jueves, 20 de septiembre de 2012

The Story of the Stone Child of Sens.

A lithopaedion, or stone-child, is a dead fetus, usually the result of a primary or secondary abdominal pregnancy, that  has been retained by the mother and subsequently calcified. This is the story of the earliest known case of this
phenomenon. It was discovered in 1582, at the autopsy of a 68-year-old woman in the French city of Sens, and described in a thesis by the physician Jean d'Ailleboust. The woman had carried her lithopaedion for 28 years. The ultimate fate of the lithopaedion specimen, which was widely traded throughout Europe in the 1600s before finally ending up in
Copenhagen, is traced.

On May 16 1582, in the city of Sens, the 68-year-old Madame Colombe Chatri breathed her last. She was the wife of Loys Carita, a tailor, described as being of small stature, but otherwise 'bien forme & corpulent'. Twenty-eight years earlier, Madame Chatri had, for the first time, shown signs of pregnancy.

 Her menstruations ceased, her breasts swelled, her stomach increased in size, and she could even feel the child move within her. Some time before her birth was due,
Colombe Chatri was seized by violent labour pains. A great quantity of amniotic fluid, tinged with blood, was passed.
In spite of the predictions of the Sens midwives,

however, there was no childbirth; instead, her labour pains ceased, the movements of the child could no longer be felt, and her breasts diminished in size. Afterwards, Madame Chatri felt quite unwell, and she had to remain in bed for three full years. She could feel a hard tumour of considerable size, situated in the lower abdomen. Until the end of her life, she complained of tiredness, abdominal pains and loss of appetite. Only by means of provoking the appetite with herbs and vinegar sauces could she eat anything at all. When
gossiping with her neighbours in the street, they talked about her strange obstetrical mishap, and there was much speculation that she still had a fetus within her, and that it would kill her one day. Madame Chatri and her husband
consulted several physicians and surgeons, but none of them
could suggest a cure.

In 1582, at the age of 68, Madame Chatri was described as being broken down by disease and old age. She died that year, and since there had been much gossip about her mysterious pregnancy many years ago, her husband requested that her body was to be dissected by two skilful surgeons, Claude le Noir and Iehan Couttas.
They cut through the stomach and peritoneum, and viewed the prodigious growth, which was wrinkled and formed like a turkey's crest. It was hard and brittle like a shell, and covered with what seemed like scales. The surgeons
'plunged their razors into it', but without being able to penetrate the hard shell. After wearing out the edge of their knives on the hard tumour, they fetched mauls and a drill, and finally succeeded to break it. They felt the head and right shoulder of the lithopaedion, but it was not until they had broken off a large portion of the covering shell, and seen the wonderful sight inside, that they understood what they were dealing with.
They ran to fetch some physicians, Jean d'Ailleboust among them. He could see a glimpse of the lithopaedion, which was covered by detritus and the remains of its inner membranes, and was as astonished as his surgical colleagues.
All the time, curious townsmen came running in to see this prodigy. The surgeons were busy telling the story, and to demonstrate the infant more clearly, they grasped the opening in the calcified shell with their iron hooks to tear it apart. After tearing with all their force, they broke it open,
and took out the lithopaedion, which they set out to dissect further. This was done with great haste, and Jean d'Ailleboust deplored that they had made it impossible to study closer the anatomy of the calcified shell and the nourishing vessels. The shape of the lithopaedion was roughly that of its rounded, calcified shell. The knees were bent, and the legs drawn up towards the chest. The feet and lower legs were fused by the calcific deposits. It could clearly be seen that the fetus was of the female sex. The head was lightly tilted to the right, and supported by the left arm.
The right arm extended down towards the navel: its hand had been broken off through carelessness when the lithopaedion was extracted. The bones of the head were transparent, and the fontanelles were not closed. The skin of the head was partially covered with hair. The lithopaedion had one sole tooth, situated in the lower jaw.

Not long after it had been delivered, the stone-child of Sens became one of the foremost curiosities of France. People traveled hundreds of miles to see and admire it. Jean d'Ailleboust needed no encouragement to write a thorough
Latin pamphlet about it, detailing the case history of Madame Chatri as well as the autopsy findings1. It was published in 1582, by the Sens printer Jean Sauvine, and soon became a medical best seller.

