Liverpool Architecture Triptych

2022 - The Albert Docks on Kentmere 400.

What I was trying to capture here was the dominating red brick Albert Docks; imposing. They are built for business and industry. They feel stoic. But just out of centre, modernity is creeping in in the form of the Museum of Liverpool, which was temporarily hosting the Tate Gallery at the time. In this photo, I see that metropolitan has taken root in Liverpool.

2022 - Bold Street Coffee on Kentmere 400.

In this photo, I like to imagine what the two ladies are talking about. Where the man at the door heading out to after closing up his cafe.

In this photo, I like to imagine what the two ladies are talking about. Where the man at the door heading out to after closing up his cafe. I could have easily walked past this scene. I wonder what conversations he overheard that day. But camera in hand, on a mission, I did stop. I was forced to focus, slow down, and see if I could capture the scene around the coffee shop.

2022 - 5 past 9 at the Liver building on Kentmere 400.

This is the iconic Liver Building. It’s grandeur is impressive, however, it now seems to be merely the administrative building for a food and drinks company.

I find comfort in that. Like the Liver building, expectations are high, with people often overestimating what you can do, what you can achieve. Just doing something is better than falling into disrepair because nobody could figure out what you should do to make the most of your time.

This is a photo of the Liver Building. It is a bland and uninteresting take on one of the most photographed buildings in the North of England. But I took a photograph. I took a light reading, focused my rangefinder, made the composition, prepared my film canister, paid for it to be developed.

A lot went into this grainy, poorly exposed, blandly composed photograph. That is OK. It was fun. It is enough.

Closing Thoughts

We can go and do something we don’t know much about, in a place we are unfamiliar with, and find the time to slow down and focus. There can be meaning in making something mediocre. It can spark adventure, you may meet strangers, and for me it helps me slow down when my urge is to speed up.

Architecture photography in a small city might be the best way to give yourself an excuse to get out there, and try to capture what you feel.

Camera Nerd Details

• Yashica Electro 35 CC
• Kentmere 400
• Developed and scanned by Analogue Wonderland (referral code for £5 free)

The story

I recently answered a question on Bio.SE regarding the medical case of a French man called Tarrare who was alive in the revolution. The case has achieved near-legendary status due to the fantastic accounts of his showmanship, his seemingly insatiable hunger, his botched attempt at espionage, and his tragic descent into cannibalism.

I am not a medical doctor. I cannot at all approach this case from the angle of a diagnostician and hope to conclusively form a diagnosis that nobody else has managed to notice. I have however had a lot of fun reading this case and would like to share my views on this incredible story.

If you want to read more about the exploits and drama surrounding Tarrare, I don’t think I could do a better job than the source material (it is only a couple of pages), or a more dramatised blog post can be read here.

Here I will regurgitate my answer, embellished with a few opinions that wouldn’t suit the Stack Exchange format.

Tarrare’s life

Tarrare was a showman who was renowned for his insatiable appetite including eating cats, dogs, and snakes sometimes raw. He is also said to have eaten many inedible items. At the time, he was alleged to have committed cannibalism of a 14-month-old baby and was caught in the act of cannibalising cadavers by hospital staff.

He was given away as a child by his parents and served in the French Revolutionary Army.

Tarrare died at the age of around 26. From the book “Anomalies and Curiosities of Medicine” originally published in 1896 by Gould and Pyle:

He was of middle height and was always heated and sweating. He died of purulent diarrhoea, all his intestines and peritoneum being in a suppurating condition.

This record is 100 years after Tarreres death and is largely based on the 1819 London Medical and Physical Journal. The earlier record claims:

At seventeen years of age, Tarrare weighed only one hundred pounds, and was already able to eat, in twenty-four hours, a quarter of a bullock of that weight.

From these accounts, I form the opinion that Tarrare ate an incredibly poor diet of raw meat and offal and countless inedible objects. There are references to throwing up after consuming raw animals and chronic diarrhoea. There are references to sleeping for large periods after eating large quantities of food.

Autopsy

A passage from the 1819 London Medical and Physical Journal:

This is the closest article we have to a contemporary record. From this account we gather that his stomach was enlarged and ulcerated, his gall bladder was enlarged, and his liver was diseased and enlarged. Also, it might be a factor that his appetite was lost during these final days, common among patients with diarrhoea. The record at the time, as quoted above, attributes the cause of death to diarrhoea.

