Pancreas – Hermit of the Abdomen

Ashley Davidoff MD

O’ Dear pancreas

You have been called the hermit of the abdomen
By whom I do not know
But in your dark and hidden way, you have
spoken without a word
from the gurgling depths of the abdomen
Yes – you have earned this lonely title
and a coin should be tossed
to the person who coined the phrase

But it took a long time to understand who this hermit was – and what he was doing in the darkness of the abdomen

From the day of antiquity
You have been looked upon by many
Herophilus, the father of anatomy had the first incisive insights into you
As he was one of very few who had the guts to explore the guts in open fashion

Aristotle at the same time seemed to have known something about you
But then you lay unharmed and unexplored for almost 500 years
Until Rufus mistook you for a piece of meat –
You must have laughed at the “pan kreas” thing
How wrong he was – you evasive little trickster

And then the Talmud – always seeming to be right
Thought you were the finger of the liver –
Little did they know how independant you were

While Vesalius was up to your “hide and seek” game
The magical eyes of da Vinci missed you completely
Even though he saw the serpiginous splenic artery snake right above you

Your ducts seemed to have intrigued the next generation, Wharton, Wirsung, and de Graaf
As you sustained the pain of the quill penetrating your inner gut
(I forget you were already dead but it must of hurt just watching!)

A little later it was that man called Vater and the little Italian Santorini found your minor duct and your nipple
And so by this time we had a good understanding of you in your nakedness
But of course, as said – you were dead

And so young Bernard explored your factories, and got a sense of your canine workings,
But you were able to hold on to your sweet secret for just a little longer
Until the Langerhans found the family jewels in the famous 2% of your population-
The islets – those beautiful eyelits – governess of all things sweet in the body

Eberle Bernard Danilevsky, and Kuhne joined up across the world to expose your antacid and enigmatic enzymatic brew
And once again your wonderful workings for a better world were exposed –
And we knew then, that you were the quiet and effective type –
A hermit who did good
But did not want the limelight

To see you as you lived and breathed in the flesh
was the mission of Wilhelm the X-Ray man
who crusaded the path to visualise 40,000 Angstroms under the skin

abdomen, pancreas, liver, gallbladder, kidneys, CT scan, Art in Anatomy, Ashley Davidoff MD

And then there was a slew of heroes who learned to slew your sickened parts – including the famous Whipple who was able to Whipple you in an inimitable way

And then a bone guy – for God’s sakes – a bone guy! – called Banting and his student Best
Exposed the insular chemistry of you insulin that had given you the power over the sweet
Never mind – in the end it was for the good of all –
And a new era was borne

And so we try to understand your form as our scans explore you as you live and breathe
And we stare in awe at your odd shape – why oh why did you choose that shape?
What are you supposed to look like? – we have no clue
And we are happy – so happy for you that you are well nourished by a double blood supply
And we wonder why you have no skin – we thought all the organs had a skin
Except for your tail – almost a foreskin

And you are off axis on two planes – what is that all about? – kinda crooked

And your twin origins and the intimacy with the duodenum, of the ventral twin
And the strange fusion of the Wirsung guy excluding the little Italian Santorini
It seems to me that your matrimonial fusion with Wirsung and the bile duct has led to more problems than the merger was worth
It does not seem in the long run, to have been a marriage made in heaven
What was that all about? Is there a grand plan to come?

And so we try to understand your diseases
And in some way we understand that the guy glugging down the bottle
Could be punished by your reaction
But why Oh why are you so nasty to those whose misfortune it is to have stones roll down and get no satisfaction.. down the green vile bile route
Have you not learned to live with the green secretion by now
And did you not know that by reacting the way you do, that you are cutting off your nose to spite you head?

While type 2 seems remote from you
We don’t know about this Type 1 business
Why are you made to suffer so much at the hands of your own body on your own body?
We feel sorry for you – to have your own buddies reject you – must be awful
And then to see so many young ones suffer because you don’t work
And we once again see and understand what power you control from that deep dark hermit home of yours

And the cancer thing … so silently it creeps on you causing your collagen to counter
And only making things worse as it strangles nerve, blood vessel, and your spouse duct – the green one, – without regard

And then I think of you in your prime and in your happiness
When you are with you two buddies – the splenic vein and the renal vein
And you all look so much alike, and happy swimming in that deep ocean where you hide
And I wish this was forever

Life, Cells,the US Constitution, and Trees

is an odd combination of concepts. At first glance the title of the blog reveals a wide discrepancy of ideas, but in fact there are unifying concepts that bring them together.

