George II is the only British monarch known to have died while defecating. At about seven o’clock on the morning of October 25th, 1760, one of the page boys at Kensington Palace heard a loud noise from the King’s private apartment, as if a piece of furniture had fallen over.* When the valet went to investigate, he found His Majesty dead on the floor; he had been using his ‘necessary-stool’. The royal physicians were summoned, and since their patient was beyond any medical aid they were instructed to dissect and embalm the royal body. This is what they found:
Upon examining the parts, we found the two great arteries, (the aorta and pulmonary artery, as far as they are contained within the pericardium) and the right ventricle of the heart stretched beyond their natural state; and, in the trunk of the aorta, we found a transverse fissure on its inner side, about an inch and half long, through which some blood had recently passed, under its external coat, and formed an elevated echymosis.
An ecchymosis is an area of subcutaneous bleeding – essentially, a bruise.
The image at the top of this post is an engraving of George’s heart made during autopsy. The aorta is the arch-shaped blood vessel, and on the right-hand side you can just make out the bulge in its wall that killed him. This is known as an aortic dissection, a condition in which the inner wall of the artery becomes weak and tears, separating from the outer layers of the vessel. George’s is one of the earliest known examples.
*In his letters – but not his far more decorous official memoir of the king’s reign – the royal biographer Robert Walpole described this noise as being ‘louder than royal wind’.
An elderly, Afro-American came into the VA Medical Hospital complaining of pain from an injury from a blow to the top of his during a mugging. He was treated and released. He returned a few days later, still suffering. An X-ray showed a bullet lodged in the middle of his brain. Neurosurgeons determined that any attempt to remove it surgically would result in a fatal outcome. A creative surgeon in Palo Alto conceived an ingenious method of removing it. A device for precisely positioning the patient in a huge centrifuge (used for testing prospective astronauts) was constructed, the patient was placed in it and brought up to speed. Centrifuged, the bullet was forced back along the entry path without further damage to the brain.
That is amazing. Charles Ballance, the first British surgeon to gain any sort of regular experience of cardiac repair, suggested after WW1 that the removal of missiles from the cardiac chambers might be facilitated by a large electromagnet, since bullets and shrapnel were mostly made of steel. The first person to put it into practice, thirty years later, was Dwight Harken during his wartime service in England. He had a massive electromagnet installed above his operating table. Unfortunately the first time he turned it on, the bullet stayed where it was but surgical instruments (mostly made of steel) flew through the air at lethal speed!
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