. Yeah.
Speaker 1: I mean, if you've heard about trepid nation before, you
Speaker 1: think about, Okay, that's just a crazy you know, why
Speaker 1: would somebody drill a hole in the skull? It's just
Speaker 1: because they thought there were demons, you know. But there
Speaker 1: are real medical reasons, as you're saying. And I guess
Speaker 1: we don't know what the ancients knew. You know, it's
Speaker 1: hard to say whether in some cases they may have
Speaker 1: been doing it just for superstitious reasons or they had
Speaker 1: some kind of medical prompting that was legitimate. Yeah, and
Speaker 1: you get into, um, you know, an argument back and
Speaker 1: forth over it too, because to a certain extent, um
Speaker 1: archaeologists in the past have looked at some of these
Speaker 1: examples and they've they've said well, there's no way that
Speaker 1: these individuals were carrying this out for legitimate medical purposes.
Speaker 1: These are savages, these are ancient people. Uh, but uh,
Speaker 1: there's a lot of evidence to suggest that they were
Speaker 1: actually dealing with they were actually performing medical procedures to
Speaker 1: deal with with head wounds, to deal with u swelling
Speaker 1: of the brain um due to you know, blunt force
Speaker 1: trauma to the skull, trying to relieve that pressure by
Speaker 1: creating uh this whole in the skull itself. But of course,
Speaker 1: trepination doesn't have necessarily a very good record in terms
Speaker 1: of the survivability of the procedure. Oh no, yeah, even
Speaker 1: by the late nineteenth century, only ten percent of patients
Speaker 1: survived a Western trepination due to infection. And I want
Speaker 1: to stress Western because when you do look to some
Speaker 1: of the so called primitive cultures out there, uh, it
Speaker 1: seems that they actually may have had a lower and
Speaker 1: more reality rate with their definations. Um. But eventually we
Speaker 1: were able to bring that up, obviously, because neurosurgery is
Speaker 1: not the uh you know, a nine mortality rate and
Speaker 1: ever that it used to be. I mean, we're just
Speaker 1: generally better at, uh fighting off infection post surgery. Now,
Speaker 1: there are a lot of reasons now that surgery in
Speaker 1: general is safer. Yeah, And a lot of people point
Speaker 1: to American neurosurgeon Harvey Cushing lived eighteen sixty nine through
Speaker 1: nineteen thirty nine as as one of the key individuals
Speaker 1: who was able to bring that neurosurgery mortality right down
Speaker 1: to less than ten percent um and and ultimately ushering
Speaker 1: in the modern age of neurosurgery in which some people
Speaker 1: do neurosurgery just for fun. Yeah, well for fun or
Speaker 1: for enlightenment, m consciousness intention Yeah. I don't want to.
Speaker 1: I don't want to go too far off the beaten
Speaker 1: path here. But we did see the rise of often
Speaker 1: self trepanned psychonauts in the nineteen sixties and seventies. You
Speaker 1: had this individual who was Dutch, interestingly enough, tying into
Speaker 1: the origins of our paintings here. Yeah. Former medical student
Speaker 1: Bart Hughes lived through two thousand and four. Uh, and
Speaker 1: he stands as voluntary trepidations pioneering visionary and so so.
Speaker 1: So he added the idea that trepidation is good for
Speaker 1: your mind, right, yeah, he um so, And this was
Speaker 1: apparently he admenced. This was a mescal and induced revelation.
Speaker 1: But his whole thing is that when we became bipeds,
Speaker 1: when we rose up on two legs, it altered the way,
Speaker 1: um uh, the fluids moved through our brain. It altered
Speaker 1: blood flow. It also altered the movement of cerebral spinal
Speaker 1: fluid and and and so he thought that this would
Speaker 1: be He was trying to figure out, how can I, uh,
Speaker 1: you know, get healthy flow of blood to the brain.
Speaker 1: So he considered, um, he considered um making a hole
Speaker 1: uh in his the base of his spinal column to
Speaker 1: rain out some of the fluid. But he eventually decided, Okay,
Speaker 1: what I'll do is I'll just I'll trepan myself. I'll
Speaker 1: make this hole in my skull. And it's important to
Speaker 1: note here we're talking about just a hole in the skull.