Although the picture is painted that the autopsy occurred soon after death, we have no idea if this was hours, days, weeks, and conditions were much less sterile than modern morgues. I am not sure if the “corruption” mentioned is significant. One source claims Tarrare died of TB, however, I cannot find any corroborating evidence. Another source recounts Tarrare blaming his demise on eating a golden fork.

These post mortem observations could have developed from 20 years of eating an exceptionally poor, unhygienic, and often inedible diet and may or may not have been the cause of his underlying condition.

Summary

So we have a few things to consider.

• Polyphagia including inedible object consumption
• Died young
• Gastrointestinal abnormalities identified postmortem
• Chronic fever and sweating
• Chronic diarrhoea and vomiting
• Periods of prolonged sleep

Polyphagia

The London Medical and Physical Journal describes Tarrare as having polyphagia which in his case could not be cured by acids, opium, or tobacco.

Colloquially, polyphagia means ingesting a wide variety of items. However, if they meant “polyphagia” medically, it could be a symptom.

Polyphagia is a medical symptom defined as excessive hunger. In modern times, this can indicate a disorder such as diabetes (improper production or reception of insulin) or Kleine–Levin syndrome (a disorder of the hypothalamus). It could also indicate a genetic condition Prader–Willi syndrome and Bardet–Biedl syndrome.

The full list of causes from Wikipedia is:

• Anxiety
• Stress
• Depression
• Orexigenic drugs
• Diabetes mellitus
• Hyperthyroidism
• Hypoglycemia
• Fatigue
• Premenstrual syndrome
• Prader–Willi syndrome
  • From the NHS: Prader-Willi syndrome is a rare genetic condition that causes a wide range of physical symptoms, learning difficulties and behavioural problems.
• Bulimia
• Graves’ disease
• Autoimmune thyroid disorder that can lead to an intolerance of heat
• Kleine–Levin syndrome
• A sleeping disorder

We cannot know if Tarrare’s polyphagia was brought on by his stressful exhausting life, his poor diet, or some genetic condition. We cannot even be sure if his condition was responsible directly or indirectly for his death. We cannot know if his sweating was related to his underlying condition, or a chronic state of infection. The only cause for his eating we can rule out from the above list of underlying causes is premenstrual syndrome (PMS) and orexigenic drugs (which are not documented). There could be a case made for most of the other causes.

Concluding remarks

Given the scarceness of good quality medical records, the anecdotal nature of what was recorded, and the relatively poor diagnostic power of medical practitioners of the time, it would be, in my non-medical opinion, impossible to conclusively form a diagnosis.

From discussions on the Bio.SE forums, we have concluded that cholera could have been the illness that finally struck him down although his death was a dozen years or so before the first European epidemic, and 50 years before Cholera was first cultures and described. It seems to me however that the laxness of his guts, skin, and jaw, could all be accounted for by excessive abuse due to his polyphagia. His insatiable appetite could have been derived from a bulimic-like effect of diarrhoea as a consequence of poor hygiene and diet in conjunction with some metabolic disorder. If there was a more systemic disease at play (such as Ehlers-Danlos syndrome), being the showman he was, I am sure Tarrare would have performed contortion acts and it would have been documented.

So in reality, it could have been any number of pathogens that finally got the best of him, and any number of underlying conditions that exacerbated his illness.

T. BRADLEY, M. D., A. F. M. WILLICH, M.D., J. P. PFAFF, M.D., R. RATTY, M.D., J. ADAMS, M.D., A. A. NOEHDEN, M.D., W. SHEARMAN, MSD., J. ARNEMAN, M.D., W. ROYSTON, Esq., SAMUEL FOTHERGILL, M.D. AND WILLIAM T. (1819). THE LONDON MEDICAL and PHYSICAL JOURNAL, Published by Oxford Univ. 1986;XXX:60. Retrieved from https://books.google.co.uk/books?id=4e0EAAAAQAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

Context

A while ago I saw a question on the Biology Stack Exchange Network. “What are the side-effects of long-term liquid breathing?” This is a topic that has long interested me, so I decided to post an answer. Over time the answer grew in size and depth. It now reads more as a stand alone piece rather than the quick Q&A summary answer it is supposed to be.

Overview.

The validity of liquid breathing is a very interesting question. The ideas behind this have been around for a while and the methods are covered in great detail elsewhere.

