Posted on August 30, 2016February 17, 2023 by Ashley Davidoff

Pain, Pain -Go Away!

pain-0002-catalogue-signedb

You came with no warning and no invitation

You came with a single message of doom and gloom

I had no control

It was fate

It was no joke

I had to take you seriously

You seem to be endless and to be going nowhere

With the unintended intention to taunt and haunt me

You are the source of my suffering.

Since the dawn of man

You have accompanied us with a not so gentle reminder

That everything is not OK

Some say you are protective

But it is sometimes hard to understand

All I know is that I suffer

Nociceptors sense the feeling

They come in different forms

Transmitting pain from pressure, prick, or improper heat,

– or a severe lack of it

Quickly the sensation travels

On the A, delta, or C train-

Impulses that run their course

From source to spinal cord

With sizzling hot news of my experience

Where they snap to a halt as they clap as a synapse

And get a second order of direction

At the gate of decision

Which waves them on to a new thoughtless action

On their way to master control.

And through and via the wire of the RAS

Which awakens an awareness of you;

And then to the thalamic relay

Where they get their new orders:

To whom they should turn

And what direction to take.

In the higher levels of limbic autonomic and homunculus centers

pain-0015-catalogue-signed

The sense becomes real

And the feeling becomes severe

And after all the science

I know not what to do

But to increase my heart rate a little,

Contract a muscle and a gland or two

And perhaps let out a scream at the height –

And impugn your intrusive impudence that imposes on me.

pain, nociceptor, poem, prayer, sensory system, thalamus, A fiber, delta fiber, C fiber, Ashley Davidoff MD. The Common Vein, Art in Anatomy

And then sometimes

We use the eyes and guise

Of X-ray Eyes

Or try a tincture of opiate

To extirpate the excruciate –

And then sometimes to no avail

Yet I could care less about your wonderful pathways of biology and science

I know that I hurt -but also in a different way

It is not only the pain that I feel

But the pain of fate as well

That was handed to me as a card in a bad deal of nature

And I have no choice but to deal with it …..

But it hurts!

person, old lady, emotional pain, aging, poverty, loneliness

See the BLOG about the Art and Science of Pain

Ashley Davidoff MD

Revised since publication as a Blog August 2016

Posted on April 29, 2016February 17, 2023 by Ashley Davidoff

Anatomy of the Liver, Alcohol, and Addiction

The Liver – Just Another Normal Miracle of the Body

24/7 Clockwork Purple

The liver is the largest gland in the body and is central to many metabolic functions. It is known as the body’s “metabolic warehouse.”

The liver serves several important functions. It is integral to the digestive system, producing both internal and external secretions. The external secretion, bile, aids in the digestive process, while internal secretions are responsible for the metabolism of both nitrogenous and carbohydrate materials absorbed from the intestine.

Some of the liver’s functions take milliseconds and others take days and sometimes weeks. It secretes bile in order to alter toxic substances chemically (e.g. converts ammonia to urea), converts glucose to glycogen, and can produce glucose from breaking down certain proteins. The liver also synthesizes triglycerides and cholesterol, breaks down fatty acids and produces plasma proteins necessary for the clotting of blood such as clotting factors I, III, V, VII, IX and XI. Nearly 30% of the blood pumped by the heart passes through the liver each minute.

One of the unique structural features of the liver is its dual blood supply. It is supplied both by an artery (hepatic artery) and a vein (yes a vein!) – the portal vein. The portal vein drains the gastrointestinal tract of digested metabolic products and transports the nutrients to the liver for processing.

Four to five thousand years ago, the sheep’s liver held godly powers in the Babylonian culture. The Babylonians, and many cultures thereafter, believed that since the liver was the largest organ, it certainly must be the organ of most importance.

The Cells

Hepatocytes are the major cellular component of the liver, comprising approximately 70% by volume. Structurally they are characterised by their large size and the absence of a basement membrane. Functionally they are characterised by their remarkable metabolic and regenerative capability. Kupffer cells are found within the space of Disse and they act as macrophages of the liver, identifying and removing substances and organisms toxic to the body.

The Cells

The AiA rendering of cells in the round provide an image that is reminiscent of craters on the moon surface. The thought process behind the image is the formation of tissues from cells. The building of the whole from the parts starts with the cell and progresses to the tissue and finally the organ. In this instance, groups of liver cells are artistically combined to form a tissue and an imaginary spherical organ.

Cellular Organization

Organization of the Liver Cells in Cords Along the Rivers of Blood Flow

The liver is a compound tubular serous gland. The cells are arranged in plates or cords alongside rivulets of a capillary network called sinusoids. The spaces of Disse are spaces below the lining of the Kupffer cells. The plates and cords are lined by the sinusoids which are the channels which carry blood to the liver. Just below the sinusoids, between the wall of the sinusoid and the capsule of the liver there is a space called the space of Disse which carries the lymphatic fluid of the liver.