Speaker 1: It's not drilling all the way into brain. It's but
Speaker 1: the but the premise here is that if you were
Speaker 1: to just remove a little bit of skull there, it
Speaker 1: would allow the pressure inside the brain to be relieved
Speaker 1: and therefore allow increased blood flow through the brain, allow
Speaker 1: a better removal of toxins. That there's there's actually some
Speaker 1: interesting research going on and going into this even today. Uh,
Speaker 1: and they make some kind of compelling arguments for it.
Speaker 1: But then the experts also argue that brain function is
Speaker 1: not limited by normal blood flow, and then increased brain
Speaker 1: metabolism might actually stress the system. So it's not it's
Speaker 1: not a cut and dry situation, but you have individualstation situation. Yeah,
Speaker 1: but you have individuals out there who are very strong
Speaker 1: proponent all of trefinnation as a means of achieving up
Speaker 1: a higher state of consciousness. Okay, and so this informs
Speaker 1: our interpretation of the painting. How like, are we thinking
Speaker 1: that maybe what we're seeing in this painting is we're
Speaker 1: misunderstanding it and it's a form of trepidation or it's
Speaker 1: really just sort of related to the general concept. Essentially,
Speaker 1: it means that if there's any kind of stone removal
Speaker 1: going on, if they're removing a stone from the brain,
Speaker 1: either in fact or merely allegorically, then there there and
Speaker 1: they're dealing with trepidation. And certainly trepidation predated these paintings.
Speaker 1: It was practiced to some degree at the time. And
Speaker 1: uh and and it would have been known to the artists.
Speaker 1: There were woodcuts, there were you know, instruction manuals and
Speaker 1: as many of the medical texts showing how this was
Speaker 1: u this procedure was carried out. So, as you probably
Speaker 1: well know, kidney stones and bladder stones are very much
Speaker 1: a reality. Yes they are, and as Joe will shortly
Speaker 1: relate to us, there's sort of removal is is also
Speaker 1: very much reality and one that dates back to antiquity.
Speaker 1: But is there actually such a thing as a cranial stone?
Speaker 1: I mean, we know there there are mineral formations that
Speaker 1: can happen in the body. Can that happen in your brain? Well?
Speaker 1: Can it happen? Is is a question we'll get to.
Speaker 1: Was it happening at the time that individuals think that
Speaker 1: this was happening in the Middle Ages and in the
Speaker 1: centuries to follow well, As related by Mathis Kerschel, Frederick Mall,
Speaker 1: and Philip van karen Brock in the paper A Stone
Speaker 1: Never Cut for a New Interpretation of the Cure of
Speaker 1: Folly by Hieronymous Bosh published in the Journal International Urology. Uh,
Speaker 1: there's no evidence to suggest this was ever carried out
Speaker 1: in real life. There are no historical sources from the
Speaker 1: period that mentioned genuine or fraudulent stone operations. And I
Speaker 1: also want to add that apparently there were existing accounts
Speaker 1: of quackery that was going on in the nether Lands.
Speaker 1: You're in the fifteen and sixteenth century. Doubt they don't
Speaker 1: mention any kind of fake stone removals or or fake
Speaker 1: trepid nations going on. But it was presented theatrically in
Speaker 1: performances for the masses, because clearly the painting makes us think.
Speaker 1: The painting has a lot to say, and you can
Speaker 1: imagine that extrapolated to street performances for the common individuals. Yeah,
Speaker 1: the idea was that there there were plays that had
Speaker 1: scenes of the the extraction of the stone of madness, right,
Speaker 1: cutting for the stone in the head, not unlike our
Speaker 1: little drama at the beginning of this episode. It makes
Speaker 1: you wonder because what other types of fiction that we
Speaker 1: have today depict things going on that are plausible In
Speaker 1: the same way that cutting for the stone is a
Speaker 1: plausible thing that could have happened. You can imagine quacks
Speaker 1: cutting into people's heads pretending to remove a stone. Uh,
Speaker 1: without researching it any I would be tempted to say, um,
Speaker 1: nefarious kidney removal while on vacation. Yeah, there's place you
Speaker 1: know you Yeah, exactly if if historians of the future
Speaker 1: look back at our fiction as a as a judge
Speaker 1: to see what's happening in our culture today, and they're
Speaker 1: not They can tell the difference between fantasy and realistic fiction.
Speaker 1: You know, they don't think that Star Wars is happening
Speaker 1: in our culture today. But you know, they look at
Speaker 1: some kind of realistic drama where somebody has a kidney
Speaker 1: stolen in Las Vegas, they wake up in a bathtub
Speaker 1: full of ice. Um. I mean they could conclude, oh,
Speaker 1: this must have been something that happened a lot in
Speaker 1: the early two thousand's because clearly it's depicted in their art.