The United States is one of the advanced cultures of the modern world. Its magnificent constitution states “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.” The wisdom rests firstly in the notion that “we the people” is the focus of all subsequent intentions resolutions and actions. Secondly it provides hope and promise of a happy and safe society. This statement of the constitution is satisfied in the biology of the cell, but not to the same extent in the dynamics of society. We do not fully appreciate what perfection has been accomplished in the microcosm of our bodies nor how apt the opening statement is to the cells that make up living organisms. The cells in truth realise all the promises of the preamble, including a perfect union, justice, tranquility, defence, general welfare, liberty, and posterity.

Trees, US Ideology, Cells, and the Body

Living structures are characterized by their ability to move, grow, reproduce, acquire and transport metabolic products, and protect themselves — all so they can function and contribute to the bigger community. The cell as the basic building block of life and living organisms performs all the described functions effortlessly, innately and automatically. For the cell, life happens without struggle or effort. People perform the same characteristics of life, but many individuals struggle to fulfil basic needs to satisfaction.

Constitutional Makeup of the Body

The AiA art piece puts the cell in the centre of the body. The cells, acting in combination with other cells, give life to their person in accordance with the preamble of the constitution. People in combination with other people give life to their society.

From a physical perspective, biology has worked out a mechanism to keep all the 3.7 trillion cells of a single human being satisfied, fed, protected and fully functioning in their specific capacity. The liver cell is fulfilled in its capacity as a liver cell, and the same for the myocardial and brain cell. In fact all animal cells live and do what they were born to do, and are fulfilled until disease or death. The world of botany has accomplished similar magnificence.

Constitutional Makeup of the Tree

Tree cells in combination give life to the tree in accordance with the principles of the constitution.

The 7.1 billion humans of the earth are still stuttering along, despite the lofty aspirations of the US Constitution. Many citizens go hungry, innumerable are homeless and countless die in war. The particular focus of this blog is to observe and appreciate the success of cells in the body, and try to understand and apply the processes that make them so successful to our society at large.

Branching Patterns in Nature – Success Story of Delivery and Waste Removal

YinYang Tree – From Environment to Life in the Trees

The AiA rendering amplifies the arborising pattern of the roots and the branches in a background of the environment fuelled by the sun, air- filled atmosphere, and the earth. The tree unit consists of two opposing forces just like the negative and positive forces of the atom. The bare roots represent one force and the leaf filled flowering branches the other. They need each other and both need the environment (and the environment needs them) to develop, flourish and contribute. They use a branching system at both ends to move nutrients and water efficiently .

What Do We as A Society Have to Learn from from the Yin-Yang Tree?

Opposing forces, when working together, enable both to flourish as individuals and as a new unit. We need the man with the woman, the roots with the wings, the roots with the branches, the winter with the summer, the past with the future, the positive with the negative. In the realm of tubes and flow we need a difference in pressure – a relative positive and a relative negative in order for the contents of the tube to flow.

In the Leaves

The geometric arborising pattern is universal and is shown in veins of the ivy leaf

Heart Shaped Chines Lantern Flower

The dried flower reveals a delicate capillary-like infrastructure which is the transport mechanism for the petals. The flower enfolds and defends a barely appreciated, delicate fruit buried within its husk. The need to protect its fruit manifests parental love which it can only do because it has an efficient transport mechanism to maintain itself.

Branching Patterns in the Body –The Vascular System

Supply and Removal of Metabolites and Waste

The transport systems of biology are exemplified by phenomenal branching tube morphology that is efficient. The delivery and removal system in the form of arteries, capillaries and veins is 60,000 miles long (2.5 X the distance around the earth) – and with a pump that beats on the average of 72 times per minute, 3.7 trillion cells are continually fed and cleared of waste, and as a result can be productive and fulfilled. Food is delivered and is waste removed from the front door of every cell constantly. Each cell understands and applies the Goldilocks principle – “Take Not too much , nor too little, but what is just right for your needs.”

The Pulsatile Miracle Circulation

The Circulation; A Pump, Arteries, Capillaries, and Veins

Capillary Network At the Front Door of the Cells

Specific Circulations

Note that the abdomen has been turned upside down in order to appreciate the tree like formation of the portal vein and small bowel.