The overall answer to the hypothetical question is rather surprising. There may be actually potential benefits to perpetual liquid ventilation for people with certain diseases. Trials so far have not found side effects in fluorocarbon liquid breathing.

So lets talk about the history of liquid breathing and case studies, then we will move onto the hypothetical situation of liquid breathing indefinitely.

A great review (Shaffer et al, 1992) covers the field in great depth.

User @MCM pointed out in the comments that my original answer did no emphasise that animal diaphragms are not powerful enough to move the liquid in and out of the lungs. I should mention now that the below cases all use ventilators to pump the fluid into and out of the lungs. The difficulty of breathing this without a ventilator is emphasised by David Blaine at 4:54 in this TED talk who said it was like trying to breathe with an elephant standing on your chest.

Case studies.

As early as the 1920s, poisonous gas research that lead to the infamous mustard gas found that lungs could tolerate large quantities of saline briefly without damage.

Animals.

Kylstra, the first pioneer introducing the idea of land animals breathing liquids (Kylstra et al., 1962), found mice could withstand 4 hours of 160 atmospheres of pressure.

Clark found that mice and rats could breathe oxygen bubbled silicone oils and survive for a few hours after emersion.

In 1965, he discovered that the fluorocarbon known as FC75 not only supported respiration during total immersion but the mice survived indefinitely in apparent good health.

The most recent study I can find is the partial use of fluorocarbon liquid ventilation in adult respiratory distress syndrome (ARDS) of rabbits. The same improvements in breathing were not observed in saline liquid breathing or conventional ventilators.

Humans.

In humans PFCs were first used successfully in 1989 for the ventilation of young infants near death.

Marked improvement in lung compliance, without a compromise of cardiovascular status was noted in all three patients.

All three infants died of their severe preexisting respiratory complications, but the trial showed liquid breathing can support gas exchange in humans. However developing lungs of infants cannot rely on mechanical ventilators for prolonged periods as nearly a quarter of premature infants of those that do later developed chronic breathing problems.

Biomedical application.

There are a fair few researches and doctors who believe fluorocarbon liquid ventilation has some advantages over gas ventilation. It reduces stress at the area of interfacial surface tension in the distressed, surfactant-deficient lung. This would be ideal and appropriate for ARDS in human adults. A more sophisticated use would be using fluorocarbons as a drug delivery system straight to damaged lung tissue.

(All the above can be found in the 1992 review. There is also data on the different properties of suitable FCs)

Real world potential.

Is perpetual liquid breathing possible? …And healthy?

So this is where we stand with the case studies; mice can breath liquids indefinitely and stay in good health, rabbits with ARDS survive where breathable gas would not help, and there is a contingency in the biomedical community that it can be better than gas ventilation for medical treatment. To me it seems that there is nothing to suggest a fully grown adult would suffer from breathing liquids. The inertness of the fluorocarbons implies any toxicity would only reveal itself in a timescale of years, and everything else about the compounds pose no danger and may make gas transfer across the lungs easier.

This relatively modest success is perhaps no surprise. The exchange interface of our lungs relies on a mucous (liquid) so the gases can permeate the lung tissue. Expanding on that idea should certainly not rule out the possibility of liquid breathing.

The biggest drawback, besides the cost of a long term experiment and being dependent on a mechanical ventilator, is that these are very small case studies of success. Given the massive amounts of unknowns (particularly for long term studies), switching to purely liquid ventilation in an adult human could have unforeseen risks and would be considered dangerous by any ethics board (or insurance company)!

On a lighter note, here is a YouTube video of what Maddie, a biology podcaster from the BBC, had to say on the matter of living in total submersion. Lots of skin problems, risk of infection after a few days etc.

Again, a very interesting, albeit understudied, topic!

Shaffer, T. H., Wolfson, M. R. & Clark, L. C. Liquid ventilation. Pediatr. Pulmonol. 14, 102–109 (1992).

Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.1950140208?sid=nlm%3Apubmed

What is a Journal IF?

“Impact Factor” (IF) is a term that aims to do what it says on the tin; it’s a rating of the impact of an article. But it is more than just a number for an individual article. IF is used to determine an academic’s success in a given job position, their right to a grant or future job, and on a more day-to-day level it gives them bragging rights. In a quest to increase the IF of a paper, researchers often aim to get their work published in journals that are not always the most appropriate. Instead, they would rather publish in a journal with the highest IF that will consider their paper.