Organization of the Liver Cells in Cords in the Liver Lobule

The cells of the liver are organized in cords and plates and are organized like spokes of a wheel around the central vein. The periphery of the lobule contains groups of portal triads consisting of portal vein (dark blue), hepatic artery (red) and bile duct (green).

The structural liver unit is called a lobule. Cellular plates branch and anastomose alongside and in parallel with the sinusoids. Each lobule measures 1-2mm and is shaped like a hexagon. A central venule lies at the center of the lobule and is the destination of the sinusoids, which carry both hepatic arteriole as well as portal venous blood. At the periphery of the lobules are sets of portal triads consisting of portal vein, bile duct and hepatic artery. The biliary system collects bile from the liver and evolves into an independent network terminating in the common bile duct which empties bile, into the duodenum. The hepatic artery and portal vein supply the liver with metabolic substrates via the sinusoids, and also collect metabolic products produced by the liver to transport to the rest of the body.

Anatomy of the Liver in a Nutshell–

From its Embryonic Beginnings to Full Member of the Society of the Body

Pleasure

Alcohol – Drink of the Gods in Moderation and Poison of the Devil in Excess

Anatomy of the Initial Positive Effects of Alcohol

“Drink because you are happy, but never because you are miserable.”
― G.K. Chesterton,

Social Drinking: The Prostate Having a Drink with the Uterus

The uterus and prostate are out on a date and sharing a cocktail The uterus approximates a rectangular shape as does the prostate, accounting for their fascination with each other and their similarity with the shape of the wine glass. The uterus is accompanied by the ovaries and the vagina which forms the stem of the wine glass. The prostate is accompanied by the Seminal vesicles and Cowper’s glands and the urethra which acts as the stem of the wine glass. The male secretion seen in the urethra consists of a mixture of sperm, prostatic secretions, and seminal vesicle secretions.

Social drinking to celebrate an event is a wonderful means to enable people to open up to each other

As G.K. Chesterton wrote – “Drink because you are happy, but never because you are miserable.”

William Shakespeare, in Othello, on the other hand wrote – “I would not put a thief in my mouth to steal my brains.”

Most cultures favor the use of alcohol in celebration of events, and the positive effects of alcohol when used judiciously is to promote a pleasurable feeling via the nucleus accumbens, and to reduce stressful feelings (often social interactions) by reducing inhibitions by acting on the amygdala

Anatomy of the Feeling of Pleasure and the Nucleus Accumbens

The nucleus accumbens is one of the most primitive part of the brain. It is part of the basal part of the forebrain. It is a paired structure. Alcohol promotes pleasure by stimulating the nucleus accumbens.

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The Nucleus Accumbens

The coronal section of the brain shows the nucleus accumbens (ringed red) opposite its partner at the base of the brain. It lies just inferior to the internal capsule and frontal horns, near the hypoyhalamus

Courtesy Department of Anatomy and Neurobiology at Boston University School of Medicine Dr. Jennifer Luebke , and Dr. Douglas Rosene

Artistic Rendition of the Nucleus Accumbens on a sagittal T1 Weighted MRI

The nucleus accumbens, which is the site enabling the sensation of pleasure is shown as a red dot at the base of brain near the hypothalamus.

Stress

Anatomy of Stress and the Amygdala

The amygdalae are paired structures that are part of the limbic system that play an important part in emotional reactions including the reactions to stress. Alcohol reduces the uncomfortable emotion of stress and distress. Stress, in general is healthy, while distress on the other hand is not. The distinction between the two is not always obvious. Social situations are often stressful since in general people are “forced”into a position with “new” people they do not know too well. Using alcohol in such a social situation disinhibits the individuals, reduces the feeling of stress and promotes a sense of social confidence.. The origin of the physiology is in the amygdala.

Amygdala of the Forebrain in Sagittal Projection

The amygdala (red arrow)is a nucleus that is part of the limbic system. It is a paired structure. They are located deep in the temporal lobes and participate in emotional reactions, memory, and decision making.

Peer Pressure

Stressful social situations are particularly prominent in adolescence when peer pressure is pervasive. The college experience with new adventures of socialization, combined with freedom from the constraints of paternal disciplines are ripe for the use of substance abuse.

Peer Pressure

The scene: Party night – adolescent on the right, different innocent, alone and anxious. The in- crowd on the left are homogenous, powerful in number and stature, and encourage the newcomer to join in and be “one of us” – perhaps drink or smoke – and this is how it starts.
Educate, support, and love your children – Promote confidence in themselves so when they are confronted they can just say “no!”

Loneliness

Loneliness

Alone and bored, some turn to alcohol to provide relief. It is a short term, and short sighted relief to the problem

Early Addiction

Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism.