Speaker 1: And these are not these films are not just complete
Speaker 1: works with fantasy. So therefore maybe it happened. Yeah, and
Speaker 1: that brings us back to actual stone removal, the sort
Speaker 1: of stone removals we know, Um, we're carried out or attempted,
Speaker 1: uh in many cases at the time. Yeah. So I
Speaker 1: mentioned earlier how in the Middle Ages, coming into the
Speaker 1: early modern period sir jury really was a last resort,
Speaker 1: especially any significantly invasive surgery deep internal surgery, that was
Speaker 1: really really a last resort at the time. Surgeons just
Speaker 1: didn't have safe, reliable ways of putting a patient to sleep. So,
Speaker 1: as we said earlier, you have to imagine internal surgery
Speaker 1: with knives going deep inside you while you're awake, or
Speaker 1: taking a drug that might kill you. And that's that's
Speaker 1: an interesting It's it's a real Sophie's choice there. Yeah.
Speaker 1: So you remember that line from the Hippocratic Oath I
Speaker 1: said where I will not cut, not even for the stone.
Speaker 1: That's sort of an indicator that of all the things
Speaker 1: people would come to an ancient or medieval doctor begging
Speaker 1: to be cut open for at the time when this
Speaker 1: was painful and dangerous, stones in the urinary tract have
Speaker 1: got to be some of the worst things to merrit
Speaker 1: a mention like this, you know, Like, so the doctor
Speaker 1: is saying, you know, of all the things that I
Speaker 1: may be tempted to do for a person that I
Speaker 1: shouldn't do, cutting for a stone has got to be
Speaker 1: near the top to merit a mention like this. Yeah.
Speaker 1: I mean, I I've never suffered the experience of having
Speaker 1: a stone in my body, but I know we have
Speaker 1: listeners who surely have, And I would love to hear
Speaker 1: from you and your account and how that ties into
Speaker 1: your appreciation of our episode today. Yeah, I want to
Speaker 1: read a little selection from a paper called the History
Speaker 1: of Urinary Stones in Parallel with Civilization by ahmet Te
Speaker 1: Feckley and Fatine says I yearly. So this is what
Speaker 1: they write. During the medieval period in Europe ten to
Speaker 1: fourteen thirty eight, there was little activity in the management
Speaker 1: of stone disease in this era. Lithotomists and that's you know,
Speaker 1: a person who would remove stones, the lithos the stone
Speaker 1: for a living. Lithotomists were essentially commercial travelers, moving from
Speaker 1: town to town looking for business and cutting all who
Speaker 1: came their way, Often uneducated and occasionally dishonest, some were
Speaker 1: great showman. The procedure was generally performed in the public
Speaker 1: without anesthesia and generally lasted a few minutes. However, lithotomus
Speaker 1: were held responsible for their bad results and find accordingly.
Speaker 1: So as we've said, this surgery, Yeah, that sounds cute, right,
Speaker 1: the surgery is dangerous. Uh. Didn't you have some stats
Speaker 1: on the mortality rates? Yes, and these are from that
Speaker 1: a Stone Never Cut paper that are referenced earlier and
Speaker 1: all clue to link to that A landing page for
Speaker 1: this episode. But around the fifteenth century you saw about fifty,
Speaker 1: but our sources on that are a little I have
Speaker 1: to approximate. Yeah, from the seventeenth century up to the
Speaker 1: mid eighteenth century, you see variable um status. You see
Speaker 1: it as low as two point five, but also as
Speaker 1: high as sixty seven point eight. Sounds like it matters
Speaker 1: who's doing your your stone cutting, yes, as well as
Speaker 1: who is undergoing the surgery. Apparently the best outcomes occurred
Speaker 1: when you had a boy suffering a small stone. The
Speaker 1: older the individual, the larger the stone. Uh. And also
Speaker 1: if the individual is female, these would all really um
Speaker 1: tip the scales in the in favor of death. Okay,
Speaker 1: So do we have an actual account of what like
Speaker 1: did anybody make records of what this was like on
Speaker 1: the ground, Yes, they did, because these tended to be
Speaker 1: very memorable, uh for surgeries. Uh. And one that we
Speaker 1: have here today, this one actually ties into a painting
Speaker 1: is all an engineering A second, but it concerns jen
Speaker 1: did Dut a Dutch blacksmith, and uh a do it
Speaker 1: yourself lethotomist did dute beyond dute? And uh so that's
Speaker 1: that's just the best name for a do it yourself. Yeah.