IF is supposedly a metric that captures the academic importance of a journal. It is reported as being the number of citations each article gets in the previous 2 years. Wikipedia explains IF very thoroughly, and I wouldn’t want to repeat all of that here.

Rossner et al. believe that the IF is not exactly as straight forward as implied. They touch on some very troubling issues that should undermine the authority of the journal IF.

• The numerator of the IF includes different article types to the denominator. This means that articles can be factored into increasing the numerator without increasing the denominator, for example front matter can validly gather citations, but does not count as an article, allowing the journal to accumulate “free” citations.
• Articles, reviews, and front matter are curated by hand by Thomson Scientific. These designations were found to be routinely incorrect when the group purchased data from Thomson Scientific for scrutiny.
• These designations can be negotiated in a non-transparent way. This has allowed journals to vastly reduce their article number inflating the citations per article.
• Retracted articles still count.
• The mean average is skewed by blockbuster publications, meaning the IF does not reflect the majority of articles in a journal.

In a self-analysis of their 2005 IF, Nature noted that 89% of their citations came from only 25% of the papers published.

• The data you can purchase from Thomson Scientific is not the data they use to calculate the IF.

When we requested the database used to calculate the published IFs (i.e., including the erroneous records), Thomson Scientific sent us a second database. But these data still did not match the published IF data. This database appeared to have been assembled in an ad hoc manner to create a facsimile of the published data that might appease

I find it astonishing scientists tolerate such an unscientific method of deciding the scientific quality and validity of individuals and groups.

The article ends in an optimistic tone, calling for other metrics to emerge that may usurp the opaque and ill-defined IF.

Rossner, M., Van Epps, H. & Hill, E. Show me the data. J. Cell Biol. 179, 1091–1092 (2007).

Retrieved from http://jcb.rupress.org/content/179/6/1091.full

I’m Just Looking For Some Answers

Nicola Davis of the Guardian opens her interview of Robbert Dijkraaf with an antiquated recording from a Johns Hopkins review. The voice we hear describes a thought-provoking anecdote.

I was showing a friend of mine through one of the laboratories at Johns Hopkins University, where he was talking with a research scientist.

He said “This is all very wonderful. But, what does it mean? What value has it? How can you use it?”

The scientist said “I don’t know. I’m just looking for some answers.”

This exchange sets the stage perfectly to understand Abraham Flexner’s passion for a spiritual & intellectual approach to curiosity-driven discovery. In this essay, Flexner argues for rejecting the institutional constraints placed on academics. The essay is considered a classic and was republished by Flexner in 1955 with some minor alterations and again, posthumously, in 2017 along with a companion essay by Robbert Dijkgraaf.

Reform from pragmatism to curiosty

Abraham Flexner was responsible for large reform in both science and medicine in North America throughout his lifetime. Particularly, “The Usefulness of Useless Knowledge” published in 1939 changed the behaviour of many Universities. It was common for universities to practise a utilitarian teaching method. A typical case of such teaching was the University of Columbia which offered courses like poultry raising and beekeeping indicative of the short-term incremental focus of academic institutes. Flexner argued that universities needed to cultivate their academics curiosity, and not constrain it to the most immediate practical purpose. Given that “translational research focus” is making a resurgence throughout the life sciences, we need to consider this essay again.

We gain some insight into Flexner’s critical nature in this paper when he talks about Marconi’s historic Nobel prize-winning feat of the invention of the wireless radio as merely the last stage of the work by Maxwell and Hertz, discrediting Marconi of any bona fide discovery.

The inventor in the legal sense was, of course, Marconi, but what did Marconi invent? Merely the last technical detail, mainly the now obsolete receiving device called coherer, almost universally discarded."

Through this point and similar mentions of great progress, he emphasises that the real discoveries behind the key revolutionary inventions such as the radio were “blue sky” research initiatives. In Flexner’s day, and indeed our own, such abstracted research proposals performed by Hertz and Maxwell would, if not struggle to get funding, be strongly discouraged. Their retrospectively important studies were only made possible because scientists were allowed to explore what was curious to them.

Do we need the same push for creativity now?