Carl Jung

The signs of early addiction

There are a few early warning signs that are forebears of early addiction as they start to surface.

They include; drinking alone, hiding and lying about the habit, blacking out, neglecting responsibility, deteriorating relationships, drinking in dangerous circumstances (eg before driving) and inability to quit.

Too Much of a Good Thing- can make your life tipsy turvy and turn you upside down –

shows bottles of alcohol in different positions and personify the state of inebriation. Alcoholic intoxication is a form of poisoning, and can make your life tipsy turvy and turn you upside down. The art piece expresses the uncontrolled situation of inebriation. When the liver cannot metabolize the alcohol due to excess in the blood stream drunkenness ensues. At lower blood levels there is a sensation of elation and lack of social reserve. With higher levels of alcohol in the blood, cerebral and cerebellar dysfunction ensues with ataxia, imbalance and muscle incoordination. Forebrain impairment includes disability to make appropriate decisions. Coma and death can ensue when blood levels are extremely high.

Drunk Man in the Town Square

A drunk man in the town plaza is toying with the idea of another swig. His indifference to his environment, and lack of judgement suggests he is inebriated. However his body language with an outstretched arm holding the bottle and the other hand pointed in another direction may suggest, at least idealistically, symbolically and hopefully subconsciously, that he realises he could go one of two ways “Decision time” he says to himself – “on the one hand I could take a swig .. Yet on the other I may take a different and more healthful course” Which way do you think he would go? (Photograph modified to enable anonymity)

Cirrhosis

Normal Liver and Cirrhosis

The left sided image shows the CT scan of a normal liver. The liver is the biggest structure that you can appreciate on the CT scan and is triangular in shape. The scan on the right shows a liver with cirrhosis. Alcohol pickles and scars the liver making it look like a knobby shrunken prune. The first image reflects healthy and romantic enjoyment of two people enjoying a beer at sunset. The colorful sunset transposes int a black and white background providing the mood of a lonely alcoholic. The alcoholic drinks in loneliness and in excess, until finally the person and the the bottle do not remain upright symbolically reflecting physical and psychosocial failure.

The Failing Liver

Normal Liver and Cirrhosis and Ascites

The AiA rendering shows a normal liver on the left, and a person with cirrhosis on the right evidenced by a shrunken, knobbly and pickled liver, jaundice of the skin and a distended abdomen caused by the accumulation of litres of fluid (ascites). In the long run, the addiction results in much suffering, a miserable existence, and immediately life threatening hemorrhagic episodes.

Alcoholism and Ascites

(Photograph modified to enable anonymity)

Liver Cancer

Liver Cancer

Liver cancer, frequently arises as a complication of cirrhosis and most particularly from alcoholic cirrhosis. The AiA rendering of the liver shows the inner workings of the organ, now inhibited by the large yellow cancer preventing the clockwork function of the liver. The liver starts to fail as a result of the cirrhosis so that the synthesis of biochemical products that keep the body going are no longer produced to the degree which they are needed.

Wasting of Body and Life

The collage shows normal healthy liver cells (top left) with a healthy appearing torso (CT scan reconstruction bottom left). The top right image reflect cancerous hepatic cells where the nuclear to cytoplasmic ratio is too large meaning that the the nuclei are too big and the cytoplasm too scanty. This finding is one of the typical findings in cancer. An emaciated torso (bottom right) is seen in contrast to the healthy counterpart.

Artistically the stark reality of health and disease is exposed. This terrible disease stares at us in stark graphic reality.

Philosophically – the cancer cell is like a rebel in the community, who only has selfish interests and contributes nothing to the welfare of the community. As a result the whole community of the body eventually fails, and hence the emaciation of the body.

Lessons? Kick the Habit Early or Kick the Bucket

liver-00021- small sign

Posted on April 19, 2016February 17, 2023 by Ashley Davidoff

Life, Cells, the US Constitution, and Trees

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?

Posted on March 28, 2016February 17, 2023 by Ashley Davidoff

I am the Colon- In the Bowels of the Body, I Reside and Work

A Poem about the Colon

I am the Colon

I have not captured the imagination of poets, artists, and historians.

Unlike my brothers and sisters the heart, liver, and the brain,

I am usually a subject that is avoided in cultured circles,

And commonly the butt of coarse jocularity in casual circles.

My contents are usually used as expletives of disgust and disagreement,

While my tail end is used in reference to the last and the least.

Let me tell you my story …..

I am the colon – they also call me the large bowel.

Some call me the “large howl” because of the noises that I make.

I do make noises – most of the time I sing a droning song while I go about my work,

Almost like a bass or double bass.

Sometimes I have to let off steam and then the wind instruments take charge,

With sounds that range from a piercing bleat to the beautiful alto furtive blurt.