Speaker 1: And there and there's a painting of the painting of
Speaker 1: this individual called a Portrait of Jan d Dute by
Speaker 1: Carol uh Di Savillene, and this was painted in sixteen
Speaker 1: fifty five. I'll try to include a ink to this
Speaker 1: painting so you can see it. Oh, he looks real
Speaker 1: satisfied with himself. Yeah. Explain described his painting for the listeners. Jow. Well,
Speaker 1: he's posed as if for a camera, and he's in
Speaker 1: his left hand holding up what looks like an egg,
Speaker 1: but I guess it's supposed to be a huge stone.
Speaker 1: And in his other hand he's just just kind of
Speaker 1: near the bottom of the painting, posed on the table.
Speaker 1: He's got what looks like a razor. So and and
Speaker 1: he's he he's not exactly smiling, but he's got pride
Speaker 1: in his eyes. Yeah. And uh, as the painting might suggest,
Speaker 1: he apparently survived at least for five years. But we
Speaker 1: know of of his case from an account written by
Speaker 1: Nicholas Tulp's six seventy two text Um Observation. He's medica
Speaker 1: and uh and this is this is just a sample
Speaker 1: translated obviously from that book. Only letting his brother help him,
Speaker 1: he instructed him to pull aside his grown him while
Speaker 1: he grabbed the stone in his left hand and cut
Speaker 1: bravely in the perennium with a knife he had secretly prepared.
Speaker 1: I don't know why it was secretly prepared. Uh. And
Speaker 1: by standing again and again managed to make the wound
Speaker 1: long enough to allow the stone to pass. To get
Speaker 1: the stone out was more difficult, and he had to
Speaker 1: stick two fingers into the wound on either side to
Speaker 1: remove it with leveraged force, and it finally popped out
Speaker 1: of hiding with an explosive noise and tearing of the bladder.
Speaker 1: Now the more courageous than careful operation was completed, and
Speaker 1: the enemy that had declared war on him was safely
Speaker 1: on the ground. He sent for a healer who sewed
Speaker 1: up the two sides of the wound together. That's just
Speaker 1: troubling I And I will note that in the painting
Speaker 1: here portrait of Jan dedut Uh, we don't see Uh.
Speaker 1: We only see Hi from the waist up, So God
Speaker 1: knows what the finished state of things were just soaked
Speaker 1: in blood. And there are other accounts out there as well.
Speaker 1: There was one in particular that I ran across years
Speaker 1: years ago, and I was trying to find it. But
Speaker 1: in involved. I want to say, a royal individual or
Speaker 1: an astronomer or someone of you know, of means and
Speaker 1: importance who had to undergo a stone removal surgery and
Speaker 1: it was just a bloody disaster and they ended up
Speaker 1: dying on the table. But after the life of me,
Speaker 1: I can't remember who it was. Okay, So we've seen
Speaker 1: that sometimes the body grows some stones inside it. You
Speaker 1: you've got these, uh, these formations of mineral deposits that
Speaker 1: can be very problematic, especially depending on where they occur.
Speaker 1: Sometimes they're so problematic medieval surgeons would go in for them,
Speaker 1: despite how dangerous surgery was at the time. And how
Speaker 1: exactly does this affect the head, because like we've said,
Speaker 1: we're not really aware from the public record that people
Speaker 1: ever cut into people's skulls for stones at the time.
Speaker 1: But maybe just maybe there's one sort of crany old
Speaker 1: phenomenon we could look at as a as a possible
Speaker 1: candidate for what what's going on here If this is
Speaker 1: intended to depict a real scene, if you're just saying,
Speaker 1: is it remotely possible, yeah, that that just could happen,
Speaker 1: That Bosh is depicting something that could have really happened,
Speaker 1: and here we want to talk about the meningioma. So
Speaker 1: a meningioma is a name for like a class of
Speaker 1: tumors that affect the brain and the spinal cord, though
Speaker 1: they actually don't grow from brain or spinal cord tissue itself,
Speaker 1: but from the meninji's or the man ninjas, which are
Speaker 1: thin layers of tissue that wrap around the outside of
Speaker 1: these organs. So around the outside of your brain you've
Speaker 1: got a thin layer of this tissue, and this is
Speaker 1: where this meningioma can occur. It's it's like a tumor
Speaker 1: um and because they appear on this outer tissue, they
Speaker 1: typically happened at the top or the outer curve of
Speaker 1: the brain. Also sometimes at the base of the skull.