The essay reintroduced a platonic concept seldom seen in the modern world. It introduces scientists, artists, and poets as being aligned in their wonderful attempt to push the boundaries of curiosity and knowledge. He presents these as separate to engineers and lawyers for which a “usefulness” to their work is the ultimate point.

Flexner’s essay is a reminder that, if left unchecked, the world will see science as an “input-output” tool that responds proportionally to the input applied by administrators. Indeed, science is much more peculiar and behaves more like the arts. If we want great scientific progress, we must make sure talented, ambitious, and curious people are given unbridled space to explore the world around them and trust that as a collective that they make great discoveries.

Much more am I pleading for the abolition of the word “use,” and for the freeing of the human spirit.

Flexner, A. (1939). The Usefulness of Useless Knowledge. Harpers, (179), 544–552.

Retrieved from https://library.ias.edu/files/UsefulnessHarpers.pdf

We need philosophers of biology.

In modern molecular biology, we seldom come across pure philosophers of biology. However, there are problems that need addressing in the philosophy of biology. Back in the mid 20th century, Hull was experiencing a different problem; hypocritical philosophers discussing biology and failing to grasp its complexity, its scientific method, and being blind to their own prejudices. David Lee Hull raised the bar on what the field of the philosophy of biology is and can be.

In conclusion, there are many things that philosophy of biology might be. A philosopher might uncover, explicate, and possibly solve problems in biological theory and methodology. He might even go on to communicate these results to other philosophers, to scientists, and especially to biologists. He might show what consequences biological phenomena and theories have for other sciences and for philosophy or to show what consequences other sciences and even philosophy have for biology. These are some of the things which philosophers of biology might do. With rare exception, they have not. What philosophy of biology is not? It must be admitted that thus far it is not very relevant to biology, nor biology to it.

Hull was the driving force behind the philosophy of biology becoming a subject in its own right. One important concept to be aware of is that in 1983 he published a book that reviewed science through the 19th century. He describes that the English-speaking scientific world became self-aware to what it means to have a convincing piece of evidence in his book, “Darwin and His Critics: The Reception of Darwin’s Theory of Evolution by the Scientific Community”. He then goes on to describe how the scientific method of biology is indeed undergoing an evolution of its own. So keep that in mind. His ideas consist of primarily (i) what is good evidence and (ii) science changes in an evolutionary way.

Priests of Biology

The 1969 essay “What Philosophy of Biology is not” is in my view a related precursor to his later work. He, like many, attacks critics of Darwin’s natural selection. Peculiarly his criticisms are directed at misinformed philosophers. He argues their criticisms of natural selection are tautological misunderstandings of a physical system. Broadly the essay concludes that the philosophy of biology is not merely discussing the soul and nature of self in the context of poorly understood evolution.

What kind of proof is necessary before a scientific theory can be accepted?

One point he makes requires some understanding of a Philosopher, Andrew van Melsen, and a Jesuit Priest, Teilhard de Chardin. Van Melsen proposed the idea that natural sciences deal with only outside reality and fail to touch the inside manifestation of the self. He believes in souls and had a hierarchy between plants, animals, and higher beings. However, the same van Melsen also claims that Darwin’s theory of Evolution is below par as a scientific theory as it lacks foundation. Hull agrees that Darwin’s foundations aren’t convincing enough by themselves, but he quickly strips the notion that van Melsen’s own ideas are in anyway scientific since they cannot be interrogated. I can see why Hull went on to be quoted as saying:

Hypocrisy is the lubricant of society.

His sympathy for the views of van Melsen is further tamed as he mockingly states:

But he also discusses the evolutionary views of G. G. Simpson and Teilhard de Chardin as if they were on an equal footing scientifically. If the synthetic theory of evolution is based on belief, what must Teilhard’s theory be based on? What kind of proof is necessary before a scientific theory can be accepted? Is there no difference between the evidence adduced in support of modern evolutionary theory and Teilhard’s views?

Overall, whilst this paper solidified the place of the philosophy of biology as a school of thought and in many ways was the foundation for much of Hulls’ work that would follow, the essay “What the Philosophy of Biology is not” is a 28 page dense philosophical exploration of an entire field covering the life work of many philosophers; it’s not an easy read and has few conclusions the brief reader can take away confidently. But the frustration of Hull and his whimsical rebuttals to the misunderstandings of his peers and colleagues results in some gems.

D. L. Hull, What philosophy of biology is not. Synthese. 20, 157–184 (1969).