Content warning: We’re getting medical today and that includes the naughty bits and fetal development, so if you haven’t had The Talk with the kids, your car ride’s about to get awkward.
Health is foremost on people’s minds these days, thanks to the virus and everybody promises to lose weight day, or as some call it, new years. Maybe you’re focusing on health overall, being careful of what you put in your body, scouring food labels and the backs of shampoo bottles for ingredients you can’t pronounce. I don’t want to dissuade you, but right now, no matter how careful you’ve been, your body contains things like formaldehyde, hydrogen peroxide and acetone…and that’s all by design. My name’s…
Apologies to those listeners of a more delicate constitution, but it’s going to be another one of *those episodes, like the food episode where i talked about maggot cheese. But, hey, you’re learning, and isn’t that the most important thing. Today we’re going to be talking about things your body does, or makes, without you even knowing about it. Let’s start with my namesake body part, the mouth. At the back of your mouth, your throat is flanked by two guards called tonsils. Their job is the immune system’s first line of defense against bacteria and viruses that enter your mouth, by gathering bacteria-laden gunk in their various folds and crevices. It’s like Bastion trying to get past the Sphinx gate in The Neverending Story, except not at all like that. Normally, the tonsils just quietly go about their business, but sometimes they catch too much gunk. What happens to a surplus of food particles and other debris getting back into a small pocket of tonsil flesh? It forms tonsil stones.
Let me not drop you in the deep end like that. First, let’s talk about some stones you might be more familiar with, and might have right now, gallstones and kidney stones. Gallstones are fairly common, but unless you’ve treated them or had them, few people know what they are. The gallbladder is a storage organ connected to the liver by a network of bile ducts. It produces bile to absorb the fats in our diet. When the gallbladder isn’t on active duty, such as when you’re fasting, bile isn’t released and fills the gallbladder. When you eat, the bowel sends a signal to the gallbladder that it’s time to release bile. But if something messes up that system — like high cholesterol, fasting, pregnancy, or losing the genetic dice throw — the gallbladder might not empty often enough or completely enough, and Bob’s your uncle, gallstones. This isn’t a bolt from the blue situation, about 20% of people will develop gallstones at some point in their life. Look at the people on either side of you, then look at two other people — one of you is gonna have gallstones. Don’t fret, though, only about 20% of people with them will actually develop symptoms. Small stones work their way down the bile duct into the intestines and [sfx flush] away they go. Of course, we as a people are getting fatter by the day, so the number is increasing and the average age of sufferers is dropping.
Gallstones hunt in packs, so if you have them, you probably have plural. And they can seriously [bleep] your [bleep] up. Common complaints include abdominal pain, back pain, chest pain that feels like a heart attack, vomiting, and loose, greasy, stinking poops, because why not. They can also exacerbate existing conditions and even cause strokes. But what they *can’t do, no matter what your gran says, is make you more likely to get kidney stones. Kidney stones and gallstones live in the same building, but they don’t even pass each other in the hall. Gallstones are made of unprocessed cholesterol, while kidney stones are made of calcium and salts. A predisposition, certain medications, not drinking enough water, and a diet high in protein and sodium are among the risk factors that can get you into trouble.
Calcium is a mineral, so this bodily stone is quintessentially lithic, very stone-like. As long as the stone is small or stays in your kidney, you won’t feel it, but if it finds its way into the ureter, the tube connecting the kidney and bladder, you’re gonna have a bad time. It now has to work its way all the way out. Don’t be picturing smooth river rocks or the gravel from your driveway. Calcium is a mineral and kidney stones are crystals. Do you know what a fractal is? One of those pictures where you can zoom in on an endlessly repeating pattern. They’re like that, but all straight lines and points. If you’ve never looked at something I’ve put in the show notes, today is the day, because I had no idea how absolutely satanic these things are. I never knew. No wonder everyone says it hurts worse than childbirth. Oh, and they can block up your urine, so that’s fun. Speaking of fun, one surprising way to help pass a kidney stone is to ride on a rollercoaster. Researchers found that riding the Big Thunder Mountain Railroad roller coaster at Disney World could help ease the passage of small kidney stones. A few patients reported passing small stones after going on the ride. Human trials to look for a connection would be hard to organize, so researchers built a 3D model of a kidney, complete with stones of different sizes, hid it in a backpack, and went on the ride twenty times. No word if they were using a fast pass or had to stand in line each time. They found that where you sat improved the efficacy of Big Thunder Mountain as a medical device. When the researchers sat at the front, the stones only passed 17% of the time, while sitting in the last car saw stones passing 64% of the time.