Speaker 1: But this would make sense in the picture right, the
Speaker 1: top or the outer curve of the brain. That's where
Speaker 1: we see Bosch's tin funnel hat wearing. Doctor might be
Speaker 1: the generous word cutting here. So these these tumors are
Speaker 1: typically non cancerous. They're containing cysts or calcifications. Interestingly, so
Speaker 1: that would be collections of minerals, you know, stone formations,
Speaker 1: just like you might have in your bladder or something.
Speaker 1: So a mineral collection or cyst. But of course since
Speaker 1: they grow they press against the brain. Even though they're
Speaker 1: non cancerous, they still need to be removed. So this
Speaker 1: could be what we're seeing in the painting. I don't
Speaker 1: know what you think about that. Yeah, I think in
Speaker 1: terms of just I don't think it. It is what
Speaker 1: we're saying. But in terms of of making an argument,
Speaker 1: what is it possible? Is it? Is it realistically possible
Speaker 1: that that that there could be a stone of madness?
Speaker 1: Like this is the closest real world possibility. Um and
Speaker 1: and in what case would it be a stone of madness? Well,
Speaker 1: there's a paper the referred to. This is a two
Speaker 1: thousand to letter to Neurology India by Prasada Krishnan uh
Speaker 1: and UH a few other co authors as well, and
Speaker 1: they they were looking at a particular individual that that
Speaker 1: had one of these um meningioma's growing inside the skull,
Speaker 1: and they found that it can result in irrelevant speech, forgetfulness,
Speaker 1: behavioral abnormalities such as disinhibition, emotional liability, and just excessive talking.
Speaker 1: So specifically they will get a sixty five year old patient,
Speaker 1: uh and UH. They they actually performed a craniotomy and
Speaker 1: gross total excision of the legion, uh, cutting her curing
Speaker 1: her of all the symptoms in the process. So, in
Speaker 1: other words, this is one case in two thousand twelve,
Speaker 1: with of course modern surgical um tools and procedures um
Speaker 1: at hand, the surgeons were able to remove a stone
Speaker 1: like growth from a humans goal and uh, and in
Speaker 1: doing so cure the individual of their abnormal mental state. Huh. Okay, So,
Speaker 1: while we have no evidence that operations like this took
Speaker 1: place in the Middle Ages or Bosh's time, it is
Speaker 1: at least possible that this could be the kind of
Speaker 1: thing going on here. Yeah, so it would sort of
Speaker 1: match the scene described. Yeah, so it might be a
Speaker 1: case where we're accidentally art ends up giving us a
Speaker 1: glimpse of what an actual surgeon's blade with one day
Speaker 1: and cover. Okay, Well, I've got another question though. One
Speaker 1: of the things that when I was researching medieval surgery
Speaker 1: I came across is that one one of the most
Speaker 1: common surgical procedures in medieval Europe would have been uh,
Speaker 1: treatment of battlefield wounds. Yeah, so what if what we're
Speaker 1: actually seeing is something that is that has not just
Speaker 1: grown inside the head, not a stone of madness, but
Speaker 1: a missile of madness, something that has come from the
Speaker 1: outside and is being treated or removed. Yeah, I mean indeed, uh.
Speaker 1: Contemporary and ancient use of trefor nation. Uh. It was
Speaker 1: often employed to deal with head trauma, either to you know,
Speaker 1: mitigate brain swelling due to blow a blow to the skull,
Speaker 1: or to remove a bone fragment, or even a missile
Speaker 1: of some sort from uh, from underneath the skull or
Speaker 1: in the skull, or possibly in the brain. Uh. So
Speaker 1: I think you could make a granted weak case for
Speaker 1: the stone of folly having some relation to battle injury. Um,
Speaker 1: only in this case you've not been hit by a
Speaker 1: stone from the enemy sling, but rather a dose of
Speaker 1: folly from the face. Yeah. When I was preparing for
Speaker 1: this episode, one of the things I did was I
Speaker 1: watched part of a short documentary that had a scene
Speaker 1: about an injury that the young Henry the Fifth actually
Speaker 1: suffered on the battlefield when he was a teenager, where
Speaker 1: he got an arrow lodged in his head, and they
Speaker 1: were talking about what happened when it was a non
Speaker 1: fatal wound. But you know, at the time, of course,
Speaker 1: if they leave the arrow head in your wound, it's
Speaker 1: going to get infected and you're gonna die. Uh. And
Speaker 1: they talked about the procedures that the surgeons of the
Speaker 1: day went through to try to remove this arrow head
Speaker 1: from his head, and eventually he lived. He survived the procedure.