When my contents are fluid I can tinkle along like a triangle in a percussion band.

Borborygmi they are called –quite a fancy name for a rather primitive sound.

Talking about music, I was surprised to read that Mozart took an interest in me.

His scatological letters are infamous, though admittedly his music is genius.

I am somewhat proud of his obsession for me.

So much for what people think or have thought. Let me give you my perspective.

My body is unique! No other structure in the body comes close.

With my taenia coli and rounded haustra I am adorned in appendices epiploica.

The three beautiful, graceful and gracile taenia run along the entire length of my body.

I really like these sleek muscles

Sleek Tenia Coli Muscle and Voluptuous Haustra

So symmetrically positioned around my circumference.

They are always a tad tight, giving me my voluptuous bulges – the haustra.

I like those too.

They give me haughtiness and sometimes a naughtiness – those haughty naughty voluptuous haustra.

…and here it comes again: their fancy shmancy name: “appendices epiploica.”

The Ugly Appendices Epiploica

I hate them! I don’t understand what function they play …

What in heaven’s name was God thinking when he put those fatty …things!… on my waist?

I detest them! Do you hear me? D-E-T-E-S-T!

They may have been the fashion in the time of Adam and Eve,

But God, please get with the times – they are way out of fashion.

Now all riled up I continue my rant and rave.

Chyme they call it!

Chyme my ass! (Oops, I should not have said that.)

They give it a fancy Latin name to make you think it is elegant.

What would you feel like if you were dealt the grime and sludge that I am dealt?

It is pure muck with all the good things removed – dirty slimy muck!

And this is only the beginning.

Wait for the obnoxious gas that those bacteria fellows produce.

It presses on my sides and makes the jowls of my bowels howl.

Talk about noxious and obnoxious – we should bring OSHA down here.

I feel a little better now that I have let off some steam,

So I resign myself to my lot in life and I deal with it and in it.

My cryptic workers – God bless mein lieber kinder, the crypts of Lieberkuhn:

God Bless Mein Lieber Crypts of Lieberkuhn

They take that stuff into their crypts and work away at it for hours and sometimes days.

And voila – with bubble, bubble, toil and trouble,

A well molded product of dehydrated debris

Mixed with a tincture of mucus, a bead of sweat, and fermented gas for the rise,

To which I add a drop of color with my stercobilin

To form beautiful compacted nuggets called scybalae.

Getting rid of the product and passing it on into the free world is yet another story.

Some wondrous interactions are going on between me and my muscles (and you and your muscles, and your marvelous mind and body).

To cut a long story short, the coordination is quite something until we finally get the job done.

I heave a sigh of relief when I see the fruit of my labor out of the door.

In the end I am very happy to be part of your body,

To do my little thing, retrieve some water, and earn my keep.

So that you can experience another wondrous day, enjoy another meal,

And live to tell another tail … end story.

The End

This poem has been modified from its original version published in the module on The Colon in the The Common Vein web site

Posted on March 14, 2016February 17, 2023 by Ashley Davidoff

Art, Anatomy, and Wisdom of the Kidneys

Art Anatomy and Wisdom of the Kidneys

March is NATIONAL KIDNEY MONTH and March 14 2016 is WORLD KIDNEY DAY – dedicated to my teachers Dr Edward Smith and the late Dr Harry Mellins and …. so here goes.

The Kidneys and Their Golden Adrenals

serve to preserve our precious water. The kidneys face each other (eye to eye) in the body as trusting life long partners. When the going gets tough for the one, the other is there to fill the void. How much more can one ask of a life long partner?

The Nephron – The Little People and the Backbone of the Kidney

nephron, proximal tubule, Bowman's capsule, glomerulus, loop of Henle, arteriole, kidneys, renal, genitourinary tract, genitourinary system,bladder, urethra, Art in Anatomy, Ashley Davidoff MD Filter, Flow Concentrate

The story of urine production is the story of the complex physiology. The diagram simplifies the steps in the production of urine involved in the production of urine using linear and wavy shapes and showing the connectivity and interdependence of the parts. Blood (red) is filtered by the Bowman’s capsule(blue). The filtered plasma travels through a series of tubes (yellow) called proximal convolued tubule, loop of Henle, then distal convoluted tubule and with the magic of physiology enables water reabsorption and subsequent concentrated urine production. The urine is collected by collecting tubules, and transported via the calyces, renal pelvis and then ureters (orange) to the bladder (oval orange). The final pathway is out back to the environment via the urethra. The art is a combination of minimalism, linearity, and spherism .

Filter Flow and and Concentate

Same story – different way of artistically portraying the structural and functional order of urine production

Parts of the Kidney Using Labels

Fish Eye View of a Kidney Nephron

is a sphere providing a view of the tissues making up the micro-tubular structure of the filtering system of the kidneys. The connections between the tubular systems, arteries and veins, and the positioning of the loops of Henle are essential to the micro-function and macro-function of the kidney. The style of spherism provides a sense of wholeness.

