Funtabulously Frivolous Friday Five 339

They are recipients of the Royal Humane Society award.

As you may recall from last week’s FFFF that the Royal Humane Society recognises individuals’ bravery when saving others.

Alexander I, Tsar of all the Russians, saved a Polish peasant while out riding.

Isambard Kingdom Brunel is best known for designing bridges, tunnels, and iron-clad ships. But did you know in 1828 he rescued five men in two separate incidents during the building of the Thames Tunnel?

15 years before Bram Stroker published Dracula he saved a man from the River Thames.

Duncan Goodhew is a national treasure in the UK for winning Gold at the Moscow Olympics for 100 metre breaststroke. He also won recognition for saving the life of an elderly man. Goodhew saw the man collapse and thought he was having a heart attack. He loosened the man’s collar and started giving mouth to mouth resuscitation. He later found out he saved a senior politician, the Labour MP, the Rt Hon Robert Sheldon.

But let us go further back what of the first award in July 1774…

Thomas, the son of John Joseph, a child aged about 14 months, dwelling by the Iron Foundry near the Falcon Stairs, wandering from its mother and other women who were drinking tea together in a chandler’s shop, got into a back kitchen, and fell through a trap, the door of which was carelessly left open, into an aqueduct communicating with the River Thames.

The women heard it fall, and ran to the place, but could not perceive the child. Their screams brought a shoemaker, who lived in an adjacent house, to the place, but he was fearful of jumping in, lest he should fall upon the child.

Thomas Vincent, a waterman, who was amongst the crowd brought together by the cries of the distressed mother, being informed of the event, ran round by several houses, and climbing over the walls of the aqueduct, waded up to the place to the height of his chest in the water, proceeding cautiously, and feeling for the infant with his feet as he advanced; for he imagined the returning tide might have carried it to a distance from the place: nor was he altogether deceived; as he felt the child about ten feet from the opening.

He took it up, and gave it to the women through the hole through which it had fallen. From seven to ten minutes must have elapsed from the falling-in of the child to the time it was taken out.

The women upon the strictest examination affirmed, that the child was to all appearance dead; its eyes were fixed, it lay breathless, and void either of motion or pulse.

They shook, and beat it on its back for some little time, and laying it upon a counter in the shop, rubbed tis belly and chest with dry salt; the friction was scarcely continued three minutes before the child began to gasp, and give other signs of returning life, which encreased [sic] till they were enabled to pour some salt and water down its throat.

This excited a vomiting, by which the child threw up a considerable quantity of water and mud from its stomach, and in a few minutes more it was restored to the joyful arms of its mother.

In the course of the evening it had two or three convulsive fits, but these were of short duration, and returned no more.

The person who had taken the child out of the water ran for Mr. Boyse, one of the Medical Assistants to this Society: he not being at home, his journeyman went to the house, but he found the child pretty well recovered.

The waterman had the reward promised by the society.

The First Award – Royal Humane Society

Reference:

• Royal Humane Society

Zinc toxicity.

The scenario described is a real one.  A young adult schizophrenic patient has been reported who ingested 461 pennies. Within a few days, he had the noted symptoms.  Since the situation was not believed to be an emergency the coins were not removed.

Twenty days after admission, the patient developed severe bleeding with hypotension requiring inotropic support as well as transfusion. A radiograph of the stomach revealed metallic densities consistent with coins in the stomach and groups of coins more distally in the bowel. Emergent laparotomy showed the stomach to be grossly distended with a blood clot. Through a gastrotomy, 2 L of clot were removed along with 461 coins, including 425 U.S. pennies, 11 nickels, 18 dimes, 6 quarters, and one Canadian cent 

Copper pennies made before 1982 contained 95% copper and only 5% zinc. However, due to the increasing cost of copper, pennies made in 1982 and thereafter contained primarily zinc (97.6% zinc and only 2.4% copper.

The patient died 3 weeks later of multisystem organ failure.  The patient’s autopsy revealed acute hemorrhagic esophagitis, acute tubular necrosis, massive acute hepatic necrosis, mild fibrosis of the pancreas, and hypercellular bone marrow.  The stomach, which had contained most of the coins, revealed mild chronic inflammation, dilated vessels with unorganized thrombi, transmural acute inflammation, and necrosis.  Thus, the ingestion of so many pennies, at one time, can be lethal.

Reference:

• Bennett DR, Baird CJ, Chan KM, Crookes PF, Bremner CG, Gottlieb MM, Naritoku WY. Zinc toxicity following massive coin ingestion. Am J Forensic Med Pathol. 1997 Jun;18(2):148-53.

1,894 coins weighing just over 8kg.

Despite us finding two interesting cases for our FFFFs. Coin pica in large amounts is actually quite rare. While we commonly see the accidental ingestion by an exploratory toddler there are only 7 documented cases of massive coin ingestion in the literature.

The case above is of a 51 yr old man who was later diagnosed with schizophrenia. He ingested mainly Yen which are primarily copper. He fortunately recovered from his perforated stomach and made a full recovery without any toxicity from the coins. Out of the seven cases in the literature, 3 died of multi-organ failure and the rest survived mainly suffering from anaemia.

References

• Sekiya K, Mori S, Otomo Y. Coin pica-induced gastric perforation resulting from ingestion of 1,894 coins, 8 kg in total: case report and review of published works. Acute Med Surg. 2017 Oct 24;5(2):177-180

3 pounds (1.3 kg) each year.

Numerous studies have shown that food portion sizes in fast food restaurants are getting bigger and bigger, along with customers’ waistlines.  A study in the Journal of the American Dietetic Association (2003;103:41–47) has found that soft drinks are a particular problem.