Speaker 1: But this does kind of show how, even at a
Speaker 1: time when surgery is known to be very dangerous, if
Speaker 1: you've got a major head wound, you really don't have
Speaker 1: any other choice. Yeah, It's either do it and possibly
Speaker 1: die or just die. Alright. So this this brings us
Speaker 1: back though, to to the painting itself. So we've already
Speaker 1: established that cutting for your urinary stones was complicated and
Speaker 1: dangerous treatment mortality rate. Furthermore, trepidation was an even riskier
Speaker 1: proposal at the time perhaticized mortality rate, maybe maybe even
Speaker 1: more depending on who's trying to carry it out. So,
Speaker 1: whether cutting into the brain or bowel, surgical practices of
Speaker 1: the time we're just not up to snuff. And as
Speaker 1: far as treatment of madness goes, this was an age
Speaker 1: before psychiatry was even a word. We didn't get back
Speaker 1: to eighteen o eight. The four humors still held sway
Speaker 1: over our understanding of human experience. Uh, there were and
Speaker 1: there were very few treatments for uh mental illness. Uh.
Speaker 1: The asylum was really one of the few options for
Speaker 1: individuals who really had severe mental illness, which wasn't really
Speaker 1: a treatment, right. And that's actually one of the arguments
Speaker 1: for Peter Brugal the Elder's painting cutting out of the
Speaker 1: Stone of Madness, which you said it looks like a madhouse.
Speaker 1: One argument is is that he was depicting the brutal
Speaker 1: treatment of afflicted individuals within the madhouse, not that they
Speaker 1: were actually carved upon and had stones pulled out of
Speaker 1: their heads, but that the treatment they were sieved was
Speaker 1: was comparable to that level of brutality and ineffectiveness. Okay,
Speaker 1: so yeah, it's it's sort of just like an extreme
Speaker 1: example that's fictional to communicate the reality of the total,
Speaker 1: the total picture of the conditions, much like you might say,
Speaker 1: use this not really very plausible scenario of waking up
Speaker 1: in a bathtub missing kidney to depict the general sort
Speaker 1: of lawlessness of of a society or something like that,
Speaker 1: you know, the predatory nature of wherever you are Las
Speaker 1: Vegas or something. Yeah, Now, in terms of actual trepidation,
Speaker 1: it was certainly on the table for head trauma and
Speaker 1: psycho surgery was proposed in Europe as earlier the twelfth century,
Speaker 1: but there are actually very few reports of it being
Speaker 1: effectively employed before. So it seems like the predominant theory
Speaker 1: here is that this painting is there there a number
Speaker 1: of things going on, but one possibility here is that
Speaker 1: it's less about an actual surgery and more about a
Speaker 1: symbol for the the the the the ineffectiveness of surgery
Speaker 1: as a whole. Yeah, so it's not just about our
Speaker 1: cruelty but also about our our ignorance and fumbling. Yeah, like,
Speaker 1: we we have such a disastrous record removing these stones
Speaker 1: that are occurring in the body. Let's just push it
Speaker 1: into a more comedic and symbolic area by having the
Speaker 1: quack surgeon or perhaps just surgeon with you know, bundering
Speaker 1: and incomplete understanding of human physiology and imagine than him
Speaker 1: operating on an even more dangerous part of the human anatomy,
Speaker 1: the brain itself, and then trying to remove some stone
Speaker 1: from from that part of the body as well. So
Speaker 1: in Bosch's painting, Uh, it seems that it's less about
Speaker 1: any about this being an actual procedure that was attempted.