Compared to all that, tonsil stones should be a breeze. I mean, if you don’t notice something in your mouth and throat, as opposed to the nebulous mush that is our internal organs, how bad can it be? It can be a lot worse for the people around you. The morbidly curious among us may have watched the videos online of tonsil stone extractions, I assume while waiting for new episodes of Dr Pimple Popper. Tonsil stones are smelly, little white globs of no-thank-you that build up in crypts of the tonsils. In addition to acting as bacterial bouncers with their mucus-y coating, your tonsils produce white blood cells and antibodies to help prevent infections. If particles of food and spent white blood cells build up in the crypt and pack together, boom, tonsil stones. If you like to throw around medical Latin, they are technically called tonsilliths or tonsilloliths, “lith” meanings “stone,” like in “paleolithic.”
Thankfully, gross as they are, tonsil stones aren’t really what you’d call a problem. They don’t tend to cause pain and only cause a small percentage of noteworthy bad breath. You might feel a little tickle in the throat, like there’s something there that you can’t quite clear, but that’s usually it. Good oral hygiene tends to prevent them, but if you do get them gargling with warm salt water should do the trick. Of course, if they’re actively bothering you, you could talk to your GP, dentist, or ENT doctor, or do like people on the internet are doing and squeeze them like spots. If you do go that route, and I hereby legally absolve myself of any responsibility, be sure to use something flexible without sharp edges, like the tip of a water pick. Do mind the gag reflex. If your case turns out to be serious, your doctor can use a laser to scar the crypts, called tonsil cryptolysis, to make it harder for stones to form in the future.
Got it in you for one more bodily stone? Good, because this one actually has a life outside the body, and it has a name like a movie villain patterned on the CEO of Amazon. Introducing, the bezoar. A bezoar is a solid mass of indigestible material that accumulates in and can sometimes block, your digestive tract. They usually form in the stomach, sometimes in the small intestine, and rarely in the large intestine of both children and adults. You’re more likely to develop one if you had diabetes or renal disease, have decreased stomach acid production or reduced stomach emptying, often as the result of surgery, and, especially alarming with a pulmonary plague running around, have your breathing aided by machine. If you enjoy variety, good news, there are different kinds of bezoars, depending on what they’re made of. Phytobezoars, the most common type, are made up of indigestible food fibers, which is why you need to increase your water consumption if your new year’s resolution to eat healthy includes, as it should, taking in more fiber. Pharmacobezoars are clumps of medication that didn’t dissolve properly in your digestive tract. Trichobezoars are often seen as a complication of certain psychiatric conditions. Trichobezoars are made of hair or other fibers eaten by the sufferer in what is known as “Rapunzel’s syndrome,” which is most common in adolescent girls.
Bezoars can cause lack of appetite, vomiting, weight loss, gastric ulcers, intestinal bleeding and obstruction, leading to tissue death (gangrene) in a portion of the digestive tract. Like other small stones, smaller bezoars may pass on their own, or you can take medication to help them dissolve. Large bezoars, especially trichobezoars, often require surgery. If you’re not very hungry tomorrow and have a bit of an upset tumtum, it’s probably *not a bezoar. They’re quite rare and it’s much more likely you’re still queasy from listening to this episode.
People have known about bezoars for centuries, because they exist not only in humans, but also in animals, who we are often in the habit of disassembling. The word bezoar comes from the Persian word meaning antidote. That’s a strange name for an affliction, but that’s because these strange rock-like objects were thought to be a universal cure for poison. Like many old-fashioned curatives, it addressed a wide array of conditions from leprosy to measles to cholera and depression. Your prescription might be to add ground bezoar powder to your win, wear it as a chain, or just drop the whole bezoar into your cup to neutralize any and all poisons a disgruntled employee or romantic rival might have put there. Arabian doctors had been using bezoars since the 8th century, and brought them into western medicine in the 12th century as an antidote to arsenic, a favorite poison used to assassinate European nobles. By the 16th century, bezoars use had become quite popular and their value went through the roof. They were at one point, these clumps of bodily excretions and inedible rubbish, worth more than their weight in gold. 10 times as much, in fact. Today, that would cost over $600 per gram, which is also six times the price per gram of cocaine, which is why I looked that up, FBI man looking at my browser history was why I looked that up. Bezoars were most available to the rich — Queen Elizabeth I even had a bezoar set in a silver ring.