An Ocean View of the Nephron

“Ocean View of a Kidney Nephron with Glomerulus Bowman’s Tubules Henle Arterioles and Venules at Sunset” shows a an out of context depiction of the nephron. The art piece has a surreal appearance with the sun at the bottom of the ocean and the tubules of the nephron with shapes reminiscent of Miro. In addition there is a sense of spherism with the vascular system surrounding the nephron and the round shape of the sun. The water theme and the colors create a quiet and peaceful ambiance.

Moods of the Kidney Nephron

“Moods of the Kidney Nephron with Glomerulus Bowman’s Tubules Henle Arterioles and Venules in All Colors” is collage of different colors of the nephron indicating different moods. The art piece has a surreal appearance with a hint of Miro in the shapes of the structures. The moods projected by the colors are mostly upbeat.

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Kidneys – Macro and Micro

“Kidneys- Macro and Micro” combines the histology of the kidney with its macroscopic image. The nephron with the arteriole, glomerulus, Bowman’s capsule, proximal and distal convoluted tubules, loop of Henle, and collecting ducts are shown in the their distribution in the cortex and medulla of the kidney. The collecting ducts enter the papilla, then the calyx and reach the ureters via the infundibulum and renal pelvis.

Kidneys Water to Water

“Water to Water, Dust to Dust – If you have to Pee, then You Must” is one of the captions that has been used to describe this image. 95% of urine is water and the” dust” is represented by organic and inorganic compounds. These include urea, chloride, sodium, potassium, organic solutes including urea, creatinine, uric acid. In addition there are trace amounts of enzymes, carbohydrates, hormones, fatty acids, pigments, and mucins. The inorganic ions include sodium (Na⁺), potassium (K⁺), chloride (Cl^–), magnesium (Mg²⁺), calcium (Ca²⁺), ammonium (NH₄⁺), sulfates (SO₄^2-), and phosphates (e.g., PO₄^3-).

Kidneys Ureters and Bladder in Pink

“Kidneys, Ureters, and Bladder in Pink” is abdominal X-ray of the abdomen after contrast injection and shows the kidneys, calyces, renal pelvis, ureters and urinary bladder. The pink hue softens the classical black and white X-ray, but is in contrast to obvious blackened skeletal structures, including the lumbar spine, and pelvic bones.

The Dancing Kidneys

The Hora at the Royal Renal Wedding

“The Kidney Hora at the Royal Renal Wedding” shows the bride and groom in the center of the first hora dance at their wedding. The dancing guests are derived from original CT angiograms showing the renal arteries and kidneys . The bride is derived from a nephrostogram (UPJ traumatic disruption) and the groom was created from a retrograde pyelogram.

Dancing the Rock ‘N Roll

“Kidneys Doing the Rock and Roll with Arteries and Veins Holding Tight” is the venous phase of an MRI angiogram . The kidneys each in different party colors, with a background of pastel colors gives a feeling or mood of celebration and delight. The way they are bonded with vein on vein, and artery on artery provides the sense of partners holding tight in a rock and roll dance at the festivity.

Paso Doble

“Paso Doble of the Kidneys in the Autumn” shows a duet in the Fall. It portrays the passion of male and female in a fiery dance. The image was derived from a CT urogram showing the kidneys, calyces, renal pelves, ureters and bladder. The mature and mellow colors are reflected in the yellows and oranges but are also characteristic Spanish colors.

Renal Arteries Doing the Rumba

“The Renal Arteries Doing the Rumba” shows two fashionable folks pairing in an elegant rumba . The two images are derived from separate CT angiograms and shows a normal aorta with renal arteries in different projections. The dancer on the left has a sleek twist while the the dancer on the right is in upright position with open arms for his partner.

The Renal Arteries Hip Hopping

“The Renal Arteries Doing the Hip Hop” shows two fashionable folks in a high spirited rippin hot wild Hip Hop dance. The two images are derived from separate CT angiograms and shows the aging atherosclerotic aorta with the renal arteries in different projections. The dancer on the left has two stents at the origin of the renal arteries that look like part of the dress. The dancer on the right has a small infrarenal aortic aneurysm and an accessory renal artery on the right. The elongated heads of the dancers give them a funky and wild look.