The liver is seen at bottom left in purple and the spleen (right) in orange

The Spleen

The Splenic Arterial Tree

The Kidneys

Renal Veins By Doppler Ultrasound in Spring

The Liver

The Hepatic Venules

Ductal Systems

Ducts of the Breast

Histology of the Glands of the Breast

Bile Ductal System Working Night and Day

Dilated Biliary Ductal System and the Bonsai Tree

The Tree of the Prostate Gland

Organs and Other Structures with Tree Like Shapes

A Forest of Kidney Trees

Ginkgo Lung Tree

A Winter Tree of Hands Under the Moonlight

The Brain

The Brain Tree

Derivation of the Brain Tree – Artistic Recreation

The Arbor Vitae – Tree of Life of the Cerebellum

Tree -Like Purkinje Cells

Drawing of Purkinje cells (A) and granule cells (B) from pigeon cerebellum by Santiago Ramón y Cajal, 1899; Instituto Cajal, Madrid, Spain. Public Domain

Drawing by Camillo Golgi of a hippocampus stained using the silver nitrate method and digitally rendered by the artist

This treelike branching pattern of neurons responsible for consciousness seems to be a structural feature of the universe itself.

Realising “We the People” – First Step – Efficient Supply and Removal of Metabolites and Waste for the People of the World

Without adequate food and water, the promise of “We the people” of the preamble of the constitution cannot be fulfilled. Currently 1 in 9 people in the world do not have enough food. Without this basic need they are unable to lead an active and healthy life. Is it because there is not enough food in the world? Is it because the 3rd world starving countries are too far away from the excess food of the farms of abundance? The skin cell at the tip of the most remote toe or the most remote cell at the top of the head are equally supplied according to their need. In a healthy individual no cell gets left behind. Yet many people get left behind in the world.

How to do it?

To some extent we have built and continue to build an arborising network for water supply and waste removal. In the US 86% of the population have clean water delivered. In developing countries efficient water supply and sewerage facilities are lacking. One in 10 people lack safe access to clean water, and 1 in 3 lack access to a toilet (water.org). Building a similar network that spans the world and delivers food to the front door of all the people of the world is the obvious first step. Yet it seems like a pipe dream. The network of information provided by the internet was also a pipe dream for people like Nikola Tesla who had a vision for a “world wireless system” in the early 1900s. The ability to deliver real time information to the front door via the world wide web is only 30 years old. Could anybody prior to 20th century imagine such a technological accomplishment? If only we could deliver food via an innate arborising pattern. What if, for example, a high calorie liquid energy food could be delivered alongside the arborising water system? It may not be a classical meal but it is certainly more than nothing. The practical intent of this blog is to draw parallels between biology and society, which can learn from an almost perfect delivery and removal system, most commonly in the form of tree-like branching.

The universe has evolved over about 13.7 billion years and in so doing has the wisdom of time on its side. Over this time, it has developed systems that optimise energy and efficiency. We as thinking biological beings have evolved highly developed biological processes over the last 2.4 billion years. We have developed a mind and free choice. The mind for us has been a double edged sword – both a gift and a curse. A gift because it has given us an ego, individuality, tribalism, heterogeneous cultures, poetry, literature, art, theater, science, dance, athletics, religion, and organization, but a curse that has brought ego, selfishness, pride, religion, jealousy, murder, bigotry, prejudice, and tribalism. The desire to live in “a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity” requires that basic biological requirements are available and met. The cells of the healthy body have acquired the aspirations of the US Constitution.

The cell has no mind nor ego and is therefore waiting only for evolutionary changes. We as thinking beings want it all now, and continue to try and improve our lot in a lifetime and are too impatient to be happy with our lot. We therefore push the double-edged envelope with our ego and in so doing while we are social beings we are competitive individuals at the same time. This creates an internal conflict and conflict with others making perfect union a dream rather than reality. The start for the world should be an efficient low energy, arborising delivery system, for food and water system for all people. Without this the US Constitutional aspirations are only a dream.

Hillel recognized the conflict. “If I am not for myself,” he said, “who will be for me? And if I am only for myself, what am I. And if not now when then?” It is the balance of “I” and “they” that we have to find. The cells have done it – Why can’t we?

ART IN ANATOMY

Category: Arteries

Pancreas – Hermit of the Abdomen

Pancreas – Hermit of the Abdomen

Life, Cells, the US Constitution, and Trees

Life, Cells,the US Constitution, and Trees

Branching Patterns in Nature – Success Story of Delivery and Waste Removal

What Do We as A Society Have to Learn from from the Yin-Yang Tree?

Branching Patterns in the Body –The Vascular System

Specific Circulations

The Brain

The Heart

The Lungs

The Gastrointestinal Tract

The Spleen

The Kidneys

The Liver

Ductal Systems

Organs and Other Structures with Tree Like Shapes

The Brain