Bezoar
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
A bezoar or enterolith is a sort of calculus or concretion, a stone found in the intestines of mostly ruminant animals, but occurring among others including humans. There are several varieties of bezoar, some of which have inorganic constituents and others organic. Bezoars consist of ingested foreign materials that accumulate within the gastrointestinal tract and are classified according to the materials of which they are composed. Trichobezoars (hair) and phytobezoars (fruit/vegetable) are the most frequent forms. Bezoars usually form in the stomach and can pass into the small bowel where they occasionally cause small bowel obstruction. Predisposing factors include inadequate chewing, high-fiber diets, and previous gastric surgery.
History
Bezoars were formerly sought after because they were believed to have the power of a universal antidote against any poison. It was believed that a drinking glass which contained a bezoar set within would neutralize any poison poured into the glass. The word "bezoar" ultimately comes from the Persian pâdzahr (پادزهر), which literally means "protection from poison." In fact, some types of trichobezoar are apparently able to precipitate or bind arsenic compounds (long used as poison) from a solution.
In 1575, the surgeon Ambroise Paré described an experiment to test the properties of the Bezoar Stone. At the time, the Bezoar stone was deemed to be able to cure the effects of any poison, but Paré believed this was impossible. It happened that a cook at Paré's court was caught stealing fine silver cutlery. In his shame, the cook agreed to be poisoned. He then used the Bezoar stone to no great avail as he died in agony days after. Paré had proved that the Bezoar stone could not cure all poisons as was commonly believed at the time.
A famous case in the common law of England (Chandelor v. Lopus, 79 Eng Rep. 3, Cro. Jac. 4, Eng. Ct. Exch. 1603) announced the rule of caveat emptor, "let the buyer beware" if the goods he purchased are in fact genuine and effective. The case concerned a purchaser who sued for the return of the purchase price of an allegedly fraudulent bezoar. (How the plaintiff discovered that the bezoar did not work is not discussed in the report.) Judicial scepticism over the alleged magical powers of bezoars may well have justified this judgment in this particular case. The ruling, however, was seized on and formed an impediment to the formation of effective consumer protection remedies and the law of implied warranty well into the nineteenth century.
The Merck Manual of Diagnosis and Therapy notes that persimmons have been identified as causing epidemics of intestinal bezoars, and that up to ninety percent of food boluses that occur from eating too much of the fruit require surgery for removal.[1]
Bezoar pearls
In addition to bivalve pearls, there are a group of sacred natural gemstones largely considered bezoar stones, which were first documented in the Garuda Purana, one of the books of Hindu holy text Atharvaveda. In addition to oyster pearls, also enumerated are the Conch Pearl, Cobra Pearl, Boar Pearl, Elephant Pearl, Bamboo Pearl, Whale Pearl, Fish Pearl, and Cloud Pearl. These pearls were later documented in the treatise Brihat-Samhita ("The Great Compilation") of Varahamihira, the Indian mathematician. The first documented contact with these artifacts by the Western world is described in the sole volume of 18th Century scientist Albertus Seba, entitled Cabinet of Natural Curiosities. Therein, a large collection of bezoar stones and non-oyster pearls were hand-sketched, and the collection of these items were on display in a forum which was the precursor of the modern day museum. Today, the original 446-plate volume, part of the greater work Locupletissimi Rerum Naturalium Thesauri Accurata Descriptio, is on permanent exhibit at the Koninklijke Bibliotheek in The Hague, Netherlands.
While the sacred Nine Pearls of Vedic tradition are typically considered bezoars, the Bamboo Pearl forms in the stem of the Bamboo plant, while others such as the Cloud Pearl have no known formation process.
Types of bezoars
- Food boli (singular, bolus) imitate true bezoars and are composed of loose aggregates of food items such as seeds, fruit pith, or pits as well as other types of items such as shellac, bubble gum, and concretions of some medications.
- Pharmacobezoars (or medication bezoars) are mostly tablets or semi-liquid masses of drugs.
- Phytobezoars are composed of nondigestible food material (e.g., cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility.
- Trichobezoar is a bezoar formed from hair - an extreme form of hairball. Humans who frequently consume hair sometimes require these to be removed. This has also been called Rapunzel syndrome.
Fluoroscopic images demonstrate a bezoar in the stomach
Miscellaneous
- Other types of bezoars are formed from items such as stone or sand, usually in young children.
- Ox bezoars are used in Chinese herbology, where they are called Niu-huang.
- In alchemy, animal bezoar is the heart and lungs of the viper, pulverized together.Template:Ref label
- In alchemy, mineral bezoar is an emetic powder of antimony, correct with spirit of nitre, and softened by repeated lotions, which were said to carry off the purgative virtue of the antimony, and substitute a diaphoretic one. It promoted sweat like the stone of the same name. Template:Ref label
In popular culture
- A Darwin Award was awarded to someone who died from a bezoar resulting from compulsively eating her own hair [2].
- The first mention of the bezoar stone is by the Arabic and Persian writers. In the Arabic work attributed to Aristotle, and which was certainly written by the ninth and possibly as early as the seventh century, it is even described among the precious stones. The same is true of the oldest Persian work on medicine, namely, that of Abu Mansur Muwaffak, composed about the middle of the tenth century. A valuable monograph on the bezoar was written in 1625 by Caspar Bauhin, a learned professor and physician of Basel; this work contains all that was then known of the various qualities ascribed to this substance by the older authors.
- In the Harry Potter series, bezoars are, as noted by Professor Snape in Harry's first potions lesson, "a stone taken from the stomach of a goat, which will protect from most poisons." In Harry Potter and the Half-Blood Prince, Harry uses a bezoar to save Ron Weasley's life when he accidentally drinks poisoned mead.
See also
- bezoardicum
- Snake-Stones
References
- ↑ Merk Manual, Rahway, New Jersey, Sixteenth Edition, Gastrointestinal Disorders, Section 52, page 780
- Barry Levine. 1999. Principles of Forensic Toxicology. Amer. Assoc. for Clinical Chemistry. ISBN ISBN 1-890883-87-5.
- The Poison Sleuths: Arsenic - The King of Poisons. Retrieved March 10 2007.
- This webpage is a reprint by the author of an article originally published in the 1997 issue of Science Reporter, published by the National Institute of Science Communication (CSIR) in India.
External links
- A trichobezoar at the National Museum of Health and Medicine, Washington DC.
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