Anytime a commodity becomes that valuable, a new industry springs up — knockoffs and counterfeits. Yes, counterfeit gut stones. Jesuit priests in Goa, India would make their own bezoars, called Goa stones, with shells, silt, resin and maybe bits of actual bezoars. They could even contain crushed gemstones for the top of the product range. They believed these too would counteract poison and cure the plague, so it wasn’t as if they were selling a pig in a poke, which is good because Goa stones could also be extravagantly expensive. The bezoar bubble burst in 1575, French surgeon Ambroise Paré set out to debunk their pharmacological value. A cook in Paré’s house was caught stealing silver and sentenced to be hanged, and Pare saw an opportunity. He offered the cook a deal — agree to be poisoned and treated immediately with a bezoar. If the bezoar worked, the cook would live and could go free. Wanna guess how it went? Yeah, the cook died horribly and Paré had the “proof” he needed.
Bezoars aside, your digestive system does all manner of things you’re not aware of. For example, did you know your stomach can blush? When you blush, you get a burst of adrenaline and your sympathetic nervous system reacts and causes blood flows to increase throughout the body. It’s a part of the fight or flight reflex. Blood vessels dilate throughout the body, to help pump more oxygenated blood to your muscles. All the blood vessels dilate, including the ones in your face that bring even more attention to that fart you thought you’d covered with a cough, and the ones in your digestive system.
Have you ever had a gut feeling or trusted your gut instinct? Were you being literal or metaphorical? … Are you sure? Our brain and gut are connected by an extensive network of neurons. Chemicals and hormones constantly provide constant status updates on things like hunger, stress, contamination, imbalances, and whatnot. This internal IT system is called the brain-gut axis and the brain and gut are constantly conferring with and influencing one another. That’s why our emotional reactions manifest as a physical sensation, like the way your stomach drops when a bad-news phone call comes in or it ties up in knots when you’re stressed. The nerves in your gut, the enteric nervous system, to give it its proper name, is called the body’s second brain. While our gut brain can’t do math, or maths for my listeners in the home counties, like the head brain can, it’s busy maintaining the constant workings of our digestive system, from appetite to arse.
So the digestive system has its own brain, but why don’t any other organ systems? I for one would like more oversight on respiration. One reason is that the digestive system answers to more than just our brain. Your guts are the landlord to billions of microbes. The gut has to maintain an environment that supports the type of tenants you want while keeping the riff-raff in check. One good turn deserves another and happy microbes help us digest food, have a strong immune system and even set our mood. Recent research shows that our microbiota influences the body’s level of the potent neurotransmitter serotonin, which regulates feelings of happiness.
You know what else your digestive system has – taste receptors, all the way to the end. If you’ve ever had a plate of spicy vindaloo or a breakfast burrito piled high with hatch chilis, then 6 hours found yourself seated upon the throne, praying for death and debating giving yourself a pepto-bismol enema, you already know what I’m talking about. Bonus fact: New Mexico has an official state question – “red or green?” — referring to your preference in chilis. The correct answer is both, aka Christmas. The spiciness of food often comes from capsaicin, which causes our brains to register a burning sensation when it binds to your TRPV1 receptors. TRPV1 receptors don’t only live in your mouth, where you’re expecting the burn, but are all over your body. These receptors also respond to actual heat, so their omnipresence helps protect us from things like brushing against a hot pan on the stove. With all heat, your body attempts to cool itself back down, which is why you sweat and your face flushes when you eat spicy food. Capsaicin isn’t digested completely by the stomach and intestines, meaning some of it is still there where it reaches the TRPV1 receptors… in your anus. That’s why ridiculously hot food hurts as bad on the way out as it did on the way in.
If that fact is old news, how about one I learned not two days ago while writing this — men have taste receptors in their testicles. Specifically, the T1R and T2R receptors, which detect sour, bitter, and umami, the savory flavor found in soy sauce. A *responsible podcaster would point out that taste receptors are not the same as taste buds, taste buds are projections covered in taste receptors, so as to dissuade curious chaps from dipping their jubblies in a takeaway cup of soy sauce… but that sounds like much less fun. There was already an online trend of men trying it, some of whom claim it worked, but experts suspect it was the shock of the temperature change combined with the smell of the soy sauce. “Honestly, never thought I’d have to say, trust me, I have a PhD you can’t enjoy the taste of food with your testicles,” Dr. Emma Beckett, the “Miss Frizzle of food and nutrition science” tweeted. “[Do it] if that’s your jam, but please not for the taste receptor activation.” For one thing, those receptors are inside the testicles not on the outside of the scrotum. Why are they even there, then? The taste receptors on the tongue help us determine what food is good to eat, but the taste receptors in the testicles influence the production of testosterone and sperm. There seems to be a direct connection between these receptors and fecundity. This was discovered after researchers blocked the receptors in mice, who were later found to be infertile. Speaking of animals and fertility experiments, you’ll want to check out the latest bonus mini on patreon to hear about people dressing frogs and rats in tiny little pants for science.
