Among all the textbooks one had to read in the course of one’s medical studies, Bailey and Love’s ‘Short Practice of Surgery’ stands out as a literal heavyweight. I remember my first thought after reading the title: “If this is what a ‘short’ practice of surgery is like, I’m relieved we don’t have the ‘long’ practice on our curriculum!”
Anyone familiar with it will know what a formidable tome it is. I’ve seen it used as a door-stop in the students’ hostel, and it would probably be an effective missile if dropped from a sufficient height. It also added to one’s gravitas as a scholar, to say nothing of its benefits to the upper arm muscles, if one carried it around the college campus.
But it was a very readable text, in contrast to so many others. And often its little footnotes and asides in italics were so much more interesting than the rest of the textbook.
One such footnote, which appeared under “special types of mechanical intestinal obstruction”, described “trichobezoars and phytobezoars”, which according to the text, are “firm masses of undigested hairball and fruit/vegetable fibre, respectively.” In case you’re wondering about the hairball bit, the text helpfully explains it can happen “due to persistent hair chewing or sucking, and may be associated with an underlying psychiatric abnormality”.
In both words trichobezoar and phytobezoar, the prefixes trycho- and phyto- were previously known to me and pretty self-explanatory i.e. pertaining to hair and plants respectively, and derived from the Greek. But ‘bezoar’ was new to me. I assumed from the context that it must be an exotic term for ‘stone’, and quashed any curiosity I might have had for its etymology with this explanation. I had enough –ologies to deal with in my medical years without needing to indulge my passion for etymology as well. We couldn’t Google things then, but an old (1964) edition of The Concise Oxford Dictionary we had at home told me that the word was derived from the Persian word ‘pādzahr’ which apparently meant ‘antidote’. This made no sense, but as it hardly seemed like a viva question, I put it out of my mind. I might have seen a bezoar in a pathology specimen jar, but there my experience of it as a medical student or doctor ended.
I didn’t dream that there’d be a Goa angle to the ‘bezoar’, but apparently there is one. I realised this after my first visit to the Metropolitan Museum of Art New York. On view in gallery 463 is a stunning exhibit titled ‘Goa stone and container’. The description dates it to the late 17th to early 18th century.
It further explained that Goa stones were manufactured by Jesuits in the late 17th century, and were ‘manmade’ versions of bezoars, “gallstones from ruminants” such as sheep, deer, antelope. Reassuring to note that no humans were harmed in the process. Bezoars were apparently highly coveted for their supposed medicinal and talismanic powers, especially their believed properties as a universal antidote to any poison, which is therefore how it got its Persian name.
Prior to stumbling upon this exhibit, I had not heard of the Goa stone before. The literature about it is pretty sparse and scattered, with curiously a disproportionate amount of knowledge gleaned from American sources.
The Goa stone apparently was initially made from genuine bezoars, but became so popular that when naturally occurring bezoars from animal sources became scarce, they began to be fashioned artificially by mixing them with other elements such as shell, amber, musk, resin, and crushed precious stones. They were ingested by scraping them and mixing the scrapings with tea or water. They were highly prized for their properties and were worth literally more than their weight in gold, and often encased in elaborate, ornate, hand-crafted containers made of gold (as in the exhibit at the Met) and exported to Europe. Another surviving specimen of the Goa stone was made for the Duke of Alba in the late 16th century and now resides in the Kunsthistorisches Museum, Vienna, while another was auctioned at Christies London for an unknown sum. The specimen at the Met was brought to England in the 18th century by a British officer in the East India Company.
But do we know how effective such cure-alls really were? There is an intriguing story from 1575 when the celebrated French surgeon Ambroise Paré wanted to publicly prove that bezoars were ineffective as antidotes. A cook in the royal court had been caught stealing and sentenced to death by hanging but Paré apparently persuaded him to agree to death by poisoning instead. Despite administering the supposed antidote, the hapless cook died horribly many hours later.
But recent experiments show that when crushed bezoars are mixed in arsenic-laced solutions, the toxic compound arsenite does indeed get removed by binding to sulphur compounds in the protein of degraded hair, a major component of bezoars.
For those interested, there is an informative short video about the Met Museum exhibit titled ‘Paradox’, by curator Maryam Ekhtiar. It allows you a close-up look at the exquisite filigree craftsmanship of the 20-carat gold case, teeming with mythological creatures, such as unicorns, griffins, as well as more earthly ones. “Works of art aren’t always what they seem”, says Ekhtiar in the video. “The dissonance between the case which is so elaborate and so extravagant, and what’s inside, which is creepy and unexpected; that, I think is the most amazing attribute of this work. It’s the paradox that it presents that totally surprises you.”
Interactive technology on the website of the Metropolitan Museum allows you to examine the exhibit at even closer quarters, from every angle, virtually turning it round, lifting the lid, in a way you would not be able to handle the actual exhibit.
Just as I was preparing to send this into print, my son indicated to me that he already knew about bezoars and their believed powers. When I asked him where he learnt this, he called my attention to page 147 of J.K. Rowling’s ‘Harry Potter and the Philosopher’s Stone’. It is a topic that Severus Snape puts up for discussion to his class during their Potions lesson in their first year at Hogwarts School of Witchcraft and Wizardry. Who says children’s books cannot be educational as well?
(An edited version of this article was published on 11 September 2016 in my weekend column ‘On the Upbeat’ in the Panorama section of the Navhind Times Goa India)