The Kidney Tree

Summertime in the Kidney Tree

This art piece shows a color Doppler of the kidney and outlines the renovascular tree . The black and white has been replaced by a skyblue color, while the red and blue of the Doppler has been replaced by the green, blue and purples of summer color. The image has been given an impressionistic feel with a Seurat pointillism effect. The result is an image that has a feel of Seurat’s “A Sunday Afternoon on the Island of La Grande Jatte”

Forest of Trees of the Renal Veins

A rendering of a Doppler ultrasound that has been reconstructed in 3D revealing the veins subtending the kidney. Artistically the tree like structure of the veins has been rendered to create a forest of trees. The work gives a sense that the viewer is deep within the quiet of the forest, since only the base of the tree trunks dominate the view. The color provides a mood of peacefulness, and the magnification of the trunks provides a spirituality and humbles the viewer in the face of the magnificence and grandeur of nature.

Forest of Trees on CT Urogram

The CT scan has been reconstructed in the coronal plane revealing the bonds between the kidneys, calyces, pelves, ureters, and the bladder. Artistically the tree like structure of the kidneys has been rendered to create a bunch of flowers or forest of trees depending on the perspective of the viewer.

Lessons from the Kidney Tree

Time for the Summer, Time for the Winter

This artpiece teaches us the unpredictability of fate and time . The power Doppler ultrasound of the kidneys shows a variation of the renal vasculature. On the left side, the vascular system is abundant, while on the right side, just the skeleton of the veins is demonstrated. The artist saw this image as an opportunity to explore concepts such as opposites, abundance, paucity, situational changes, time, and life lessons. Relevant quotes include “Make Hay while the Sun Shines” and “There is a Time for Every Every Season” . Artistically a sharp line differentiates the left side from the right. This abrupt change from the one season to the next can also infer unpredictable, and fateful situational change in life. In this case -there is a seasonal change, but the situation could just as easily reflect an abrupt change with the arrival of a devastating disease on the doorstep of life. This image precedes a similar image showing the browns of the fall to the left and the winter to the right (below).

Time for the Fall, Time for the Winter

This artpiece teaches us the same lesson of unpredictability of fate and time. Rather than going from summer to winter as time changes, this image goes from the browns of fall to the black and white of winter

Lessons from the Kidneys

The Pair in Purple

The art piece shows the kidneys with calyces, infundibula, renal pelves, and ureters. The pair have a intimate position as they face each other. They have the same purpose in life -to rid the body of waste and to preserve water. There is a commitment by the kidneys to each other The art represents a promise of the kidneys to stay together through thick and thin – till death do them part. Personal ego plays no part in their relationship. There is a clarity and simplicity in the art piece at the surface with well known underlying extreme complexity of the physiology.

Said the Kidney to the Heart…

“You allow me to be myself, and do what I do best. Without you I would be nothing!” Said the heart to the kidneys “You rid us of waste and toxins, and you recycle our water. Without you, we all would be nothing!” This profound conversation between the two organs contains the universal wisdom of biology and life . We all need to do what we do best. When we do this, the whole society of cells, organs, or people benefit. The success of the one is the success of all. The art piece shows the collaborative form of the two kidneys resulting in a heart shaped tree. The color of the trunk of golden urine brings the artistic element back to the reality of the kidney function and the gushing forth of urine.

And so ends the story of the Art, Anatomy and Wisdom of the Kidneys

Posted on February 5, 2016February 17, 2023 by Ashley Davidoff

Heart Symbolisms – Cultural Anatomy

Heaven’s Heart

Heart symbolisms abound in almost every culture. The heart has been the center of almost every civilization, and assigned the epicentre of physical emotional and spiritual life. In ancient cultures the brain was mostly ignored and its many functions were attributed to the heart. Despite new knowledge, many of the ancient cultural concepts remain ingrained in the religion, the psyche, language, literature, poetry, and art of modern civilization.

In the West, the heart has evolved as a symbol of love, in both romantic and religious spheres. In the East, it is seen as a symbol of wisdom and spirituality.

Heart Symbolisms in History

Ancient belief in almost every major culture put the heart and heart symbolisms at the centre of the body and soul . Life with all its emotions, thoughts and beliefs centered around the heart.

The iconic heart symbol was identified in the culture of the Cro Magnon hunters of Europe before the last Ice Age (10,000-8000 BCE). The inference of the icon to the hunters remains a mystery.

The ancient Egyptians (3500BC-1000 BC) believed the heart controlled the mind and soul, and that it was the center of morality. It was also considered the source of memory, emotions, and personality. They believed that God spoke to individuals through the heart. There was concern among Egyptians that after death, that the heart might testify against the deceased; to prevent this, the ancient Egyptians often wrapped a heart scarab within the bandages to prevent the heart from speaking. They also preserved the heart during mummification so it would not be weighed during judgement after death.

The 5000 year old ancient Chinese culture believes that the heart is the root of the body, mind and soul of life. Additionally it controls joy, reflects facial expression, and has important roles in the psyche.