He also supplied a curious drawing (Figure 1) of the lithopaedion and its 'mother'. It is believed to depict the corpse of Columba Chatri lying on a richly padded bed, her abdomen dissected to show the lithopaedion in situ within its
calcified shell. Beside the bed, the lithopaedion is laid out on a pillow.  This practice was not unknown at the time:

 Although Jean d'Ailleboust was very unwilling to part from his great treasure, it is recorded that, in the late 1500s, it was purchased by a wealthy merchant, Monsieur Prestesiegle, who put it in his famous private museum of curiosities in Paris. It was examined there by Madame Louise Bourgeouis, the leading French midwife of her time5. Later, the lithopaedion was purchased by Etienne Carteron, a wealthy Paris goldsmith. He sold it, in 1628, to Gillebert
Bodey, a jewel merchant of Venice.  In the early 1650s, King Frederick III of Denmark was building up a large cabinet of curiosities at his castle in Copenhagen. In 1653, Frederick III bought the stone-child from its owner.

 The document of sale and certificate signed in 1628 were also turned over to the King, as well as a hand written copy of Jean d'Ailleboust's autopsy report, with a slightly different illustration (Figure 3): they are still kept in the
Royal Library of Copenhagen (Gl kgl Saml No. 1641). The sum paid was a well-kept secret, but it is unlikely that the Franco-Italian merchant let the King have it cheaply, particularly since he had himself paid a very high price for it.  A few years later, Thomas Bartholin described the lithopaedion closer in one of his collections of anatomical anecdotes9. By this time, it had become much the worse for wear, and it is likely that during its years in private hands, the lithopaedion had not always been treated with the reverence due to its age and fragility. Both arms were now broken off, the jaw was injured, and the skin
lacerated (Figure 2b). 

In the illustration (Figure 2c), the miserable-looking specimen is depicted sitting lopsidedly on a box. Part of the missing arm had been refastened, but otherwise, the lithopaedion was unchanged since it was described by Thomas Bartholin. In Jacobsen's 1710 catalogue10, it was more thoroughly described. The skin was now missing in large parts, and where it remained, it was quite black, giving the lithopaedion a strange aspect, as if it had been partly

In the 1820s, the Danish government decided to dissolve the Royal museum, and many preparations were scrapped or sold by public auction. Many bizarre pieces changed hands under these circumstances; among them the hand of a mermaid, solemnly described by Thomas Bartholin 170 years earlier, and an egg allegedly laid by a Norwegian peasant woman12. The lithopaedion was not among the preparations sold or thrown away, probably because it was still considered valuable. In 1826, it was transferred to the Danish Museum of Natural History, along with several other human, animal and vegetable specimens. In the late nineteenth century, the remaining exhibits from the Danish Museum of Natural History were transferred to the Zoological Museum of Copenhagen University, and a good many zoological specimens are still there. However, the lithopaedion had disappeared somewhere along the way,
together with the other medical curiosities from King Frederick's museum, among them a dicephalic child preserved in spirits, and a minute fetus, alleged to be one of the 365 children of the prolific Dutch countess Margaret
of Henneberg. It may well be that the lithopaedion of Sens was scrapped at this time, along with the other older medical specimens, of which no trace remains. An extensive search for them in the existing Danish museums has been fruitless.

A beautiful Latin poem was written by Jean d'Ailleboust in 1582 to celebrate the lithopaedion of Sens. He recalled the classical myth that after the Flood, the world was repopulated by the two survivors, Deucalion and Pyrrha, who walked the earth, throwing stones behind them, which, on striking the ground, became living people:

Pinxit Deucalion saxis post terga repulsis
Ex duro nostrum marmore molle genus:
Qui fit ut infantis, mutata sorte, tenellum
Nunc corpus saxis proxima membra gerat!

From the rocks Deucalion had dropped behind,
was fashioned the living flesh of humankind:
How was it then done, that a tender babe well formed

Information via:

"The earliest known case of a lithopaedion"
Jan Bondeson MD LicSc
J R Soc Med 1996;89:13-18

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