Speaker 1: But more all right, let's take the stone removal surgeries
Speaker 1: that we know we're ocurring and that we know had
Speaker 1: such a disastrous record. Let's extrapolate that, and then and
Speaker 1: take our fictional doctor who's either a quack or just
Speaker 1: a you know, a blundering but well meaning individual who's
Speaker 1: dealing with just a limited understanding of human physiology and
Speaker 1: and uh and and and and disease and infection. And
Speaker 1: let's have him not operate on on this already dangerous
Speaker 1: part of the human body, but let's have him operate
Speaker 1: on an even more dangerous area for surgery, the human
Speaker 1: brain itself. Let's have him pull a stone out of there. Yeah.
Speaker 1: So it's sort of a fictional symbol of not only
Speaker 1: not just like Brugal's vision of our the cruelty and
Speaker 1: chaos of the madhouse, but also of our just lack
Speaker 1: of knowledge and the way we fumble through medicine. Yeah.
Speaker 1: And they're they're additional interpretations that are sometimes thrown in
Speaker 1: as well, the quack uh interpretation that we mentioned already,
Speaker 1: that it is essentially psychic surgery. Uh. There's also the
Speaker 1: idea that the folly here is the patients for wishing
Speaker 1: the swift easy removal of a thing which must be
Speaker 1: one either spiritually or you know a few of the
Speaker 1: mysteries of alchemy. Yeah, fool and his money are easily parted. Yeah.
Speaker 1: Another one of the interpretations that I'm I'm not sure
Speaker 1: I can agree with, but I at least found very
Speaker 1: interesting and liked came from that that paper reference to
Speaker 1: stone never cut four, which it was good, It was
Speaker 1: interesting to read. Uh. They pointed out the three people
Speaker 1: in the painting, so that the patient is laying in
Speaker 1: this chair suffering, as you said, reclining, seeming to groan,
Speaker 1: get it out. You've got the doctor cutting him, and
Speaker 1: then you've got the monk, and then you've got the
Speaker 1: ladies sitting there with the book on her head. And
Speaker 1: the way they interpreted the painting was that he's surrounded
Speaker 1: by symbolic characters embodying medicine, religion, and philosophy, and that
Speaker 1: that none of them really offer him a solution, the
Speaker 1: philosopher being the what looks like a nun with the
Speaker 1: closed book, the sealed book resting atop her head. Yeah.
Speaker 1: I'm not sure if I buy that interpretation, but I
Speaker 1: like it. Yeah, I like it too, And yeah, I
Speaker 1: mean she still looks more like a nun than a
Speaker 1: philosopher to me. But that's that's the rough thing about
Speaker 1: interpreting these older pieces of art is they were not
Speaker 1: meant to speak to me or you. They were they
Speaker 1: were meant to speak to an individual living in the time.
Speaker 1: So they're they're kind of speaking across time and space
Speaker 1: here and we can just do our best to try
Speaker 1: and interpret them. But but I do like that interpretation
Speaker 1: because it takes it, it extrapolates it beyond uh, mere
Speaker 1: medical science, and it just shows this it's is comical take,
Speaker 1: but also a one that that kind of just pokes
Speaker 1: fun at at our attempts to master anything. Here are
Speaker 1: the three learned individuals and what are they accomplishing with
Speaker 1: against this individual's pain, discomfort or madness boredom? Yeah? All right,
Speaker 1: so there you have it. I'm going to make sure
Speaker 1: that the landing page for this episode links to examples
Speaker 1: of all the works of art that we referenced here,
Speaker 1: so you can pull them up, look at him, draw
Speaker 1: your own conclusions, make your own interpretations about what's going on.
Speaker 1: Um And I will also link to that to some
Speaker 1: of the papers that we reference here as well. But
Speaker 1: I'd say, if you are feeling not quite well in
Speaker 1: your in your mind or in your mental state, uh,
Speaker 1: let us advise you don't cut for the stone or
Speaker 1: pay anyone else to cut for the stone. Go go
Speaker 1: see a modern medical doctor. And if that doctor has
Speaker 1: a tin funnel on his or her head, pay extra,
Speaker 1: pay pay extra? Yes, all right, hey. In the meantime,
Speaker 1: I'll be sure to visit Stuff to Blow your Mind
Speaker 1: dot com. That's we will find all the podcast episodes,
Speaker 1: who find videos, who find blog posts, who find links
Speaker 1: out for our social media accounts, Uh follow us there.
Speaker 1: We're on Facebook and Twitter is Blow the Mind. We're
Speaker 1: on tumbler as Stuff to Blow Your Mind. And if
Speaker 1: you want to get in touch with us with feedback
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