Review and CTA
When taking pregnant women into account, the average number of skeletons per person is greater than one. And I’m going to go out on a limb and say that the average number of nipples is greater than two, that scene from The Wall notwithstanding. If you didn’t get that, ask you parents. Or your grandparents, I don’t have a lot of audience demographics. We’re talking about extra nipples and while they’re statistically rare, they’re not as rare as you think. Zac Efron, Lily Allen, MArk Wahlberg, Harry Styles, Carrie Underwood, Tilda Swinton, and several other people I assume are famous, have one. I wanted to work in a reference to Scaramanga from The Man With the Golden Gun, but I’ve already alienated everyone born before 1990. Better stick to the science then.
They’re called supernumerary nipples, meaning more than the usual number of nipples. The first scientific notation on it came in 1878 from a German named Leichenstern, who estimated one in 500 people, or .2% of the population, have them. Turns out he underestimated, probably. Many people have taken up the mantle to take a census of extra nipples. One study estimated 0.6% of white infants and 1.63% of Black infants in America have them. Another estimated 2.5% of Israeli and 5.6% of German children have them. Yet another study reported that 5% of Japanese women but only 1.6% of Japanese men have additional nipples. Most studies find them to be more common in men than in women and that they are more common on the left side than the right. Here in the State, the NIH’s Office of Rare Diseases say that less than 200,000 people in the country have them. I’ve already known three people personally and I don’t even get out, so that sounds low to me. Charles Darwin himself wrote about the presence of surplus nipples in The Descent of Man. He speculated that extra nipples were atavisms, remnants of our evolutionary past that pop up during the development process.
The biggest push to scientifically understand supernumerary nipples came from a mononymic researcher named Kajava. In 1915, he sorted supernumerary nipples into eight categories, according to the types of tissue present, in a system doctors and scientists are still using. Category one is basically a whole additional breast, or polymastia, complete with areola and breast tissue. An areola with breast tissue but no nipple is category three; a nipple and areola with fatty tissue instead of glandular breast tissue is category five; an areola with neither nipple nor breast tissue is category seven. The most common type is category six, polythelia, in which an extra nipple forms, but without an areola.
Where do these hundred of thousands of category six nipples come from? All human embryos start off essentially female for the first 60ish days of development. Since females are going to “need” nipples, all the fetuses, feti?, get them. Around the fourth week of embryonic development, two strips of the ectoderm, what eventually becomes skin, thickens. These strips, called mammary lines or milk lines, form a V from each armpit down to the groin. As the weeks go on, the milk lines get thicker, graduating to mammary ridges. Eventually, the milk lines go away, mostly. In the XX chromosome set, some tissue remains on the chest, leaving us with mammary buds that develop into the bits and bods that will fill out our sweaters, make it hard to jog, and let us fulfill our mammalian heritage by nursing live young. On the flip side, the Y chromosome will set off a series of changes, like the influx of this hormone, testosterone, stimulates the growth of the penis and testes, but the nippes will always be there as a reminder the biggest, baddest, burliest biker dude or bodybuilder-type started life as a female. Take that, toxic masculinity!
If our friends the milk lines don’t disappear completely, you get a supernumerary nipple or breast. Most are located below the regular nipples, but according to one estimate, 1 in 10 are found *above the regular nipples, even up in the armpits. But along the old milk lines aren’t the only place extra nipples pop up. Extra nipples outside the milk lines are called ectopic supernumerary nipples and they are a rare segment of a rare condition. Some have theorised that ectopic nipples are modified sweat glands, or are evidence that the mammary ridges became somehow displaced during development and wound up somewhere unexpected. And they can be anywhere! The back, shoulder, arm, neck and face, the perineum, and even on the vulva. I’ll be honest with you, I’ve got a mole on my abdomen I’m having second thoughts about.
And that’s… About the frightening-sounding chemicals in your body, they’re supposed to be there. Your body made them. Formaldehyde is produced by cells during normal metabolic processes. Formaldehyde gets broken into formate, which helps make the nucleic acids adenine and guanine, half the components of DNA. Cells make hydrogen peroxide when you get an injury, to signal to the body to send platelets. Acetone comes from acetoacetate, which is created when your body breaks down fat. Remember…Thanks…