The Jewish culture goes back 5000 years as well. The Old testament, originated around 1500 BC, and references to the heart abound . It is viewed as the organ of conscience, the origin of human action, imagination, determination, emotion, love, virtue and vice, good and evil, humility and pride. The heart is revealed as the “inner” person:

“the Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart” [Samuel 16:7].

Also among many other references

“it grieved him (God) at his heart.”

Genesis 6:6

The word “heart” appears 725 times in the Old testament,

Art in the Clouds, Love, and Prayer

Love and Prayer …… a cloud in the sky that says it all… or at least some of it… The art piece is a collection of different modes of prayer with the same goal in mind ie to connect with a higher power. An idea of a central God may not necessarily fit with all religions,. The central “God” therefore in this piece relates to a central focus of core beliefs.

In Hinduism, a culture that started around 1750 BCE, teaches that the heart is the center of life, action, emotion, consciousness, and the soul. The belief is that it nourishes the organs and supplies energy for the formation of semen. Similar to Egyptian belief, it has importance in connecting heaven and earth. It also is the organ where the love of God is experienced.

In ancient Greece, Aristotle, who lived in the 4th century B.C., described the heart as the most important organ of the body. He considered it the seat of intelligence, motion, sensation and vitality.

In Christianity the heart reflects love, piety, and charity. In the art of the middle ages and thereafter, the flaming heart reflects religious passionate fervor. A flaming heart pierced by an arrow symbolizes faith despite trial, and repentance. The New Testament started in the middle of the 1st century AD. Jesus repeatedly uses “pure of heart”

Paul prays

“that Christ may dwell in your hearts through faith;” [Ephesians 3:3].

The word “heart” appears 105 times in the New Testament.

In the 1st millennium AD in ancient Mexico, the Teotihuacan culture believed that the the teyolia – the spiritual force of the heart, was responsible for life.

Galen who lived in the second century A. D., reaffirmed the Greek concepts of the heart and promoted it as the organ most closely related to the soul.

The Heart of Galen – Creator of the Vital Spirit

The AiA rendering shows the body according to Galen. Heat plays a central role in his theory. He believed the heart was closely related to the soul and the source of the body’s heat . The liver, he taught was the primary source of the humors that controlled the body, and that the heart played a subordinate role.

At the beginning of the eleventh century, the Persian, Avicenna (980-1037 AD), authored “The Book of Healing” that included medical and philosophical content. Avicenna describes the heart as the source of life.

The Aztecs a nomadic tribe of northern Mexico, arrived in Mesoamerica in the 13th century and reached their pinnacle in the 15th century. They believed that the heart, or the yollotli, was the seat of life and the soul. Before cremation a green jewel was placed in the mouth of the dead person to represent the heart. The culture also believed that human sacrifice for the offering of the heart to the Gods was required for ongoing prosperity. It was a ritual performed at the highest level and required to honour the gods. Interestingly the yollotli was also a standard of measurement from the mid chest to the tip of the outstretched arm, equivalent to about 3 feet.

In summary the heart was central to the body mind of soul in so many cultures that it pervaded day to day life, and therefore became central to the emotional aspects of most, if not all cultures. The innate need to represent these emotions in all facets of life including religion, philosophy, literature, poetry, music, and art was a natural outcome.

The History of the Icon

History of the Shape of the Heart Icon

The collage reveals the symbols that contributed to the shape of the heart icon as we know it. The shape of the heart became familiar to cultures who hunted or sacrificed animals (image top left). The heart shaped leaves and seeds had parallel emotional connections. The silphium seed for example (seen as golden heart shaped structure above) , was used by ancient Greeks for contraception and was reproduced on their coins. Organs relating to the nitty gritty of romance including breasts, mons pubis, buttocks and scrotum have rotund shape that has parallels in the icon of the heart . It is no wonder that the the shape gained popularity and application to the romantic elements of life.

This art piece was adapted and modified from public domain photograph by Frank Eugene, taken 1898, called Adam and Eve and published in Camera Work no. 30,1910

Art and the Heart – A History

History of Heart Symbolism

The earliest use of the heart as a symbol of love is found in an art piece in the middle of the 13th century. The collage depicts, romantic, religious, devotion, emotion, bravery, heraldry, mathematics, geometry, botany, card games, Valentine’s day, and finally and central in the art piece – the traditional emoticon.

Literature and the Heart

Shakespeare and the Heart

From the late Middle Ages onward, literature and poetry romanticize the heart. The above art piece used information from the Oxford Shakespeare Concordance and identifies the frequency of the word heart and heart related words (eg heartless and heartily). More than 1100 instances were found.

In the Divine Comedy, Dante (1265-1321) refers to

Love, which is quickly kindled in the gentle heart,
seized this man for the fair form that was
taken from me, and the manner still hurts me.

Also…

Pride, Envy, and Avarice are
the three sparks that have set these hearts on fire.

Valentine’s day itself first became associated with romance during the time of Geoffrey Chaucer (1343–1400).

Literature in which the word “heart” appears in the title from the late 18th, 19th and early 20th century include among many; Heart of the Midlothian – Sir Walter Scott (1771-1832), The Tell Tale Heart by Edgar Allen Poe (1809-1849, Heart of Darkness by Joseph Conrad (1857-1924), The Heart of Man by Erich Fromm (1900-1980), Heartbreak House by George Bernard Shaw (1856-1950), The Heart is a Lonely Hunter by Carson McCullers (1917-1967), Bury My Heart at Wounded Knee: An Indian History of the American West by Dee Brown (1908 – 2002)

Poetry and the Heart

The association of the heart and love abound in poetry.

Charles d’Orlean was a member of the French Royal family who lived in the 15th century. While captive in England he wrote love poems such as the one translated below

Because I cannot see you,
My heart complains day and night,
Lovely lady, peerless one of France,
And has charged me to write you
That he does not have all he desires
In the Prison of Discontent.

by Charles d’Orlean and translated by David A. Fein

Some famous poems of the the late 19th and early 20th century which include the word heart in the title; My Heart and I by Elizabeth Barrett Browning (1806-1861), If I Can Stop One Heart From Breaking, Emily Dickinson (1830-1886), Never Give All The Heart, William Butler Yeats (1865-1939), Flame Heart Claude McKay (1889-1948), The Trusting Heart, Dorithy Parker (1893 -1967), I Carry Your Heart with Me – EE Cummings (1894-1962), The Laughing Heart Charles Bukowski (1920-1994)

Music and the Heart

heart0035-catalogue-signed-500-72dpi

Middle Ages Music, Heart and Love

AiA combined two art pieces that are in the public domain; Heart shaped musical score of Baude Cordier is an offering of love to a lady. Christian and Muslim playing Lutes from the Canticles of Holy Mary during the reign of Alfonso X El Sabio (1221–1284)

Recent Music and the Heart

The Heart in Modern Song

Song ..another emotional outlet for the expression of love romance, and spirituality in culture. Between 1956 and 1978, 15 artists used the word “HEART” in the title of their song and each sold more than a million copy of their records.

Evolving Use of Heart Symbolisms

Valentines Day is a classical example of the persistent use of the symbol of the heart as a symbol of love and romance and it appears on all types of commercial products. The icon of the heart for communication on the web, in emails, electronic messaging, graffiti, in all sorts of arts and crafts abound almost adnauseum.

We seem to be returning to the world of hieroglyphics – and the icon of the heart almost always sends a positive message – and so … that is always good!

References

Jager Eric – Reading the Book of the heart from the Middle Ages to the twenty First Century; University of Chicago Press

Posted on December 27, 2015February 17, 2023 by Ashley Davidoff

Art, Hand Movement, And Season’s Lights

The Nativity Scene, Menorah and Surrounding Lights with still hands

Winter brings a dark chill. Humans respond to this discomfort by creating ways to alleviate the stress. This post focuses on one way to counter the gloom. Across the Judeo-Christian world, light is used to brighten and warm the spirits.

Art in Anatomy found a family home in Westwood, Massachusetts who illuminated their home and garden with Judeo-Christian scenes. They combined a nativity scene with a Chanukah menorah among colorful lights that adorned their house, trees, and barn.

By sleight of hand, Davidoff altered this scene by moving the camera in various directions to create different effects:

Up and Down Motion of the hands on the camera

Wave Like Motion of the hands on the camera

Looping Motion of the hands on the camera

Horizontal Motion of the hands on the camera

A Single Slow Back and Forth Sweep of the hands on the camera

The lesson: The same scene can be viewed from many perspectives. Similarly, the same God can be viewed by many different religions. The difference between the monotheistic religions is merely a difference in pathway; they all arrive at the same end point. Why kill each other if we’re all headed to the same final destination?

See the BLOG about the Art and Science of Pain

The Liver – Just Another Normal Miracle of the Body

The Cells

Pleasure

Alcohol – Drink of the Gods in Moderation and Poison of the Devil in Excess

Anatomy of the Initial Positive Effects of Alcohol

Peer Pressure

Loneliness

Early Addiction

Cirrhosis

The Failing Liver

Liver Cancer

Lessons? Kick the Habit Early or Kick the Bucket

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

A Poem about the Colon

I am the Colon

Art Anatomy and Wisdom of the Kidneys

The Nephron – The Little People and the Backbone of the Kidney

The Dancing Kidneys

The Kidney Tree

Lessons from the Kidney Tree

Lessons from the Kidneys

Heart Symbolisms in History

The History of the Icon

Art and the Heart – A History

Literature and the Heart

Poetry and the Heart

Music and the Heart

Recent Music and the Heart

Evolving Use of Heart Symbolisms